198320417-7-17-2025-11-AS-SCIS-DJZVAC-20250728161544

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320417
Report Date: 07/17/2025
Date Signed: 07/17/2025 12:54:32 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
12/17/2024 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 11-AS-20241217143234

FACILITY NAME:	BRITTANY HOUSE		FACILITY NUMBER:	198320417
ADMINISTRATOR:	WINKELBAUER, SHANE		FACILITY TYPE:	740
ADDRESS:	5401 E CENTRALIA ST		TELEPHONE:	(562) 421-4717
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90808
CAPACITY:	170	CENSUS: 96	DATE:	07/17/2025
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Joel Niblett- Administrator		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not prevent a residents from suffering multiple falls while in care.
Untrained staff administer medication.
Staff handle residents in a rough manner.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

***This report supersedes the original report delivered on 5/28/2025. On 7/17/2025, the LPA arrived at the facility to deliver the corrected 9099, providing clarification on the original report issued on 5/28/2025. ***

On 5/28/2025, at 9:00 AM, Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to deliver findings for the alleged allegations. LPA identified herself and met Joel Niblett-Administrator who was informed of the purpose of the visit.

The investigation consisted of the following:

On 5/28/2025 at 01:25 PM, LPA Allen obtained and reviewed files for Resident 1- 10 (R1-R10) , Special Incident Reports/Death-LIC624A (UIR) for R1 and R3, LPA conducted a search in Community Care Licensing (CCL) data base for death reports resulting from falls. LPA also conducted interviews with staff members1-10 (S1-S10) and Residents 1 – 10 (R1–R10)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

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-20241217143234

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: 07/17/2025

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

LPA reviewed current in-service training conducted on 1/10/2025 residents’ rights, 2/25/2025 In-service-reporting trainings, and 4/7/2025 Medication Administration (MARS)Training's signed by staff members.

Investigation revealed the following:

1 Allegation: Staff do not prevent a resident from suffering multiple falls while in care.

Interviews with staff members (S1-S10) stated residents are closely monitored throughout the day & night and are not left unattended for extended periods. For residents identified as fall risks, staff maintain close supervision, either by remaining nearby while assisting other residents or by coordinating with additional staff to ensure continuous observation and support is provided to residents.

LPA also interview Residents 1 – Resident 10 (R1–R10). Of the 10 residents, 2 stated that staff members help them with their needs and have not fallen. The remaining 8 residents were unable to engage in a clear conversation.

A random audit of resident files (R1-R6) and Special Incident Reports (SIRs) in the Community Care Licensing (CCL) database revealed no incident reports indicating that a resident death resulted from a fall. Furthermore, LPA reviewed UIRs for residents who had passed away and confirmed that their causes of death were unrelated to falls.

During a facility tour, LPA observed staff actively assisting residents, with no individuals appearing to be left unattended. Based on these observations, it appears that residents receive consistent supervision, and staff have a structured plan in place to promote safety and prevent falls. LPA reviewed current in-service training conducted on 2/25/2025 and 4/7/2025, Medication Administration Training's signed by staff members.

2. Allegation: Untrained staff administer medication

On 5/12/2025 at 11:00 AM, LPA conducted interviews with Staff 1 - Staff 10 (S1–S10). All 10 staff members stated that, to their knowledge, all medication technicians (MedTechs) are certified to pass out medications.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20241217143234

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: 07/17/2025

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

During the investigation, LPA observed that the MedTech certifications for S7 and S9 were up to date and dispense medications. Interviews with S1, S2, S3, and S8 confirmed that they hold certifications, and LPA requested and obtained staff training records for MedTechs. LPA observed re-certifications through Elite Medical Academy for S1, S2, S3, and S8. Interviews with staff also indicated that they have not seen staff members S4, S5, and S6 dispensing medications, and there are no records of current MedTech training for these staff members, only in-service training's.

3 Allegation: Staff handle residents in a rough manner.

On 5/12/2025 at 11:00 AM, LPA conducted interviews with Staff 1 - 10 (S1–S10), Of all the staff interviewed 10 out of the 10 staff stated residents have not been handled in a rough manner that could have resulted in injuries to any resident in care.

LPA interview Residents 1 – Resident 10 (R1–R10). Of the 10 residents, 2 stated that staff members have not handled them in a rough manner. The remaining 8 residents were unable to engage in a clear conversation.

Based on the evidence gathered during the investigation, the above allegations are found to be Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted, and a copy of the report was provided to the Joel Niblett- Administrator at the conclusion of the visit with appeal rights.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 3