198320417-7-3-2024-11-AS-SCIS-DAKTLU-20241031145004

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320417
Report Date: 07/01/2024
Date Signed: 07/03/2024 08:03:31 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, 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
06/24/2024 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20240624084818

FACILITY NAME:	BRITTANY HOUSE		FACILITY NUMBER:	198320417
ADMINISTRATOR:	WINKELBAUER, SHANE		FACILITY TYPE:	740
ADDRESS:	5401 E CENTRALIA ST		TELEPHONE:	(562) 421-4717
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90808
CAPACITY:	170	CENSUS: 62	DATE:	07/01/2024
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Mandy Taylor		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff does not have adequate staffing to meet resident's needs.
Staff does not ensure resident's are provided quality food.
Staff does not ensure facility is free of odor.
Staff moved resident's out of facility without notifying resident's responsible party.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Monday, July 01, 2024, Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared of COVID-19 infection. LPA Bunker met with Executive Director (ED) Mandy Taylor. LPA Bunker explained the purpose of today's visit.
LPA Bunker conducted interviews with staff members 1-3 (S1-S3) and residents 1-4 (R1-R4), asking questions relevant to the nature of the complaint. S1-S3 and R1-R4 stated the facility has adequate staffing to meet residents' needs, residents are provided quality food, staff ensures the facility is free of odor and does not move residents out of the facility without notifying the resident's responsible parties. S1-S3 and R1-R4 stated that the building offers a comfortable living environment for residents. During the visit, ED Mandy Taylor and LPA Bunker toured the facility, receptionist area, lobby, executive office, kitchen, 2 dining rooms, and the memory care unit. The following rooms were also observed 101, 107, 114, 204, 210, 215, 302, 304, 307, 308, 310, 311, 312, 313, 314, 407, 408, 410, 412, 413, 414, and 415.
See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024

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-20240624084818

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 198320417
	VISIT DATE: 07/01/2024

NARRATIVE

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Continued LIC9099-C page 2

LPA Bunker reviewed staff and residents' records and requested copies of Identification and Emergency Information, Personnel Reports, Resident's Roster, Monthly Food Menus, and Ongoing In-Service Training.

Allegation #1: Staff does not have adequate staffing to meet resident's needs.
Staff members 1-3 (S1-S3) and residents 1-4 (R1-R4) interviewed stated the facility is fully staffed and staff is always available to provide assistance to residents. S1-S3 stated this is a 24-hour care facility that operates, 7 days a week, 365 days a year. Residents are never left at the facility alone without supervision. The facility operates in three shifts 6:00 A.M. - 2:30 P.M., 2:00 P.M.- 10:30 A.M.; and 10:00 P.M. – 6:30 A.M., Sunday through Saturday. S1 stated the Executive Director and Resident Services Director are on call 24 hours a day. S1-S3 stated several residents were not screaming and were confused about their whereabouts. S1-S3 stated this is a memory care facility where residents have Dementia. S1-S3 ensures sufficient and competent staff are available to provide the necessary services to meet residents' needs. S1-S3 and R1-R4 denied the allegation.

Allegation #2: Staff does not ensure residents are provided quality food.
Staff members 1-3 (S1-S3) and residents 1-4 (R1-R4) interviewed stated residents are provided with a variety of quality food to eat. S1-S3 and R1-R4 stated the residents receive an ample supply of perishable and non-perishable food, including three (3) meals and 3 snacks per day, breakfast, lunch, dinner, and snacks daily. The staff serves well-balanced meals with a variety of food options to choose from each week. R1-R4 stated that they had no complaints about the food. S1-S3 stated every day the food menu changes and residents can select something different if they prefer. S1-S3 stated residents are not served the same food every week. The food menu for weeks 1-4, reviewed by the LPA, shows a variety of food choices. S1-S3 stated residents' food is not served on inexpensive styrofoam plates or with plastic utensils. S1-S3 and R1-R4 denied the allegation.

Allegation #3: Staff does not ensure the facility is free of odor.
Staff 1-3 (S1-S3) and residents 1-4 (R1-R4) interviewed stated the facility is free of odor. S1-S3 stated the facility does not smell like urine or feces and is cleaned, sanitized, and disinfected daily. S1 stated the facility has scent air throughout the facility. S1-S3 denied the allegation.
See continued LIC9099-C page 3

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 11-AS-20240624084818

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 198320417
	VISIT DATE: 07/01/2024

NARRATIVE

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Continued LIC9099-C page 3

Allegation #4: Staff moved residents out of the facility without notifying the resident's responsible party.
Staff members 1-3 (S1-S3) interviewed stated residents were never moved out of the facility without notifying the resident's responsible parties. S1 stated residents' responsible parties are always notified of any changes. S1-S3 denied the allegation.

Investigation revealed the following:
Staff members 1-3 (S1-S3) interviewed stated the facility is fully staffed and staff is always available to provide assistance to residents. S1-S3 ensures sufficient and competent staff are available to provide the necessary services to meet residents' needs.
S1 and LPA Bunker observed the food in the kitchen refrigerators, freezers, kitchen cabinets, and pantry. The facility had plenty of meat, chicken, beef, steak, ground beef, hamburger patties, pork loins, pork roast, meatballs, fish, ground turkey, hot dogs, pizza, sausages, lunch meat, cold cuts, variety of frozen vegetables, green beans, sweet potatoes, chili beans, mixed vegetables, stir fry vegetables, peas, corn, French fries, variety of canned vegetables, fruit mix, diced beets, fruit cups, apple sauce, peanut butter, jelly, milk, eggs, cheese, variety of breads, white & wheat bread, hot dog buns, hamburger buns, cereals, rice, noodles, pasta, macaroni & cheese, potatoes, fresh fruits, oranges, bananas, watermelons, tomatoes, fresh vegetables, onions, garlic, potatoes, carrots, sweet potatoes, broccoli, lettuce, celery, red peppers, bell peppers, variety of canned fruits, cookies, chips, crackers, desserts, cake mix, sugar, flour, coffee cream, beverages, coffee, juice, milk, sodas, water, a variety of seasoning and sauces, ketchup, mustard, mayonnaise, tomato sauce, ripe olives, mushrooms, and etc. LPA Bunker observed an ample supply of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. S1-S3 stated residents are getting enough food to eat. During the visit, LPA Bunker observed residents in the dining room who were not eating from styrofoam plates or using plastic utensils. There was no foul odor detected throughout the facility, and it did not smell of urine or feces. Staff members 1-3 (S1-S3) also stated that residents were never moved out of the facility without notifying the resident's responsible parties.
S1-S3 denied all the allegations.

See continued LIC9099-C page 4

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 11-AS-20240624084818

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 198320417
	VISIT DATE: 07/01/2024

NARRATIVE

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Continued LIC9099-C page 4

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. 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, therefore the allegation is deemed unsubstantiated.

Copies of the Complaint Investigation Report LIC9099 and LIC9099-Cs were provided to Executive Director Mandy Taylor.

There were no deficiencies cited

Exit interview conducted

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 4