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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191601027
Report Date: 01/12/2024
Date Signed: 01/16/2024 08:50:24 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/21/2023 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20231121125613
FACILITY NAME:BRITTANY HOUSEFACILITY NUMBER:
191601027
ADMINISTRATOR:COLLEN ROZATIFACILITY TYPE:
740
ADDRESS:5401 E. CENTRALIA STREETTELEPHONE:
(562) 421-4717
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:170CENSUS: 68DATE:
01/12/2024
UNANNOUNCEDTIME BEGAN:
09:08 AM
MET WITH:Executive Director Ruth TitsojTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Facility does not have a enough staff to meet the residents needs.
Facility staff leave residents in soiled diapers for a prolonged period of time.
Facility staff is serving residents cold food.
INVESTIGATION FINDINGS:
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On 01/12/24 at 9:00 am, Licensing Program Analyst (LPA) Lizeth Villegas conducted an subsequent complaint visit regarding the allegations above. LPA met with Executive Director (ED) Ruth Tistoi as the purpose of today’s visit was explained.

The investigation consisted of the following: On 12/01/23 LPA obtained copies of staff and resident rosters, timecards for the last 30 days, list of incontinence resident, list of residents that require repositioning, copies of visitors sign in sheet for last 30 days, a copy of the administrator certificate and R1's, facesheet, emergency I.D., med list, physicians report, needs and service plan, and admission agreement. On 12/01/23 LPA interviewed Office manager (OM), and staff # 1-8 (S1-S8). On 01/12/24 LPA interviewed Executive Director and residents #1-10 (R1-R10).

The investigation revealed the following:
Allegation- Facility does not have a enough staff to meet the resident’s needs.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Lizeth VillegasTELEPHONE: (818) 391-9974
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
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-20231121125613
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: BRITTANY HOUSE
FACILITY NUMBER: 191601027
VISIT DATE: 01/12/2024
NARRATIVE
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It is alleged the facility does not have a enough staff to meet the residents’ needs. On 12/01/23 LPA interviewed OM regarding the above allegation, OM denied the allegation above. Per OM, there are enough staff on each shift to provide appropriate care. OM continued to state there are 8 caregivers and 2 supervisors per shift, if there is a call out facility will find coverage, offer OT or management will cover. On 12/01/23 LPA interviewed S1-S8 about the above allegation, 5 of 8 staff interviewed stated that there are enough staff to meet residents’ needs. On 12/01/23 3 of the 8 staff interviewed reported there are not enough staff, but the facility is managing to meet the residents’ needs. On 01/12/24 LPA interviewed R1-R10 about the above allegation, 8 of 10 residents interviewed denied the above allegation, 1 of 10 residents did not want to answer LPA’s questions. LPA was unable to interview R1 as R1 is non-verbal. On 1/12/24 LPA interviewed ED regarding the above allegation, ED facility is fully staff and is still looking to hire. ED continued to state there are 2-3 caregivers per unit per shift. LPA conducted review of LIC 500 and employee timesheets for the month of November 2023 and December 24th-26th, 2023, LPA observed each shift to have enough staff available to meet the residents needs.

Allegation- Facility staff leave residents in soiled diapers for a prolonged period of time.
It is being alleged Facility staff leave residents in soiled diapers for a prolonged period of time. On 12/01/23 LPA interviewed OM regarding the above allegation, OM denied the allegation above. Per OM, residents are changed every 2 hours or as needed, OM continued to report the facility uses a flowsheet to monitor when a resident is changed and cleaned. On 12/01/23 LPA interviewed S1-S8 about the above allegation, 7 of 8 staff interviewed denied the allegation above stating that residents are not left in soil diapers for a prolong period, 1 of 8 staff interviewed reported that residents have been left soiled for a long period of time on days facility is short staff. On 01/12/24 LPA interviewed R1-R10 about the above allegation, 8 of 10 residents interviewed denied the above allegation, 1 of 10 residents did not want to answer LPA’s questions. LPA was unable to interview R1 as R1 is non-verbal. On 1/12/24 LPA interviewed ED regarding the above allegation, ED denied the allegation above. Per ED each unit has different needs, however residents are being changed regularly.

Allegation- Facility staff is serving residents cold food.
It is being alleged Facility staff is serving residents cold food. On 12/01/23 LPA interviewed OM regarding the above allegation, OM denied the allegation above. Per OM, lunch is served starting at 11:45 am for the lowest functioning unit, meals are served right away however, the facility does have microwaves available.
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Lizeth VillegasTELEPHONE: (818) 391-9974
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20231121125613
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: BRITTANY HOUSE
FACILITY NUMBER: 191601027
VISIT DATE: 01/12/2024
NARRATIVE
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On 12/01/23 LPA interviewed S1-S8 about the above allegation, 8 of 8 staff interviewed denied the allegation above stating that meals are served right away, and meals are covered to keep warm. Staff continued to report meals can be reheated in the microwave as needed. On 12/01/23 LPA observed lunch service and observed meals being provided to residents in a timely manner. On 01/12/24 LPA interviewed R1-R10 about the above allegation, 8 of 10 residents interviewed denied the above allegation, 1 of 10 residents did not want to answer LPA’s questions. LPA was unable to interview R1 as R1 is non-verbal. On 1/12/24 LPA interviewed ED regarding the above allegation, ED denied the above allegation. Per ED meals are provided right away in the dining room and to resident bedrooms. On 1/12/24 LPA observed lunch service and observed meals being provided to residents in a timely manner.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is Unsubstantiated.

Exit interview conducted with Executive Director Ruth Tistoi, and a copy of this report was provided.
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Lizeth VillegasTELEPHONE: (818) 391-9974
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3