191601027-10-6-2023-11-AS-SLEO-CWCSMY-20231006140042

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191601027
Report Date: 10/06/2023
Date Signed: 10/06/2023 02:02:20 PM

Document Has Been Signed on 10/06/2023 02:02 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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

FACILITY NAME:	BRITTANY HOUSE		FACILITY NUMBER:	191601027
ADMINISTRATOR:	COLLEEN ROZATTI		FACILITY TYPE:	740
ADDRESS:	5401 E. CENTRALIA STREET		TELEPHONE:	(562) 421-4717
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90808
CAPACITY:	170	CENSUS: 65	DATE:	10/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Colleen Rozatti		TIME COMPLETED:	02:15 PM

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On 10/6/2023, Licensing Program Analyst (LPA) Leandro conducted an unannounced Required – 1 Year Inspection and met with Colleen Rozatti, Administrator.

The facility census is 65 residents.

The facility is licensed to serve 170 residents, 146 may be non-ambulatory, and 24 may be bedridden. The facility also has an approved hospice waiver for 14 residents. The facility currently has 2 non-ambulatory residents.

The facility consists of 5 units, 100 resident bedrooms, 60 resident restrooms, 6 common bathrooms, commercial kitchen, 5 dining rooms, common rooms, commercial laundry room, large storage room, staff room, and office rooms.

The administrator accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards.

Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises.

Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, hot water temperature properly measured between 105 – 120 Fahrenheit. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked.

Common areas were clean and clear of hazards, doorways were free of obstructions.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro Leandro	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

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

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: BRITTANY HOUSE	FACILITY NUMBER: 191601027
	VISIT DATE: 10/06/2023

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LPA toured the commercial kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxins were kept in locked storage cabinet. First Aid kit was available. City of Long Beach Fire Department tested the fire alarm/carbon monoxide detectors, delay egress doors, and fire extinguishers on 12/10/2022. LPA observed that all bedrooms and hallways are equipped with a carbon monoxide and smoke detectors.

Facility has quarterly fire and disasters drills with staff members.

5 staff records were reviewed, 5 out of 5 staff records had current first aid certificates and had required criminal record clearances or criminal record exemptions.

5 resident records were reviewed and, 5 out of 5 client records had Admission Agreements, Medical Assessments, Pre-appraisals (or Reappraisals) and/or Needs & Services Plans.

An exit interview was conducted. A copy of this report and appeal rights were discussed and left with the Administrator.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro Leandro	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

LIC809 (FAS) - (06/04)

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