216803008-1-14-2026-21-AS-VBEI-DQHQ7Z-20260120105558

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 216803008
Report Date: 01/14/2026
Date Signed: 01/14/2026 03:00:25 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/18/2025 and conducted by Evaluator Caitlynn Felias

COMPLAINT CONTROL NUMBER: 21-AS-20251118090736

FACILITY NAME:	TERRA LINDA CHRISTIAN HOMES, INC # 5		FACILITY NUMBER:	216803008
ADMINISTRATOR:	BRIAN BAUTISTA		FACILITY TYPE:	740
ADDRESS:	631 BAMBOO TERRACE		TELEPHONE:	(415) 479-3556
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY:	6	CENSUS: 6	DATE:	01/14/2026
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Staff Members, Ronalyn Ladio and Norman Quiambao, Administrator, Bella Nachor		TIME COMPLETED:	03:10 PM

ALLEGATION(S):

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Facility did not seek timely medical

INVESTIGATION FINDINGS:

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At approximately 1:30PM, Licensing Program Analyst (LPA) Felias arrived unannounced to deliver findings for a Complaint Investigation regarding the above allegation and met with Staff Members, Ronalyn Ladio and Norman Quiambao. Administrator, Bella Nachor, arrived during visit at approximately 1:40PM.

During the course of the investigation, the Department requested and reviewed documents, conducted interviews, and made observations. The following allegation was investigated, “Staff did not seek timely medical.” Complaint alleged that Resident 1 (R1) was observed to have difficulty walking on 11/14/2025. Report stated that caregivers were using a wheelchair with R1 to prevent falls since they were not steady on their feet with "wobbly legs." Per report, R1 is usually independent with mobilization and does not require the use of a wheelchair, cane, walker, etc. Report further stated that facility staff were asked if R1 had any new or worsening symptoms and they reported that R1 was fine, happy, and eating, etc.

Continued on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 21-AS-20251118090736

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: TERRA LINDA CHRISTIAN HOMES, INC # 5	FACILITY NUMBER: 216803008
	VISIT DATE: 01/14/2026

NARRATIVE

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Continued from LIC9099
When asked if the facility called 911, Complainant was told that there was no point to call 911 because R1 was fine. Per Complainant, faciity should have contacted 911 so R1 could be checked out by medical professionals since they had a history of stroke and weakness in legs was a new symptom.

Review of R1's documents indicated that facility staff were to contact R1's home health agency in the event R1 experienced increased problems with balance. On 09/30/2025, 10/02/2025, and 10/07/2025, facility staff were instructed by R1's home health agency on the warning signs of stroke and who to contact if R1 experienced signs of stroke. Additional records showed that on 11/14/2025, emergency medical personnel conducted a stroke assessment for R1 where R1 denied being in pain and passed the stroke assessment.

Interview conducted with Staff Member 1 (S1) stated that on 11/14/2025, R1 was observed to have unsteady gait by Staff Member 2 (S2). Due to this observation, S2 contacted S1 by phone. Interview further revealed that S1 conducted a stroke assessment over the phone with S2 who reported back their observations. Per S1, R1 was not slurring their speech, did not have drooping in their face, and did not show weakness in their arms. R1 was also not reporting any pain or dizziness, any issues with vision, and ate well during breakfast. S1 also stated that they conducted the stroke assessment two additional times on 11/14/2025 - once via video call and again during their scheduled shift at the facility. During the video call assessment, S1 noted that R1 appeared to have normal behavior apart from their unsteady gait. During the assessment conducted during their scheduled shift, S1 observed R1 to have no complaints of pain and was able to walk by themselves to the restroom without supervision.
Interview conducted with Staff Member 2 (S2) stated that on 11/14/2025, they observed R1 to be "walking wobbly." Per S2, R1 denied being in pain or discomfort. Interview further corroborated statements made by S1. Per S2, they contacted S1 about R1's gait and S1 performed a stroke assessment where S2 relayed their observations verbally over the phone. S2 contacted S1 via video call so S1 could conduct a stroke assessment visually where they determined that R1 did not have any apparent signs of stroke.
Interview conducted with Home Health Agency Staff stated that on 11/14/2025, they conducted a stroke assessment with R1 and did not observe any stroke symptoms apart from R1's unsteady gait.

Based on interviews conducted, record review, and observations made, this allegation is Unsubstantiated. A finding that a complaint allegation is Unsubstantiated means that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

Exit interview conducted. Copy of report discussed and provided to Administrator. Signature on form confirms receipt of documents.

SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Caitlynn Felias
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2026

LIC9099 (FAS) - (06/04)

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