Routine inspection·October 19, 2022

Licensing Program Analyst (LPA), Shannan Hansen arrived Unannounced at Terra Linda Christian Homes, Inc #2 for the purpose of conducting a Required 1 year Infection inspection. LPA was greeted at the door by Care Giver, Crisostomo Nario. Licensee, Ana Belle Bautista arrived 20 minutes later. Facility has 6 residents, 1 with dementia, and 2 on hospice. LPA toured the facility with licensee, Ana Belle Bautista. Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Fire Extinguisher was found to be last charged on 04/07/2022 at the time of the visit. Smoke detectors and carbon monoxide detectors were found to be operational during the visit. Water temperature in resident's bathroom faucets measured between 107 degrees F and 120 degrees F which are within acceptable range of Title 22 Regulations of 105 to 120 degrees F. The facility serves residents with dementia and has a plan of operation for special care and programming. There was a sufficient supply of both perishable and nonperishable food as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. LPA observed toxins stored in unlocked closet underneath kitchen sink (see LIC 809D). The bathrooms designated for residents at the facility were supplied with individual paper towels and hand soap dispensers instead of individual hand towels. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present in the bathroom shower. All bedrooms have lighting & appropriate furnishings. Medications are centrally stored in locked cabinet in kitchen but on today’s inspection there were also medications stored in separate kitchen cabinet without lock, accessible to residents in care (see LIC 809D). Infection Control: Facility has submitted a mitigation program plan and infection control plan. Posters have been placed at facility and entrance has hand sanitizer and other items designated for visitors and staff before coming into work. Facility has PPE supply stored in front room & kitchen. Continue LIC 809-C In addition, facility has a designated area for visitors which are being allowed for visits. Residents also have available Zoom, Facetime, and telephone calls when contacting with family members and others. Staff had all PPE training required on file and have obtained N-95 fit testing. LPA Hansen reviewed Licensing Information System (LIS) with Licensee who stated that is corrected and updated at this time. LPA advised facility to contact Local County Public Health and DSS/CCL Community Care Licensing immediately if symptoms or COVID-19 + in the facility. LPA was presented with proof of current CPR & 1 st Aid certification for staff. Administrator Certificate is for Ana Belle Bautista 6001738740 Exp. 3/12/2023 All staff have received COVID booster vaccinations. Appeal of Rights Given. The following deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Failure to correct the deficiency and/or repeat deficiencies within a 12 month period may result in civil penalties. Exit interview conducted and appeal of rights provided. LPA Hansen is requesting Licensee to update and submit the following documents to CCL by 11/04/2022: LIC 308 Designated LIC 309 Administrative Organization LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 610E-S Supplemental Emergency Disaster Plan for RCFE LIC 9020 Register of Facility Resident’s Copy of Administrator Certificate Copy of Certificate of Liability Insurance