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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005809
Report Date: 08/12/2026
Date Signed: 08/12/2026 01:54:27 PM

Document Has Been Signed on 08/12/2026 01:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:BRITTA CAREFACILITY NUMBER:
306005809
ADMINISTRATOR/
DIRECTOR:		MANGISI, FRANKFACILITY TYPE:
740
ADDRESS:106 S JEANINE WAYTELEPHONE:
(714) 630-4791
CITY:ANAHEIMSTATE: CAZIP CODE:
92806
CAPACITY: 6CENSUS: 5DATE:
08/12/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Frank Mangisi, AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:05 PM
NARRATIVE
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Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by staff at 8am. During today’s visit, LPA met with Administrator (AD) Frank Mangisi and explained the purpose of the visit

The facility is a single-story seven bedroom, three bathroom residence with an approved fire clearance of two ambulatory and four non-ambulatory residents. Bedrooms #2, #4 and #6 are approved for non-ambulatory but does not match the facility sketch or physical plant. The facility has an approved hospice waiver for six. Currently the facility has a census of five residents in care in which two receive hospice services. A non-ambulatory resident was in an ambulatory room and will be relocated to the non-ambulatory room which, per facility sketch and physical plant, is bedroom #5. A deficiency will be cited. There are six private rooms and one staff room.

During today’s visit, LPA toured the facility and inspected the physical plant. The facility was 71 degrees Fahrenheit and was clean with no odors detected. Three residents were going to eat breakfast and two residents remain in their rooms and receive hospice services. The fire extinguisher was charged and inspected on 5/19/2026. The facility has not conducted a quarterly fire drill and a deficiency will be given Smoke and carbon monoxide detectors were tested and operational. The hot water temperature was tested in three of three bathrooms. The temperature ranged between 110.5 to 113.1 degrees Fahrenheit.

LPA toured the kitchen and observed the facility had two days of perishable items and seven days of non perishable food items present. The knives drawer was not secured and one of five resident medications were not secured. Staff immediately locked the knives drawer and medication. Deficiencies will be cited.
(Continued on LIC 809-C)
Alisa Ortiz
RoseMarie Ruppert
DATE: 08/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 16
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 16
Document Has Been Signed on 08/12/2026 01:54 PM - It Cannot Be Edited


Created By: RoseMarie Ruppert On 08/12/2026 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BRITTA CARE
FACILITY NUMBER: 306005809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87204(b)
Limitations -Capacity and Ambulatory Status
(b) Resident rooms approved for 24-hour care of ambulatory residents only shall not accommodate nonambulatory residents. Residents whose condition becomes nonambulatory shall not remain in rooms restricted to ambulatory residents.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation and facility sketch review the licensee did not comply with the section cited above in one of five residents which poses an immediate health and safety risk to persons in care.
POC Due Date: 08/13/2026
Plan of Correction
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AD will move non-ambulatory resident from bedroom #1 to bedroom #5; which is a non-ambulatory room.
Type A
Section Cited
CCR
87309(a)
Storage Space and Access
(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation the licensee did not comply with the section cited above in five of five residents which poses an immediate health and safety risk to persons in care.
POC Due Date: 08/13/2026
Plan of Correction
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Staff immediately located the key to lock the knives drawer.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Alisa Ortiz
NAME OF LICENSING PROGRAM MANAGER:
RoseMarie Ruppert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2026


LIC809 (FAS) - (06/04)
Page: 3 of 16
Document Has Been Signed on 08/12/2026 01:54 PM - It Cannot Be Edited


Created By: RoseMarie Ruppert On 08/12/2026 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BRITTA CARE
FACILITY NUMBER: 306005809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87309(c)
Storage Space and Access
(c) Except as specified in subsection (d), the licensee shall implement reasonable interventions in order to ensure that nutritional supplements, vitamins, alcohol, cigarettes and other potentially toxic substances, such as certain plants, gardening supplies, and auto supplies, are stored so as not to pose a hazard to residents.

