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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320417
Report Date: 07/14/2026
Date Signed: 07/14/2026 02:45:36 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
04/20/2026 and conducted by Evaluator Elvira Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260420101450
FACILITY NAME:BRITTANY HOUSEFACILITY NUMBER:
198320417
ADMINISTRATOR:ESPERANZA NAAKTGEBORENFACILITY TYPE:
740
ADDRESS:5401 E CENTRALIA STTELEPHONE:
(562) 421-4717
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:170CENSUS: 113DATE:
07/14/2026
UNANNOUNCEDTIME BEGAN:
08:16 AM
MET WITH:Esperanza NaaktaborenTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff did not seek timely medical attention for a resident.
INVESTIGATION FINDINGS:
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On 07/14/26, the department conducted an unannounced subsequent complaint visit to further investigate the allegations listed above. The department met with Esperanza Naaktgeboren, Administrator, and the purpose of the visit was explained. The department was granted entry to the facility.

The investigation consisted of the following: On 04/28/26 the department obtained the following documents: staff roster, resident roster, 24 Hour Communication Log dated: 04/13/26, an Unusual Incident/Injury Report (SIR) dated: 04/16/26, and a copy of the Physician’s Orders for residents #1-#10 (R1-R10). Additionally, the department conducted interviews with staff #1-#6 (S1-S6) and R2-R4 and attempted to interview R1. On 07/14/26, the department conducted interviews with R5-R10. Additionally, the department conducted a tour of the facility.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2026
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 6
Control Number 11-AS-20260420101450
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: 07/14/2026
NARRATIVE
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The investigation revealed the following:

For the allegation: Staff did not seek timely medical attention for a resident. It is alleged that staff failed to obtain prompt medical care for a resident who experienced a fall, waiting until the following day to seek medical attention. On 04/28/26 and 07/14/26, the department conducted interviews with S1-S6 and attempted to interview S7 but was unable to as they are no longer working at the facility. Of those interviewed, 6 out of 6 staff corroborated the allegation. An interview with S1 revealed that on 04/13/26, R1 sustained an unwitnessed fall during the night. Morning staff observed a skin tear and bruising and reported the injuries to the Med-Tech and LVN; however, the LVN did not immediately assess the resident. S1 stated that after R1 continued complaining of pain, another LVN evaluated R1 and arranged transport to the hospital, where they resident was diagnosed with a fractured femur. S1 said that they investigated and found that the delay in assessment by the LVN contributed to a delay in medical treatment for R1. On 04/28/26 and 07/14/26, the department conducted interviews with R2-R10 and attempted to interview R1 but was unable to because they passed away on 04/25/26. Of those interviewed, 9 out 9 residents could not corroborate the allegation.

On 04/28/26 and 07/14/26, the department conducted a review of records. The department reviewed a Special Incident Report (SIR) dated: 04/16/26 that reported that on 04/13/26, R1 sustained an unwitnessed fall. SIR reported that on 04/13/26 around 7:00 am, staff observed a skin tear on R1’s left elbow area, and discoloration on their left elbow and left hip. SIR further reports that the caregiver reported R1’s condition to the Med-Tech, and LVN. It states that the LVN assessed R1 around noon and treated the skin tear and noted the discoloration. It further reports that at approximately 3:00 pm, caregivers reported R1’s change of condition to the PM LVN, and R1 was sent out to Long Beach Medical Center. On 04/14/26 the facility was notified that R1 had a fracture and required surgery. The department reviewed the 24 Hour Communication Lod (dated: 04/13/26) which documented that during the AM shift it was noted that R1 was complaining of hip pain. It was also noted that staff observed a bruise like mark on R1's hip, and that R1 was unable to walk or stand up. It further notes that S2 and S7 were made aware at 7:20 AM. It was noted that on the PM shift, R1 was sent out by emergency services at 5:30 PM.Based on evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above allegation is found to be found to be substantiated. California Code of Regulations Title 22, Division 6, Chapter 8 are being cited on the attached LIC 9099D.An exit interview was conducted, and a copy of this report, along with appeal rights was provided to Esperaza Naaktgeboren.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
04/20/2026 and conducted by Evaluator Elvira Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260420101450

FACILITY NAME:BRITTANY HOUSEFACILITY NUMBER:
198320417
ADMINISTRATOR:ESPERANZA NAAKTGEBORENFACILITY TYPE:
740
ADDRESS:5401 E CENTRALIA STTELEPHONE:
(562) 421-4717
CITY:LONG BEACHSTATE:CAZIP CODE:
90808
CAPACITY:170CENSUS: 113DATE:
07/14/2026
UNANNOUNCEDTIME BEGAN:
08:16 AM
MET WITH:Esperanza NaaktaborenTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff are restraining resident.
Staff do not provide privacy for residents.
Staff leave residents in soiled briefs for extended periods of time.
Staff do not keep accurate resident records.
INVESTIGATION FINDINGS:
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On 07/14/26, the department conducted an unannounced subsequent complaint visit to further investigate the allegations listed above. The department met with Esperanza Naaktgeboren, Administrator, and the purpose of the visit was explained. The department was granted entry to the facility.

