198320417-12-29-2025-11-AS-UCOL-DQPQQN-20260126112235

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320417
Report Date: 12/29/2025
Date Signed: 12/29/2025 03:22:09 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, 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
11/03/2025 and conducted by Evaluator Socorro Leandro

COMPLAINT CONTROL NUMBER: 11-AS-20251103083205

FACILITY NAME:	BRITTANY HOUSE		FACILITY NUMBER:	198320417
ADMINISTRATOR:	JOEL NIBLETT		FACILITY TYPE:	740
ADDRESS:	5401 E CENTRALIA ST		TELEPHONE:	(562) 421-4717
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90808
CAPACITY:	170	CENSUS: 116	DATE:	12/29/2025
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Administrator - Joel Niblett		TIME COMPLETED:	03:21 PM

ALLEGATION(S):

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Staff do not answer residents calls for assistance resulting in resident falling

INVESTIGATION FINDINGS:

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On 12/29/2025, Licensing Program Analyst (LPA) Socorro Leandro conducted a subsequent complaint investigation visit regarding the allegation listed above. LPA met with the Administrator Joel Niblett, and the purpose of the visit was explained. The LPA was allowed entry to the facility.

The investigation consisted of the following: On 11/05/2025, Witness 1 (W1) was interviewed. On 11/07/2025, a tour of residents’ rooms in unit 1 was conducted and Staff 1 (S1) to Staff 3 (S3) were interviewed. On 11/13/2025, Resident 1 (R1) to Resident 7 (R7), S1, Staff 4 (S4) to Staff 7 (S7) and Witness 1 (W1) were interviewed. On 11/14/2025, Witness 2 (W2) to Witness 3 (W3) were interviewed. On 11/18/2025, Witness 4 (W4) was interviewed. On 12/29/2025, facility records were reviewed which consisted of Personnel Report dated 11/13/2025, Resident Roster dated 11/13/2025, and Face Sheet and Emergency Information for Residents in Unit 1. On 12/29/2025, R1’s records were reviewed which consisted of Physicians Report dated 06/22/2025, Service Plan dated 09/15/2025, Medication Administration Record (MAR) from 09/2025 to 10/2025, Unusual Incident Report dated 10/24/2025, and Progress Notes from 09/09/2025 to 10/27/2025.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20251103083205

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: 12/29/2025

NARRATIVE

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The investigation revealed the following:

Allegation: “Staff do not answer residents calls for assistance resulting in resident falling”, it is being alleged that on 10/24/2025, R1 had an un-witnessed fall due to staff not answering their calls for assistance. Interviews conducted with R1 to R7 revealed the following: R1’s interview was inconclusive; 3 out of 7 residents indicated that they have never fallen at the facility; 3 out of 7 residents indicated that staff assist them when they need assistance. Interviews conducted with S1 to S7 indicated the following: 7 out of 7 staff denied the allegation, furthermore, staff indicated that they assist residents when they call out for help and when they press the call button. R1’s records reviewed revealed the following: R1 is diagnosed with a mild cognitive impairment and experiences episodes of confusion according to the Physicians Report dated 06/22/2025. Unusual Incident Report dated 10/24/2025, stated that on 10/24/2025 R1 “slipped while trying to get out of bed.” Progress Notes indicate that on 10/24/2025 at around 11:10 PM, R1 had an un-witnessed fall and was sent out thru non-emergency ambulance on 10/25/2025. Based on the department’s interviews, observations, and records reviewed this allegation is unsubstantiated. 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 unsubstantiated.

No deficiencies were cited.

An exit interview was conducted, and a copy of this report was left with the Administrator, Joel Niblett.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

LIC9099 (FAS) - (06/04)

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