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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320417
Report Date: 09/24/2026
Date Signed: 09/24/2026 04:47:49 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
06/17/2026 and conducted by Evaluator Felisa Shirley
COMPLAINT CONTROL NUMBER: 11-AS-20260617125601
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: 112DATE:
09/24/2026
UNANNOUNCEDTIME BEGAN:
03:24 PM
MET WITH:Esperanza Naaktgeboren, Executive DirectorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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9
Staff verbally abused resident
Staff did not report the incident to the appropriate agencies
INVESTIGATION FINDINGS:
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*This report serves as an amendment to clarify findings. It supersedes the complaint investigation findings reflected on report created 8/17/26.

On 8/17/26, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA was met by Esperanza Naaktgeboren, Executive Director and explained the purpose of the visit is to investigate and deliver findings for the allegations mentioned above. LPA was granted access to the facility.
The investigation consisted of the following:
On 06/23/26 LPA Shirley reviewed copies of the following records: Staff and Resident Roster, Identification and Emergency Information, Medical Assessment for Residential Care facilities for the Elderly, Service Plan, Resident assessment, Incident report, dated 6/13/26, S5 Human Resource Status Change, S6 Resignation letter, 24 Hour Communication Log. LPA Felisa Shirley conducted a tour of the facility. LPA Shirley interviewed Staff 1 – Staff 8 (S1 – S8), and Resident 2 – Resident 6 (R2-R6). Resident 1 (R1) is hospitalized and cognitively impaired, not available to be interviewed.
Con'd on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
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 5
Control Number 11-AS-20260617125601
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: 09/24/2026
NARRATIVE
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The investigation revealed the following:

Allegation: Staff verbally abused resident

It is being alleged that R1 was verbally abused by a caregiver at Brittany House. Per interviews on 6/24/26, S5 stated that R1 was having behaviors, screaming and trying to fall to the floor. S5 stated that she called S6 for advice on how to assist R1 as R1 was upsetting other residents. S5 stated that S6 told her that it was okay to let R1 fall out on the floor as it was the best way to assist her. LPA Shirley interviewed S2 on 6/23/26, per interview, the Long Beach Police Department was called but no one came out to take a report.

LPA interviewed staff 1 – staff 8 (S1 – S8). Of those interviewed 3 out of 8 denied the allegation, 3 confirmed the allegation and 2 did not know. LPA interviewed resident 2 – resident 6 (R2 – R6). Of those who interviewed 5 out of 5 denied the allegation.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Staff verbally abused resident,” therefore, the allegation is unsubstantiated.

Allegation: Staff did not report the incident to the appropriate agencies

It is being alleged that facility staff failed to report incident information to required agencies such as Licensing and to the local ombudsman office. On 6/23/26, LPA Shirley observed the incident report regarding R1, dated 6/13/26. LPA Shirley also reviewed the fax confirmation sheet dated 6/15/26 for Community Care Licensing (CCL) and also the fax confirmation sheet dated 6/15/26 for the local ombudsman.

LPA interviewed staff 1 – staff 8 (S1 – S8). Of those interviewed 5 out of 8 denied the allegation, 2 staff confirmed the allegation and 1 was not sure. LPA interviewed resident 2 – resident 6 (R2 – R6). Of those who interviewed 5 out of 5 were not sure.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Staff did not report the incident to the appropriate agencies,” therefore, the allegation is unsubstantiated.

No deficiencies were cited for these allegations.

An exit interview was conducted and a copy of this report was provided to the Executive Director, Esperanza Naaktgeboren.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
06/17/2026 and conducted by Evaluator Felisa Shirley
COMPLAINT CONTROL NUMBER: 11-AS-20260617125601

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: 112DATE:
09/24/2026
UNANNOUNCEDTIME BEGAN:
03:24 PM
MET WITH:Esperanza Naaktgeboren, Executive DirectorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not providing resident's authorized representative with written incident reports
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
*This report serves as an amendment to clarify findings. It supersedes the complaint investigation findings reflected on report created 8/17/26.

On 8/17/26, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA was met by Esperanza Naaktgeboren, Executive Director and explained the purpose of the visit is to investigate and deliver findings for the allegations mentioned above. LPA was granted access to the facility.
The investigation consisted of the following:
On 06/23/26 LPA Shirley reviewed copies of the following records: Staff and Resident Roster, Identification and Emergency Information, Medical Assessment for Residential Care facilities for the Elderly, Service Plan, Resident assessment, Incident report, dated 6/13/26, S5 Human Resource Status Change, S6 Resignation letter, 24 Hour Communication Log. LPA Felisa Shirley conducted a tour of the facility. LPA Shirley interviewed Staff 1 – Staff 8 (S1 – S8), and Resident 2 – Resident 6 (R2-R6). Resident 1 (R1) is hospitalized and cognitively impaired, not available to be interviewed.
Con'd on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
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 5
Control Number 11-AS-20260617125601
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: 09/24/2026
NARRATIVE
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Allegation: Staff are not providing residents authorized representative with written incident reports

It is being alleged that a family member requested that all incident reports and concerns be provided to them in writing and this request has not been fulfilled. The family member stated that they are only notified verbally. Per interview with S2 on 6/23/26, incident reports are confidential and internal only. Per S2, staff are required to notify family and responsible parties verbally only.

LPA interviewed staff 1 – staff 8 (S1 – S8). Of those interviewed 3 out of 8 denied the allegation, 2 staff confirmed the allegation and 3 did not know. LPA interviewed resident 2 – resident 6 (R2 – R6). Of those who interviewed 2 out of 5 denied the allegation and 3 were not sure.

According to the information gathered there is sufficient evidence to support the allegation “Staff are not providing residents authorized representative with written incident reports.” Based on interview and record review the licensee violated the California Code Regulations (CCR) of Title 22, Division 6, Chapter 8.


Deficiencies are issued and an exit interview is conducted with the Executive Director, Esperanza Naaktgeboren. A copy of this report and appeal rights were provided.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 11-AS-20260617125601
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: 09/24/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/08/2026
Section Cited
CCR
87211(a)(1)
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87211 Reporting Requirements

(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case.
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The Executive Director shall submit an in-service training informing and reminding the staff the importance of providing written reports to the responsible parties/authorized representatives of residents in care. Please provide the in-service training including date, time and participants names. Training must be submitted by due date: 10/8/26 to LPA's email: felisa.shirley@dss.ca.gov or fax attn: to LPA Felisa Shirley to 424-544-1016.
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Based on interview, S2 did not provide resident’s authorized representative with a copy of the written incident report. This violation poses as a potential health and safety risk to persons 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: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5