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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320417
Report Date: 06/20/2024
Date Signed: 06/20/2024 11:06:52 AM

Substantiated


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
06/07/2024 and conducted by Evaluator Perry Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20240607142431
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: 68DATE:
06/20/2024
UNANNOUNCEDTIME BEGAN:
09:53 AM
MET WITH:Yessica MartinezTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff violated residents' personal rights.
Staff did not provide a safe and comfortable environment .
INVESTIGATION FINDINGS:
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On 06/14/24, at 10:00am, Licensing Program Analyst (LPA) Perry Scott conducted a 10-day complaint visit to the facility and was greeted by Yessica Martinez, Office Manager. LPA explained the purpose of this visit is to gather information about the complaint and deliver findings for the allegation mentioned above.

The investigation consisted of the following: LPA investigated the allegations mentioned in this complaint; and conducted interviews with staff (S1-S7), (W1-W3) and residents (R1-R5). Resident Roster (No Date), Staff Roster (Dated 06/10/2024), Admission Record for all residents (Dated 06/14/2024) and Call Sheet (No Date) were obtained from the facility.

The investigation revealed the following: Allegation #1- Staff violated residents' personal rights.

The details of the complaint alleged that staff are moving residents from two units in the facility to unit 1 without notifying the residents or the family beforehand of the move; thereby violating their personal rights, leaving them confused and upset.

Report continued on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Perry ScottTELEPHONE: (707) 849-2315
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
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-20240607142431
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: 06/20/2024
NARRATIVE
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On 06/14/24, from 10:00am-2:00pm, LPA interviewed staff (S1-S7) witnesses (W1-W3), and residents (R1-R5) regarding the allegation. 3 of 7 staff denied the allegation that the Staff violated residents' personal rights. 3 of 7 staff interviewed stated that the residents and family members were notified that the residents would be moved to another unit because of construction. They state that the family members were notified by phone or email. Whereas 4 of 7 staff were not sure if the residents’ or family were notified but received complaints from family members that they were not notified.

LPA interviewed W1-W3 about the allegation and 3 of 3 witnesses denied that the facility reported to them or the residents of the relocation to another unit. Witnesses state that their family members were confused and upset about the move and did not know what was going on in the facility. LPA interviewed R1-R5 about the allegation and 4 of 5 residents that were interviewed corroborated the allegation that Staff violated residents' personal rights. A majority of the residents interviewed stated that they and their family members were not notified of the move and felt confused about it and did not know why they were moving. They further state that some of the residents that were moved into their room were not compatible with them. They complained that some of the residents kept screaming that they didn’t know what was going on. LPA reviewed the call sheet provided (No Date) but it did not specify the date, time, or who was notified and that either the resident or family member acknowledged the notification.

Based on interviews conducted and records reviewed, the preponderance of evidence standard has been met. Therefore, the above allegation: Staff violated residents' personal rights, is found to be Substantiated. California Code of Regulations, Title 22, Division (6) and chapter (8) are being cited on the attached LIC 9099D.

Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared.

Deficiencies are issued and plans of corrections were discussed.


The investigation revealed the following: Allegation #2- Staff did not provide a safe and comfortable environment.

The details of the complaint alleged that because of construction and relocation of the residents with no attempt to make sure the residents are compatible and knowledgeable of what’s going on in the facility. It has become very crowded and chaotic, and it appears they are warehousing the residents, with no regard for their feelings, their emotional well-being, or their safety.

Report continued on LIC 9099-C

SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Perry ScottTELEPHONE: (707) 849-2315
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20240607142431
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: 06/20/2024
NARRATIVE
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On 06/14/24, from 10:00am-2:00pm, LPA interviewed staff (S1-S7), witnesses (W1-W3), and residents (R1-R5) regarding the allegation. 3 of 7 staff denied the allegation that the Staff did not provide a safe and comfortable environment. 3 of 7 staff stated that the residents and their family members were notified about the construction that would take place in the facility causing the residents to be relocated. Whereas 4 of 7 staff stated that they were not sure if the residents or their family members were notified that construction would be taking place in the facility. They further state that some family members and residents were upset and confused that construction was taking place causing the residents to be subjected to loud noises, chemical smells, and overcrowded spaces.

LPA interviewed W1-W3 about the allegation and 3 of 3 corroborated that Staff did not provide a safe and comfortable environment. They state that no one notified them that construction would be taking place and when they visited, they found the facility had strong odors from construction, too many residents in a small place with not enough caregivers to provide effective care, and they feared that the residents would be hurt in this environment. LPA interviewed R1-R5 about the allegation and 4 of 5 corroborated that Staff did not provide a safe and comfortable environment. They stated that no one advised them that construction was going to take place. They further state that during construction there were loud noises, dust, debris, and chemical smells that caused some to wear masks because of the fumes and they did not want to get sick. They state that it was very chaotic and could have been handled better.

Based on interviews conducted, the preponderance of evidence standard has been met. Therefore, the above allegation: Staff did not provide a safe and comfortable environment, is found to be Substantiated. California Code of Regulations, Title 22, Division (6) and chapter (8) are being cited on the attached LIC 9099D.

Note: *Citations not cleared by the due date will be a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared. *


Deficiencies are issued and plans of corrections were discussed.



An exit interview was conducted with Yessica Martinez, Office Manager, and a copy of this report and appeal rights were provided.

SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Perry ScottTELEPHONE: (707) 849-2315
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20240607142431
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/28/2024
Section Cited
CCR
87468.1(a)(2)
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87468.1(a)(2) Personal Rights of Residents in All Facilities. (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.

This requirement is not met as evidenced by:
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Administrator to review Personal Rights of Residents 87468.1(a)(2) and submit a statement acknowledging understanding of Title 22 Regulations by POC due date of 6/28/24 and email it to LPA Perry Scott at perry.scott@dss.ca.gov
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Based on interviews conducted, the administrator failed to ensure a resident's personal rights due to the facility not letting them know that they would be relocated to a different unit in the building, causing confusion and feeling unsafe in the facility, which posed a potential health risk to residents in care.
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Type B
06/28/2024
Section Cited
CCR
87468.1(a)(8)
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87468.1(a)(8) Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (8) To have their representatives regularly informed by the licensee of activities related to care or services, including ongoing evaluations...

This requirement is not met as evidence by:
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Administrator to review Personal Rights of Residents 87468.1(a)(8) and submit a statement acknowledging understanding of Title 22 Regulations by POC due date of 6/28/24 and email it to LPA Perry Scott at perry.scott@dss.ca.gov
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Based on interviews conducted and records reviewed the administrator failed to inform the responsible parties about the construction of the facility and movement of the residents. Which poses a potential health risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Perry ScottTELEPHONE: (707) 849-2315
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4