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on LPA's observation the licensee did not comply with the section cited above in one of five residents which poses an immediate health and safety risk to persons in care.
POC Due Date: 08/13/2026
Plan of Correction
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Staff immediately removed the pre-poured medications for one of five residents into the secured drawer.
Type A
Section Cited
CCR
87458(c)(1)(A)
Medical Assessment
(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A) Communicable tuberculosis.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA interview and record review the licensee did not comply with the section cited above in one of five resident files which poses an immediate health and safety risk to persons in care.
POC Due Date: 08/13/2026
Plan of Correction
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AD to obtain TB documentation for one of five residents and email paperwork to LPA by end of business 8/13/2026.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Alisa Ortiz
NAME OF LICENSING PROGRAM MANAGER:
RoseMarie Ruppert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2026


LIC809 (FAS) - (06/04)
Page: 4 of 16
Document Has Been Signed on 08/12/2026 01:54 PM - It Cannot Be Edited


Created By: RoseMarie Ruppert On 08/12/2026 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BRITTA CARE
FACILITY NUMBER: 306005809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1569.695(a)
Other Provisions
(a)In addition to any other requirement of this chapter, a residential care facility for the elderly shall have an emergency and disaster plan that shall include, but not be limited to, all of the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on LPA's observation and record review, the licensee did not comply with the section cited above in five of five residents in care which poses an immediate health, safety and personal rights risk to persons in care.
POC Due Date: 08/13/2026
Plan of Correction
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3
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AD will complete LIC 610E and email LPA by end of business 8/13/2026.
Type A
Section Cited
HSC
1569.695(c)
Other Provisions
(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA interviews and record review, the licensee did not comply with the section cited above in five of five residents which poses an immediate health and safety risk to persons in care.
POC Due Date: 08/13/2026
Plan of Correction
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AD will provide a quarterly fire drill training and submit signed documentation of all participants, the date and review the LIC 610E via email to LPA by end of business 8/13/2026.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Alisa Ortiz
NAME OF LICENSING PROGRAM MANAGER:
RoseMarie Ruppert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2026


LIC809 (FAS) - (06/04)
Page: 5 of 16
Document Has Been Signed on 08/12/2026 01:54 PM - It Cannot Be Edited


Created By: RoseMarie Ruppert On 08/12/2026 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BRITTA CARE
FACILITY NUMBER: 306005809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87507(e)(2)
Admission Agreements
(2) The licensee shall conspicuously post in a location accessible to public view in the facility a complete copy of the approved admission agreement, modifications and attachments, or notice of their availability from the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA observation and intervew the licensee did not comply with the section cited above for five of five residents in care which poses a potential health, safety and personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
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AD will post a facility approved Admissions Agreement in a public common area by POC due date.
Type B
Section Cited
CCR
87412(a)(11)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (11) A health screening as specified in Section 87411, Personnel Requirements - General.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA's observation, interview and file review, the licensee did not comply with the section cited above in one of five staff which poses a potential health and safety risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
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2
3
4
AD obtain a LIC 503 Health Screening Report and TB for one of five staff members
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Alisa Ortiz
NAME OF LICENSING PROGRAM MANAGER:
RoseMarie Ruppert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2026


LIC809 (FAS) - (06/04)
Page: 6 of 16
Document Has Been Signed on 08/12/2026 01:54 PM - It Cannot Be Edited


Created By: RoseMarie Ruppert On 08/12/2026 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BRITTA CARE
FACILITY NUMBER: 306005809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87412(a)(13)(B)1
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (13) For employees that are required to be fingerprinted pursuant to Section 87355, Criminal Record Clearance: (B) Documentation of either a criminal record clearance or a criminal record exemption as required by Section 87355(e). 1. For Certified Administrators, a copy their current and valid Administrative Certification meets this requirement.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA's record review, the licensee did not comply with the section cited above in one of five staff files which poses a potential personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
1
2
3
4
AD has completed CEUs and will continue to work with ACB to obtain a current Administrator's Certificate by POC due date.
Type B
Section Cited
CCR
87411(d)
Personnel Requirements - General
(d) All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA interviews and file review the licensee did not comply with the section cited above in five of five staff members which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
1
2
3
4
AD will continue to have staff do online trarining and will document annual trainings. AD will email LPA completed trainings by 9/11/2026.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Alisa Ortiz
NAME OF LICENSING PROGRAM MANAGER:
RoseMarie Ruppert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2026


LIC809 (FAS) - (06/04)
Page: 7 of 16
Document Has Been Signed on 08/12/2026 01:54 PM - It Cannot Be Edited


Created By: RoseMarie Ruppert On 08/12/2026 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BRITTA CARE
FACILITY NUMBER: 306005809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87412(c)
Personnel Records
(c) Licensees shall maintain in the personnel records verification of required staff training and orientation.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA interviews and file review the licensee did not comply with the section cited above in five of five staff files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
1
2
3
4
AD will continue to have staff complete training and print certificates in staff files by POC due date.
Type B
Section Cited
HSC
1569.625(b)(2)
Other Provisions
(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA interviews and record review, the licensee did not comply with the section cited above in five of five staff members which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
1
2
3
4
AD will continue to provide staff trainings and will document for each staff member's file.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Alisa Ortiz
NAME OF LICENSING PROGRAM MANAGER:
RoseMarie Ruppert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2026


