198320417-4-28-2025-11-AS-RORN-DHRQMQ-20250618121755

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320417
Report Date: 04/28/2025
Date Signed: 04/28/2025 03:43:11 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
04/18/2025 and conducted by Evaluator Felisa Shirley

COMPLAINT CONTROL NUMBER: 11-AS-20250418155530

FACILITY NAME:	BRITTANY HOUSE		FACILITY NUMBER:	198320417
ADMINISTRATOR:	ERIN REHBEIN		FACILITY TYPE:	740
ADDRESS:	5401 E CENTRALIA ST		TELEPHONE:	(562) 421-4717
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90808
CAPACITY:	170	CENSUS: 71	DATE:	04/28/2025
		UNANNOUNCED	TIME BEGAN:	09:08 AM
MET WITH:	Marcus Falanai, Resident Service Coordinator		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Resident sustained unexplained injuries while in care
Staff do not meet a resident's grooming need while in care
Staff did not timely address a resident's change in medical condition

INVESTIGATION FINDINGS:

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On 4/28/25, Licensing Program Analyst, (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA was met by the Resident Care Coordinator, Marcus Falanai and explained the purpose of the visit is to investigate and deliver findings for the allegations mentioned above. LPA was granted access to the facility.

The investigation consisted of the following:

On 4/28/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA Shirley requested and received copies of the following: Staff Roster, Resident Roster, incident reports for April 2025, reviewed client’s facility files and toured the facility. LPA interviewed Staff 1 – Staff 9 (S1 – S9) and Resident 1 – Resident 7 (R1 - R7).

The investigation revealed the following:
Con'd on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

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-20250418155530

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: 04/28/2025

NARRATIVE

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Allegation: Resident sustained unexplained injuries while in care

The details of the complaint allege that R1 was observed with bandages on both hands and did not remember what happened or was choosing not to say. LPA Felisa Shirley requested and received copies of all incident reports for April 2025. LPA Shirley observed an Unusual incident/Injury report, stating date occurred 4/18/25. Per interview with S9, R1 was agitated, had a suitcase packed and was trying to leave. LPA interviewed S2 and she stated that R1 was agitated that morning and S2 observed R1 sitting and scratching her wrist and observed that R1 was bleeding. R1’s wristed were treated and wrapped up by S9 and 911 was called and the family was notified.

LPA Shirley interviewed staff-1 thru staff-9 (S-1 thru S-9). LPA asked, has there been any reports of a resident with unexplained injuries. Of those interviewed, 9 out of 9 staff answered no. LPA interviewed Resident-1 thru Resident-7 (R-1 thru R-7). LPA asked, have you reported any unexplained bruises to staff. Of those interviewed, 7 out of 7 answered no.

Based on records review, interviews and observations, LPA did not find sufficient evidence to support the above allegation. 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 allegation is Unsubstantiated.

Allegation: Staff do not meet a resident’s grooming need while in care

On 4/28/25, LPA Shirley observed R1’s Physician Report dated, 9/1/23. The report stated that R1 has the capacity to groom herself. LPA Shirley reviewed R1’s Service Plan dated, 11/5/24, stating that R1is independent with grooming and would monitor for changes in condition and conduct a reappraisal as appropriate. During file review, LPA observed R1’s Comprehensive Geriatric Assessment dated, 9/14/23, which stated, always well-groomed without assistance, can cut and clean fingernails. LPA Shirley interviewed R1 and she stated that she likes her nails.

LPA Shirley interviewed staff-1 thru staff-9 (S-1 thru S-9). LPA asked, does staff meet residents grooming needs while in care. Of those interviewed, 9 out of 9 staff answered yes. LPA interviewed Resident-1 thru Resident-7 (R-1 thru R-7). LPA asked, does staff meet all of your grooming needs. Of those interviewed, 5 out of 7 answered yes, 1 did not answer and 1 groom themselves.

Con'd on 9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20250418155530

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: 04/28/2025

NARRATIVE

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Allegation: Staff did not timely address a resident’s change in medical condition

LPA Shirley interviewed staff-1 thru staff-9 (S-1 thru S-9). LPA asked, does staff address change in medical condition in a timely manner. Of those interviewed, 9 out of 9 staff answered yes. LPA interviewed Resident-1 thru Resident-7 (R-1 thru R-7). LPA asked, have you ever been ill and staff did not report your change in condition. Of those interviewed, 6 out of 7 answered no, and 1 did not answer.

On 4/18/25, R1 had bandages on her wrist. S9 was notified by S2 and S8 that R1 was bleeding. S2 observed R1 sitting and scratching herself with her nails. R1 was treated by S9, 911 was called and the family was notified. Per S9, the paramedics rebandaged the wound with the original bandages and did not take R1. The family arrived later and took R1 to the hospital. LPA observed the unusual incident/injury report which stated in the comments area, will have a meeting with family about updated service plan.

Regarding the allegations, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegation is Unsubstantiated.

No deficiencies were cited for this allegation.

An exit interview was conducted and a copy of this report was provided to the Resident Care Coordinator, Marcus Falanai.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

LIC9099 (FAS) - (06/04)

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