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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191601027
Report Date: 11/18/2021
Date Signed: 11/19/2021 06:56:54 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/10/2021 and conducted by Evaluator Susan Campos
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20211110113627
FACILITY NAME:BRITTANY HOUSEFACILITY NUMBER:
191601027
ADMINISTRATOR:COLLEEN ROZATTIFACILITY TYPE:
740
ADDRESS:5401 E. CENTRALIA STREETTELEPHONE:
(562) 421-4717
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:170CENSUS: 51DATE:
11/18/2021
UNANNOUNCEDTIME BEGAN:
12:37 PM
MET WITH:Colleen RozattiTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff left resident in soiled clothing for extended period of time resulting in a rash.
Resident sustained a bladder infection while in care.
INVESTIGATION FINDINGS:
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On 11/18/2021 at 12:37p.m., Licensing Program Analyst (LPA)/ Susan Campos, initiated a 10-day complaint investigation visit for the allegations listed above. LPA was allowed entry into the facility by Administrator Colleen Rozatti. LPA explained to Ms. Rozatti the purpose of the visit. The investigation consisted of the following: LPA conducted interviews with (5) staff members and (5) residents on 11/18/21. In addition, on 11/18/21, LPA and Ms. Rozatti conducted an inspection, for health and safety of the facilities’ physical plant, and food supply. LPA also reviewed the following documents provided by Brittany House Administrator, Rozatti: LIC 500-staff roster, client roster, staff schedule, Incident Reports from September 2021 to present, List Caregivers work hours and assigned rooms, Internal staff incident reports from September 2021 to present, R1 case notes, R1 physician report, R1 Needs and Service care plan, R1 medical documents, R1 Incontinence care plan.

Report continued on LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Michael CavaTELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Susan CamposTELEPHONE: (323) 629-7445
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 11-AS-20211110113627
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: BRITTANY HOUSE
FACILITY NUMBER: 191601027
VISIT DATE: 11/18/2021
NARRATIVE
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Investigation

Allegation: Staff left resident in soiled clothing for extended period of time resulting in a rash

The investigation revealed, per LPA interviews, with (5) staff members, and (5) residents from the Brittany House facility and review of facility documents, that the Brittany House facility does not leave residents in soiled clothing for an extended period of time resulting in a rash. LPA interviewed S1, and the LPA was informed that the facility has resident incontinence care procedures whereby every caregiver in the facility checks on the facility residents every two hours, or more often depending on need. Also, S1 stated that at the end of every work shift, all staff persons, will report to the staff, in the next work shift, if there are any resident issues to address, and also inform the next work shift staff of the residents incontinence status. Furthermore, S1 stated that has not received a report from a facility staff member or resident family member that a resident had been left in soiled clothing for an extended period of time. LPA interviewed 5 staff members, and 5 of 5 staff members, informed the LPA, that staff members provide residents with incontinence care, every two hours, and if needed more often. In addition, 5 staff members interviewed, 5 of 5 staff members, informed the LPA, that they are not aware of a resident, in the facility, with soiled clothes, for an extended period of time. The LPA interviewed 5 residents, and 5 of 5 residents, informed the LPA, that the staff assist them with their personal hygiene. In addition, LPA interviewed 5 residents, and 5 of 5 residents, informed the LPA, that the staff help them when they need assistance.

Based on information gathered, LPA did not find sufficient evidence to support allegation " Staff left resident in soiled clothing for extended period of time resulting in a rash ”

Allegation: Resident sustained a bladder infection while in care.

The investigation revealed, per LPA interviews, with (5) staff members, and (5) residents from the Brittany House facility and review of facility documents, that the Brittany House does not have a resident that sustained a bladder infection while in care. LPA interviewed S1, and the LPA was informed that the facility caregivers check on the residents every two hours, and provide residents with hydration, and also check on their incontinent needs. Also, S1 stated that there are no residents in the facility with a bladder infection, and that facility staff have not reported to S1 that there is a resident in the facility with a bladder infection. Furthermore, S1 stated that all measures are taken to prevent residents from having bladder infections, and

Report continued on LIC 9099C.

SUPERVISOR'S NAME: Michael CavaTELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Susan CamposTELEPHONE: (323) 629-7445
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20211110113627
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: BRITTANY HOUSE
FACILITY NUMBER: 191601027
VISIT DATE: 11/18/2021
NARRATIVE
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that all care givers provide residents with liquid intake throughout the day. LPA interviewed 5 staff members, and 5 of 5 staff members informed the LPA, that staff members check on the residents, every two hours for incontinence, hydration, and hygiene needs, and also that all residents are encouraged to drink liquids throughout the day. In addition, 5 of 5 staff members, informed the LPA, that they are not aware of a resident that has a bladder infection while in care. The LPA interviewed 5 residents, and 5 of 5 residents, informed the LPA, that the caregivers are available when needed. In addition, 5 residents interviewed, 5 of 5 residents informed the LPA, that they are happy with the care they receive in the facility.

Based on information gathered, the LPA did not find sufficient evidence to support allegation " Resident sustained a bladder infection while in care ”.

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, therefore the allegations are Unsubstantiated.

An exit interview was conducted with Colleen Rozatti, Administrator, and a hard copy of a LIC 9099 was provided.

SUPERVISOR'S NAME: Michael CavaTELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Susan CamposTELEPHONE: (323) 629-7445
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3