191601027-12-7-2023-11-AS-MVAO-CZJQAV-20240116110030

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191601027
Report Date: 12/07/2023
Date Signed: 12/07/2023 01:50:30 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
11/14/2023 and conducted by Evaluator Alfonso Iniguez

COMPLAINT CONTROL NUMBER: 11-AS-20231114110809

FACILITY NAME:	BRITTANY HOUSE		FACILITY NUMBER:	191601027
ADMINISTRATOR:	COLLEN ROZATI		FACILITY TYPE:	740
ADDRESS:	5401 E. CENTRALIA STREET		TELEPHONE:	(562) 421-4717
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90808
CAPACITY:	170	CENSUS: 70	DATE:	12/07/2023
		UNANNOUNCED	TIME BEGAN:	08:53 AM
MET WITH:	Mike Burstein/Consultant		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

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Staff do not ensure residents are bathed
Staff do not provide residents with activities while in care
Residents missed medications

INVESTIGATION FINDINGS:

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On 12/7/2023 LPA Alfonso Iniguez conducted an unannounced complaint visit. LPA Iniguez met with Mike Burstein/Consultant. LPA explained the purpose of this visit.

Investigation Consisted of: LPA conducted the following interviews: Consultant Interview(A#1), Witness Interview(W#1), Resident’s interviews (R#1-R#7) and Staff Interviews(S#1). LPA obtained and reviewed the following documents: Resident’s roster, Personnel roster, (R#1-R#7) Identification and Emergency Information, (R#1-R#7) Admissions agreements, (R#1-R#7) Physicians Report for Residential Care Facilities for the Elderly, (R#1-R#7) Needs and Services Plan, (R#1-R#7) Treatment Administration Records (TARS) for the months of September, October and November of 2023, Handwritten notes from contracted nurses, (R#1-R#7) Physician’s Orders and Copies of contracts between facility companies that provides nurses and Copies of October, November and December 2023 Activities Calendar.

Evaluation Report continues LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

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 5

Control Number 11-AS-20231114110809

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BRITTANY HOUSE	FACILITY NUMBER: 191601027
	VISIT DATE: 12/07/2023

NARRATIVE

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Investigation Revealed the Following:

Allegation: Staff do not ensure residents are bathed.

The details of the complaint alleged that facility staff do not ensure residents are being bathed.

During the records review, LPA Iniguez reviewed the current bathing and changing schedule for December 2023; in the schedule, it is written that residents are getting bathed twice per week or as needed. In addition, LPA reviewed the Physicians Report for Residential Care Facilities for the Elderly (RCFE)-LIC 602A, (6) out of (7) residents are not able to bathe themselves, and (5) out of (7) are not able to dress/groom themselves, these residents required assistant with their ADL’s. On the other hand, LPA reviewed the Admission Agreement, which stated that the facility would assist the residents with activities of daily living (ADLs) as needed.

During an Interview with the consultant (A#1), he stated that the facility has the necessary staff to provide care and supervision for the residents, and when it comes to residents getting assistance with their bathing and changing, (A#1) stated that “absolutely,” residents are getting assistance with their ADL’s.

During an Interview with Witness(W#1), she stated that the facility has the necessary staff to provide care and supervision for the residents, and the residents are getting assistance with their ADLs twice a week and as needed.

During interviews with residents (R#1-R#7), (6) out of (7) stated that the facility has the necessary staff to take care of them and the rest of the residents, and they are getting assistance with their bathing and dressing. Also, regarding how often the residents are getting bathed and changed, (6) out of (7) stated that every day, every other day, or as needed.

During interviews with staff (S#1-S#7), (7) out (7) stated that the facility has the necessary staff to provide care and supervision for the residents, and the residents are getting assistance with their ADLs twice a week or as needed.

Evaluation Report continues LIC 9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 11-AS-20231114110809

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BRITTANY HOUSE	FACILITY NUMBER: 191601027
	VISIT DATE: 12/07/2023

NARRATIVE

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Allegation: Staff do not provide residents with activities while in care.

The details of the complaint alleged that facility don’t provide activities for the residents in care.

During the records review, LPA Iniguez reviewed the October, November, and December 2023 Activities Calendar. LPA observed a variety of activities offered to the residents every day.

