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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320417
Report Date: 12/19/2024
Date Signed: 12/19/2024 12:06:11 PM

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
07/25/2024 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20240725125526
FACILITY NAME:BRITTANY HOUSEFACILITY NUMBER:
198320417
ADMINISTRATOR:WINKELBAUER, SHANEFACILITY TYPE:
740
ADDRESS:5401 E CENTRALIA STTELEPHONE:
(562) 421-4717
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:170CENSUS: 57DATE:
12/19/2024
UNANNOUNCEDTIME BEGAN:
08:46 AM
MET WITH:Marcuc Falanai Resident Care Coordinator TIME COMPLETED:
12:45 PM
ALLEGATION(S):
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9
Residents are forced to using facility's medical care provider.
Facility does not appropriately provided enough staff to meet the residents' needs.
Staff falsify records.
INVESTIGATION FINDINGS:
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On 12/19/24 at 9am the department conducted a subsequent complaint visit regarding the allegations above. LPA met with (S1) Marcuc Falanai as the purpose of the visit was explained.

The investigation consisted of the following: On 07/31/2024 at 9:30 am Licensing Program Analyst (LPA), David España conducted an initial complaint visit. On 07/31/2024 as part of the LPA España investigation, LPA requested documents for Resident #1-#6 (R1-R6), Staff #1-#6 (S1-S6), and a staff and resident roster. On 12/04/24 LPA Villegas obtain copies of the staff and resident rosters, and between 9:30am-1pm LPA conducted interviews with residents #3-5 (R3-R5), Staff #1 (S1), and Witness#1 (W1). On 12/19/24 LPA Villegas conducted a tour of the facility, there were no immediate health or safety concerns. On 12/19/24 between 9:30am-11:30 am LPA Villegas conducted interviews with S2-S4.

The investigation revealed the following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
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 4
Control Number 11-AS-20240725125526
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: 198320417
VISIT DATE: 12/19/2024
NARRATIVE
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Allegation: Residents are forced to using facility's medical care provider.

It is being alleged that residents are denied their right to choose healthcare providers and are being compelled to use a preferred agency contracted by the licensee. On 12/4/24 between 9:30am-1pm LPA conducted interviews with (R3-R5) regarding the allegation above, 1 of 3 residents interviewed confirmed the allegation above, 2 of 3 residents interviewed reported having no recollection if they were provided with options upon admission. On 12/4/24 LPA Villegas was unable to interview R1 as R1 is no longer receiving care at Brittany House, On 12/4/24 LPA Villegas was unable to interview R2 due to communication barrios. 12/4/24 LPA interviewed S1 regarding the allegation above, 1 of 1 staff interviewed denied the allegation above and reported that some residents come in with a medical provider and report wanting to keep them and if not, the facility has a lot of pamphlets for medical providers, home health and hospice agencies to chose from. On 12/19/24 between 9:30am-11:30 am LPA Villegas LPA interviewed S2-S4, regarding the allegation above, 3 of 3 staff interviewed denied the allegation above and reported having no knowledge of the admission process.

Allegation: Facility does not appropriately provide enough staff to meet the residents' needs.

It is being alleged that the turnover rate among staff is high. On 12/4/24 between 9:30am-1pm LPA conducted interviews with (R3-R5) regarding the allegation above, 1 of 3 residents denied the allegation above, 2 of 3 residents interviewed reported the facility is short staff at times. On 12/4/24 LPA Villegas was unable to interview R1 as R1 is no longer receiving care at Brittany House, On 12/4/24 LPA Villegas was unable to interview R2 due to communication barrios. 12/4/24 LPA interviewed S1 regarding the allegation above, 1 of 1 staff interviewed denied the allegation above and reported that there are 7 caregivers per shift. On 12/4/24 LPA conducted a review of the staff roster and per staff roster, there are (11) caregivers scheduled between 6:30am-5pm, (2) med techs scheduled between 6:30 am-2:30pm, (6) caregivers scheduled between 2:30pm--10:30pm, (1) LVN scheduled between 2:30pm--10:30pm, (2) caregivers scheduled between 10:30pm- 6:30am. On 12/19/24 between 9:30am-11:30 am LPA Villegas LPA interviewed S2-S4, regarding the allegation above, 3 of 3 staff interviewed denied the allegation above.

Allegation: Staff falsify records.

It is being alleged that the facility is attempting to modify physician's report to remove a dementia diagnosis to facilitate transfer to assisted living. On 12/4/24 between 9:30am-1pm LPA conducted interviews with (R3-R5) regarding the allegation above, 3 of 3 residents interviewed denied the allegation above.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20240725125526
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: 198320417
VISIT DATE: 12/19/2024
NARRATIVE
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On 12/4/24 LPA Villegas was unable to interview R1 as R1 is no longer receiving care at Brittany House, On 12/4/24 LPA Villegas was unable to interview R2 due to communication barrios. On 12/4/24 LPA interviewed S1 regarding the allegation above, 1 of 1 staff interviewed denied the allegation above and reported that if the allegation above was observed it would be report to supervisor for further investigation. On 12/19/24 between 9:30am-11:30 am LPA Villegas LPA interviewed S2-S4, regarding the allegation above, 3 of 3 staff interviewed denied the allegation above.

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 and a copy of this report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4