Health inspection·December 15, 2025

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews, the facility failed to ensure that one of three sampled residents (Resident 1) was treated with dignity and respect during personal care. Certified Nursing Assistant (CNA 1) used derogatory and offensive language toward Resident 1, including statements such as It smells bad and stinkyThis failure resulted in Resident 1 feeling humiliated, insulted, and emotionally distressed. The resident reported staying awake all night due to the incident on 11/29/2025.Findings:During a review of Resident 1's admission Record, the admission Record indicated Resident 1 was admitted to the facility on [DATE] with diagnoses including broken left leg, broken left wrist and generalized muscle weakness. During a review of Resident 1's History and Physical (H&P), dated 11/21/2025, the H&P indicated Resident 1 had the capacity to make decisions for herself. During a review of Resident 1's Minimum Data Set (MDS-a resident assessment tool), dated 11/26/2025, the MDS indicated Resident 1 had moderate cognitive (ability to think, understand, learn, and remember) impairment. The MDS indicated Resident 1 understood clear comprehension. The MDS indicated Resident 1 was dependent on nursing staff for toileting, showering, sitting, standing and transferring. During a review of Resident 1's Grievance Resolution Report dated 11/30/2025 at 5:57 p.m., the Grievance Resolution Report indicated that Resident 1 was interviewed regarding the incident on 11/29/2025. Resident 1 stated that CNA 1, who was assigned to her, said, It smells bad and stinky. The Grievance Resolution Report also indicated that Resident 1 felt CNA 1 and CNA 2 were in a hurry while providing personal care. The report indicated that Resident 1 was satisfied with the outcome of the investigation and with her current care. During an interview on 12/13/2025 at 12:05 p.m. with Resident 1, Resident 1 stated that on 11/29/2025, Certified Nursing Assistant (CNA 1) entered her room between 11:30 p.m. to 12:30 a.m., without saying much, then removed her soiled incontinent briefs ( a disposable absorbent garment for managing bladder or bowel leakage) and began yelling, You are trash, messy, and stinky. Resident 1 stated she had never experienced such treatment before and was shocked. Resident 1 stated CNA 1 continued making comments such as This is smelly and disgusting while cleaning her with a dry terry cloth inside her legs and genital area. Resident 1 stated she began to cry and felt humiliated, insulted, and shocked. After CNA 1 left, Resident 1 stated she stayed awake all night crying. Resident 1 stated on 11/30/2025 (the next day), CNA 2 entered her room and asked why she told CNA 1 that she had not cleaned her, which made Resident 1 cry again because she had not said anything to CNA 1. Resident 1 reported that CNA 1 later returned, apologized, and told her to forget about what happened and move on. Resident 1 stated she did not forget and reported the incident to a nurse (unknown) and the Social Worker (SW 1). Resident 1 stated SW 1 told her the facility would investigate and follow up. She stated no one ever got back to her. She stated someone later told her the investigation was final and asked her to sign a document related to the incident, which she did without reading and did not receive a copy. Resident 1 stated she also reported the incident to the Administrator and SW 1 Page 1 of 2 055041 055041 12/15/2025 The Beach Post-Acute 2725 Pacific Avenue Long Beach, CA 90806

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few on 12/1/2025. Resident 1 stated she filed a grievance indicating on 11/30/2025 at 5:57 p.m., the incident was reported to the charge nurse and RN supervisor. During an interview on 12/14/2025 at 12:16 p.m. with CNA 1, CNA 1 stated when he entered Resident 1's room, it smelled unpleasant. CNA 1 reported checking the resident's diaper and noted a strong odor, then told Resident 1 that she needed to be cleaned and mentioned that she smelled stinky. CNA 1 stated that Resident 1 began to cry but said she was okay. CNA 1 stated Resident 1 appeared offended by the word stinky, and he apologized for using it. CNA 1 stated he informed Licensed Vocational Nurse (LVN 1) on 11/30/2025 at 1 a.m., about the incident with Resident 1 . CNA 1 stated it was inappropriate to say Resident 1 was stinky. CNA 1 stated upon his return to work on 12/1/2025 he was told by Registered Nurse Supervisor (RNS 1) he could no longer take care of Resident 1. CNA 1 stated he was sorry for hurting Resident 1's feelings and recognized that his words caused Resident 1 distress. CNA 1 stated he offended, hurt and made Resident 1 cry with his words used and apologized. CNA 1 stated when he walked into the room the resident smelled awful, stinky and had dry poop on her. CNA 1 stated his words were inappropriate to Resident 1. During an interview conducted on 12/15/2025 at 7:21 a.m. with LVN 1, LVN 1 stated Registered Nurse Supervisor (RNS 1) informed him om 11/30/2025 at 3 p.m., that CNA 1 had commented that Resident 1 was smelly. LVN 1 stated the CNAs were advised to exercise greater caution when using language related to patients and their care. RNS 1 explained that verbal abuse occurs when hurtful or derogatory words are directed toward a resident.During an interview on 12/15/2025 at 8:07 a.m. with RNS 1, RNS 1 stated verbal abuse consists of words that can offend a resident, cause them to become upset, or lead them to think negatively.During an interview on 12/15/2025 at 8:39 a.m. with the Administrator ( ADM) the ADM stated verbal abuse consists of words that cause mental anguish or hurt the residents' feelings. 055041 Page 2 of 2