<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320417
Report Date: 11/06/2024
Date Signed: 11/06/2024 02:20:34 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
10/31/2024 and conducted by Evaluator Perry Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20241031111836
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: 64DATE:
11/06/2024
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Mandy TaylorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not properly reporting incidents involving the residents.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/06/24, at 9:30am, Licensing Program Analyst (LPA) Perry Scott conducted an initial complaint visit to the facility and was greeted by Mandy Taylor, Executive Director, and Marcus Falanai, Service Coordinator. LPA explained the purpose of this visit is to conduct interviews, gather facility files, and render findings in the complaint.

The investigation consisted of the following: LPA investigated the allegation mentioned in this complaint and conducted interviews with staff (S1-S8). Additionally, LPA obtained the following documents: Resident Roster (No Date), Staff Roster (Dated: 10/28/2024), and Incident Reports (Dated: 09/14/24, 09/16/24, 10/14/24, 10/15/24, 10/18/24, 10/21/24, 10/22/24, 10/28/24, 11/6/24) from the facility.
The investigation revealed the following: Staff are not properly reporting incidents involving the residents.

The details of the complaint alleged that the facility does not send in incident reports for residents when they are injured or pass away at the facility.

Complaint Investigation Report Continued on LIC9099-C


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
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 2
Control Number 11-AS-20241031111836
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: 11/06/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
On 11/06/24, from 09:20am-2:00pm, LPA interviewed staff (S1-S8) regarding the allegation. 8 of 8 staff (S1- S8) denied the allegation that the facility Staff are not properly reporting incidents involving the residents. All staff (S1-S8) stated that the facility does send in timely incident reports. S1 stated that since S1 has been in charge, the facility has sent in all reports involving a death or an injury. Staff (S3-S8) further state that when an injury or death occurs, they alert the med-Techs, caregivers, and the nurses and they either report it to the hospice agency, the family, call 911 and then write an incident report.

The department reviewed the Incident reports for the residents dated 09/14/24, 09/16/24, 10/14/24, 10/15/24, 10/18/24, 10/21/24, 10/22/24, 10/28/24, and 11/6/24 for the residents and did not observe any discrepancies in the reports or when they were sent.

Based on interviews and records reviewed, there is insufficient evidence to support the allegation that the Staff are not properly reporting incidents involving the residents. 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 citations were issued for this complaint.

An exit interview was conducted with Marcus Falanai, Service Coordinator, and a copy of this Complaint Investigation Report was provided.


SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2