LIC809 (FAS) - (06/04)
Page: 8 of 16
Document Has Been Signed on 08/12/2026 01:54 PM - It Cannot Be Edited


Created By: RoseMarie Ruppert On 08/12/2026 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BRITTA CARE
FACILITY NUMBER: 306005809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87468(b)
Personal Rights of Residents
(b) At the time the admission agreement is signed, a resident and the resident's representative shall be personally advised of and given a copy of:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA file review, the licensee did not comply with the section cited above in three of five residents which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
1
2
3
4
AD will look for signed Admissions Agreements or complete new ones for three of five residents. AD will email LPA by POC due date with the required documents.
Type B
Section Cited
CCR
87465(a)(6)
Incidental Medical and Dental Care Services
(6) When requested by the prescribing physician or the Department, a record of dosages of medications which are centrally stored shall be maintained by the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA observations, record review and interviews, the licensee did not comply with the section cited above in five of five residents which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
1
2
3
4
AD will reconcile medication lists per physican's orders for the resident files by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Alisa Ortiz
NAME OF LICENSING PROGRAM MANAGER:
RoseMarie Ruppert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2026


LIC809 (FAS) - (06/04)
Page: 9 of 16
Document Has Been Signed on 08/12/2026 01:54 PM - It Cannot Be Edited


Created By: RoseMarie Ruppert On 08/12/2026 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BRITTA CARE
FACILITY NUMBER: 306005809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87506(b)(15)
Resident Records
(b) Each resident's record shall contain at least the following information: (15) The admission agreement and pre-admission appraisal, specified in Sections 87507, Admission Agreements and 87457, Pre-admission Appraisal.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA's interviews and file review, the licensee did not comply with the section cited above in three of five residents which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
1
2
3
4
AD will complete resident appraisals for three of five residents by POC due date.
Type B
Section Cited
CCR
87463(a)
Reappraisals
(a) 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, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA's file review and interview the licensee did not comply with the section cited above in two of five residents which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
1
2
3
4
AD will complete resident appraisals by POC due daye.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Alisa Ortiz
NAME OF LICENSING PROGRAM MANAGER:
RoseMarie Ruppert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/12/2026 01:54 PM - It Cannot Be Edited


Created By: RoseMarie Ruppert On 08/12/2026 at 12:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: BRITTA CARE
FACILITY NUMBER: 306005809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87705(b)(1)(A)
Care of Persons with Dementia
(b) Licensees shall be responsible for the following: (1) Ensuring staff receive the following training as part of the training requirements specified in Section 87208 Plan of Operation: (A) Dementia care, including, but not limited to, knowledge about hydration, nutrition, skin care, communication, therapeutic activities, behavioral challenges, the environment, and assisting with activities of daily living;

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's interviews and file review, the licensee did not comply with the section cited above in five of five staff which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/11/2026
Plan of Correction
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AD will continue to provide ongoing dementia training to five of five staff. AD will email LPA documentation by 9/11/2026.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Alisa Ortiz
NAME OF LICENSING PROGRAM MANAGER:
RoseMarie Ruppert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2026


LIC809 (FAS) - (06/04)
Page: 11 of 16
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: BRITTA CARE
FACILITY NUMBER: 306005809
VISIT DATE: 08/12/2026
NARRATIVE
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(Continued from LIC 809)

Kitchen appliances were in working order and pantry and cabinets were clean. LPA observed the washer and dryer in the garage were operational with additional emergency supplies. LPA observed medication storage was secured but could not determine if medications are being given as prescribed.

LPA toured the exterior of the property and noted there was ample outdoor space for activities and a shaded seating area. Pathways were clear of hazards and obstructions.

The facility has current liability insurance. LPA reviewed five of five staff training and fingerprint records. Staff do not have trainings documented and the Administrator's Certificate has lapsed. LPA conducted a complete review of resident records and one of five files did not have Tuberculosis documentation and three of five resident files did not have Admissions Agreements. Deficiencies for staff and resident record keeping have been given. LPA spoke with Administrator regarding the Technical Support Program (TSP) and an informal meeting in the Regional Office.

The following deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations.
An exit interview was conducted with Administrator (AD) Frank Mangisi and a copy of this report was given to the facility along with a copy of the LIC 858, LIC 859; LIC 809-Ds, LIC 9102-TVs and Appeal Rights.
NAME OF LICENSING PROGRAM MANAGER: Alisa Ortiz
NAME OF LICENSING PROGRAM ANALYST: RoseMarie Ruppert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026
LIC809 (FAS) - (06/04)
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