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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320417
Report Date: 11/21/2025
Date Signed: 11/21/2025 03:36:40 PM

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
10/15/2025 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20251015105817
FACILITY NAME:BRITTANY HOUSEFACILITY NUMBER:
198320417
ADMINISTRATOR:JOEL NIBLETTFACILITY TYPE:
740
ADDRESS:5401 E CENTRALIA STTELEPHONE:
(562) 421-4717
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:170CENSUS: 131DATE:
11/21/2025
UNANNOUNCEDTIME BEGAN:
01:39 PM
MET WITH:Joel NiblettTIME COMPLETED:
03:28 PM
ALLEGATION(S):
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Facility staff do not properly address changes in condition of residents(s).
INVESTIGATION FINDINGS:
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This report supersedes report dated 10/20/25 due to additional info being added to report. This report does not change complaint findings.

On 10/20/25 at 8:51 am Licensing Program Analyst (LPA) Villegas conducted an initial complaint visit regarding the allegation(s) above. LPA met with Joel Niblett as the purpose of today’s visit was explained.
The investigation consisted of the following: On 10/20/25 LPA Villegas obtained copies of the staff and resident rosters, and copies of the following documents for Resident #11-13 (R11-R13) emergency ID form, pre-appraisals, physicians reports, service plans, and home health or hospice documentation if applicable. On 10/20/25 from 9:00 am- 11am LPA conducted Interviews with R1-R10, and from 1pm-2:30pm LPA conduct interviews with staff #1-7 (S1-S7). On 10/20/25 conducted a file review for R11-13.

The investigation revealed the following:
Allegation: Facility staff do not properly address changes in conditions of residents.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025
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-20251015105817
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: 11/21/2025
NARRATIVE
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It is being alleged that changes in conditions are going unnoticed which lead to hospitalizations. On 10/20/25 from 9:00 am- 11am LPA conducted Interviews with R1-R10 regarding the allegation above. 8 of 10 residents denied the allegation above and reported seeing a Dr. when needed. 2 of 10 residents confirmed the allegation and reported they have not been seen by a Dr. when they do not feel good. On 10/20/25 from 1pm-2:30pm LPA conduct interviews with S1-S7. 7 of 7 staff interviewed denied the allegation above and reported that med techs or LVN will assess a resident for change in condition, and resident will be sent out as needed. Additionally, during interview S1 reported that when a change in condition is observed the standard would be to call 911. On 10/20/25 LPA conducted a file review of R11-13 files. During file review LPA did not observe a re-assessment available for review when R11 returned from the hospital. LP A also observed that there was no care plan for the catheter R11 returned to the facility with, nor was there any documentation indicating that staff have been trained in catheter care.

Based on LPAs observations and interviews conducted, record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division (6) and Chapter (8) are cited on the attached LIC 9099D.

Exit interview conducted, appeal rights explained, and a copy of this report was provided.

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

DATE: 11/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20251015105817
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: 11/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/05/2025
Section Cited
CCR
87463(a)
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87463 Reappraisals: The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition.... based on records review and interviews
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Licensee/Executive Director to review regulation cited and submit a plan to CCLD detailing how facility will get into compliance. In service to be conducted on reappraisal procedures, LPA to obtain copy of in-service sign in sheet and materials reviewed.
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LPA did not observe a re-aappraisal on file for when R11 returned to the facility nor a care plan for catheter which poses a potential health and safety risk to residents in care.
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Citation was already cleared, prior to superceded report.
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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.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3