The investigation consisted of the following: On 04/28/26 the department obtained the following documents: staff roster, resident roster, 24 Hour Communication Log dated: 04/13/26, an Unusual Incident/Injury Report (SIR) dated: 04/16/26, and a copy of the Physician’s Orders for residents #1-#10 (R1-R10). Additionally, the department conducted interviews with staff #1-#6 (S1-S6) and R2-R4 and attempted to interview R1. On 07/14/26, the department conducted interviews with R5-R10. Additionally, the department conducted a tour of the facility.

Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 11-AS-20260420101450
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: 07/14/2026
NARRATIVE
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The investigation revealed the following: Allegation: Staff are restraining resident. It is being alleged that staff blocked a resident with chairs. On 04/28/26 and 07/14/26, the department conducted interviews with S1-S6 and attempted to interview S7 but was unable to as they are no longer working at the facility. Of those interviewed, 6 out of 6 staff denied the allegation. 6 out of 6 staff said they treat residents with dignity and respect. On 04/28/26 and 07/14/26, the department conducted interviews with R2-R10 and attempted to interview R1 but was unable to because they passed away on 04/25/26. Of those interviewed, 9 out of 9 residents could not corroborate the allegation. 9 out of 9 residents said staff treat them with dignity and respect.

Based on observation, records reviewed, and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been unsubstantiated.

For the allegation: Staff do not provide privacy for residents. It is being alleged that staff leave the residents’ doors open when changing them. On 04/28/26 and 07/14/26, the department conducted interviews with S1-S6 and attempted to interview S7 but was unable to as they are no longer working at the facility. Of those interviewed, 6 out of 6 staff denied the allegation. 6 of 6 staff reported that residents are afforded privacy during changes. On 04/28/26 and 07/14/26, the department conducted interviews with R2-R10 and attempted to interview R1 but was unable to because they passed away on 04/25/26. Of those interviewed, 9 out of 9 residents could not corroborate the allegation. 9 out of 9 residents said staff treat them with dignity and respect.

Based on observation, records reviewed, and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been unsubstantiated.

For the allegation: Staff leave residents in soiled briefs for an extended period of time. It is being alleged that residents are left in soiled/soaked briefs for an extended period of time. On 04/28/26 and 07/14/26, the department conducted interviews with S1-S6 and attempted to interview S7 but was unable to as they are no longer working at the facility. Of those interviewed, 6 out of 6 denied the allegation. 6 of 6 staff reported that residents are changed every 2 hours and as needed.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 11-AS-20260420101450
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: 07/14/2026
NARRATIVE
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On 04/28/26 and 07/14/26, the department conducted interviews with R2-R10 and attempted to interview R1 but was unable to because they passed away on 04/25/26. Of those interviewed, 9 out of 9 residents could not corroborate the allegation.

Based on observation, records reviewed, and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been unsubstantiated.

For the allegation: Staff do not keep accurate resident records. It is being alleged that resident files are incomplete and unorganized. It is also being alleged that there is no signed medication list on file for med-techs to reference when administering medications. On 04/28/26 and 07/14/26, the department conducted interviews with S1-S6 and attempted to interview S7 but was unable to as they are no longer working at the facility. Of those interviewed, 6 out of 6 staff denied the allegation.

On 04/28/26 and 07/14/26, the department conducted interviews with R2-R10 and attempted to interview R1 but was unable to because they passed away on 04/25/26. Of those interviewed, 9 out of 9 residents could not corroborate the allegation. 9 out of 9 residents said they receive their medication on time and as prescribed. 9 out of 9 residents said they are satisfied with the services being provided to them.

On 07/14/26, the department inspected the medication room and observed the storage, preparation, administration, and documentation of medications in compliance with Title 22 Regulations. The department found that the medications are maintained in an orderly and accurate manner. A review of Medication Administration Records (MAR) is complete and correct.

Based on observation, records reviewed, and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been unsubstantiated.

An exit interview was conducted, and a copy of this report was provided to Esperaza Naaktgeboren.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 11-AS-20260420101450
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: 07/14/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/21/2026
Section Cited
CCR
87466
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87466 Observation of the Resident: The licensee shall ensure that residents are regularly observed for changes in physical, mental..., that appropriate assistance is provided when such observation reveals unmet needs...

This requirement was not met as evidence by:
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Licensee shall provide staff with training on observation of the residents, and the importance of seeking medical attention in a timely manner. Licensee will provide copies of training materials and sign in sheet to the department by POC due date 07/21/26, via email to Elvira.Gonzalez@dss.ca.gov
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Based on interviews, and records reviewed, (R1) suffered an unwitnessed fall and a change of condition was not observed for decline in health condition. This violation poses a potential health and safety 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: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6