During an interview with the Administrator (A#1), he stated that the facility provides activities for the residents in care and has a person in charge. Also, (A#1) stated that there was not a time when the facility needed to provide activities for the residents.

During an interview with Witness(W#1), she stated that the facility provides daily activities for the residents, and there is an assigned person providing activities for the residents. If the facility ever did not offer activities for the residents, (W#1) stated that has yet to happen.

During interviews with residents (R#1-R#7), (6) out of (7) stated that the facility provides activities for the residents, and there is a person doing activities for the residents. In addition, if the facility ever did need to provide activities for the residents, (6) out of (7) residents stated that it never happened.

During interviews with staff (S#1-S#7), (7) out (7) stated that the facility is providing activities for the residents in care and that there is a person in charge of doing activities for the residents. In addition, if the facility ever did need to provide activities for the residents, (7) out of (7) residents stated that it never happened.

Allegation: Resident missed medications.

The details of the complaint alleged that there is not a licensed nurse to administer insulin to residents.

Evaluation Report continues LIC 9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 11-AS-20231114110809

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BRITTANY HOUSE	FACILITY NUMBER: 191601027
	VISIT DATE: 12/07/2023

NARRATIVE

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During the records review, LPA Iniguez reviewed the following (7) out of (7) Physician’s Order records. (6) out of (7) residents require subcutaneous injections of medication for the control of their restricted healthcare condition. In addition, LPA reviewed the Physicians Report for Residential Care Facilities for the Elderly (RCFE)-LIC 602A, (7) out of (7) residents cannot manage their treatment for their Restricted Health Care Condition as noted on the form by their physician. In addition, it is stated on the LIC 602A (6) that out of (7), residents cannot administer their injections. Furthermore, LPA reviewed the Treatment Administration Records (TARS); the prescribed medication for the resident’s restricted health care condition is found in these records. LPA noticed that some days were not marked as given; LPA asked (A#1) why are some days not observed; he said that since the contracted nurses do not have access to the electronic TARS, they had written the dose given in the residents’ chart. LPA requested a copy of the written notes and found that the days not listed in the TARS are there.

During an Interview with the Administrator (A#1), he stated that he believes residents are getting their medications as their physician prescribes, and the MedTechs and Nurses are assisting the residents with their medications. In addition, (A#1) stated that no resident has ever missed a prescribed medication, and the facility has residents with restricted healthcare conditions. Also, (A#1) stated that a registered nurse on-site or contracted will administer the injectable medication in giving medications to residents with restricted health conditions.

During the Interview with Witness(W#1), she stated that residents are getting their medications as prescribed by their physician, and the MedTechs and nurses assist the residents with their medications. Also, (W#1) stated that no resident has ever missed a prescribed medication, and the facility has some residents with restricted health conditions. In addition, (W#1) stated that the protocol to give medicines to residents with specified health conditions is first to check the resident’s blood sugar, then a licensed professional (LVN) administers the insulin, and I witness when that is done.

During interviews with residents (R#1-R#7), (6) out of (7) stated that they are getting their medications as prescribed by their physician, and the MedTechs and nurses are assisting them. Also, (6) out of (7) stated that they have never missed a medication and have a restricted health condition. In addition, (6) out of (7) noted that the facility assists them with medication to control the determined health condition, and the nurse does that.

Evaluation Report continues LIC 9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 11-AS-20231114110809

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BRITTANY HOUSE	FACILITY NUMBER: 191601027
	VISIT DATE: 12/07/2023

NARRATIVE

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During interviews with staff (S#1-S#7), (7) out (7) stated that the residents are getting their medications as prescribed by their physician, and the MedTechs are assisting the residents with their medications. Also, (7) out of (7) stated that no residents have ever missed a medication, and the facility has residents with restricted health conditions in which a nurse provides the medicines to them.

During this investigation, LPA found did not find sufficient evident to support the above-mentioned allegations.

Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation(s) are found to be UNSUBSTANTIATED.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

California Code of Regulations (Title 22, Division 6, Chapter 8).

An exit interview was conducted, and a copy of the Complaint Report was given to Mike Burstein / Consultant.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

LIC9099 (FAS) - (06/04)

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