Health inspection·August 11, 2025

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some enhances his or her sense of well-being, level of satisfaction with life, and feelings of self-worth and self-esteem. The P&P also indicated residents are to be always treated with dignity and respect and staff to promote, maintain and protect resident privacy, including bodily privacy during assistance with personal care and during treatment procedures. 2. During a review of Resident 3's admission Record, the admission record indicated Resident 3 was admitted to the facility on [DATE]. Resident 3 diagnoses included hemiplegia (paralysis of one side of the body), major depressive disorder ( or also called clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems) and anxiety disorder (a disorder characterized by nervousness characterized by a state of excessive uneasiness and apprehension, typically with compulsive behavior [repetitive, persistent, and often uncontrollable actions that a person feels driven to perform] or panic attacks). During a review of Resident 3's MDS dated [DATE], the MDS indicated Resident 3 has moderately impaired cognitive skills for daily decision making. The MDS indicated Resident 3 was dependent (helper does all of the effort, resident does none of the effort to complete the activity) in toileting hygiene, shower/ bathe self, and chair/bed-to chair transfer. During a review of Resident 3's Care Plan (CP) for at risk for further decline in function, joint mobility, contracture formation, falls, skin breakdown and increased dependence in Activities of Daily Living (ADLs, are activities related to personal care including bathing or showering, dressing, getting in and out of bed or a chair, walking, using the toilet, and eating), dated 1/14/2022, the CP indicated in the interventions/approaches, needs extensive assistance with bed mobility, w/ 2 persons physical assist, locomotion off unit, dressing, toileting, personal hygiene. During an interview on 8/11/2025 at 10:51 AM, with Resident 3, Resident 3 stated, I am upset because CNA 1 was handling me roughly. CNA1 was changing my diaper. When she is turning me and I told her, you are fucking hurting me. She told me that she will not work with me tomorrow because I was cursing her. I just said the wrong words because she is rough. During an interview on 8/11/2025 at 11 AM with CNA 1, CNA 1 stated, Saturday, Resident 3 pressed the resident's call light and asked me If I can change her. I told her I was going to give another resident a shower, so she needed to wait a little bit. When I came to change her briefs, there was a lot of bowel movement in the vaginal area. I need to clean her pretty well because it went to her creases. She told me, You are hurting me. I am getting bowel movements out of her vaginal area. I tried to clean her private part, but she said you are hurting me and then curse at me and told me to get the F out of my room. The towels might be rough. The washcloths might have rough texture also. But Resident 3 always tells me, I have a heavy hand. She is sensitive and complains of pain in everything. She was probably in a bad mood because she has to wait. During an interview on 8/11/2025 at 12:05PM, with Resident 3, Resident 3 stated, My buttocks hurts when she wiped me in the creases. It hurts every time she wipes. She wipes too hard. I told her she has to be gentle, but She cannot be gentle. She did not care. She said you will be okay. It was fine. Resident 3 also stated that Resident 2 told CNA 1, I am not fine, you are rough. I am telling you. and after that CNA 1 did not change and the resident felt CNA 1 brushed off the resident's complaint, did not listen to the resident and the resident felt disrespected. During a concurrent interview and record review on 8/11/2025 at 12:08PM with the DON, the facility's P&P titled, Accommodation of Needs, revised 3/2025 was reviewed. The P&P indicated, interacting with the residents in ways that accommodate the physical or sensory limitations of the residents, promote communication, and maintain dignity. The DON stated, Interacting Resident's preference meaning Resident 3 wants the resident's care to be individualized and be treated with non-judgmental attitude, dignity and well-being. The DON stated, the way the staff interact with residents should be accommodating on the Resident's preference. If the Resident said you (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 055376 If continuation sheet Page 2 of 3 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 055376 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/11/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Huntington Drive Health and Rehabilitation Center 400 W. Huntinton Dr. Arcadia, CA 91007 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete are hurting me, the staff should stop and ask where it hurts, how am I hurting you. It might cause pain in the Resident. Sometimes it might be the behavior of the Resident but still maintain respect and professionalism. During an interview on 8/11/2025 at 1:38 PM with the Director of Staff Development (DSD), DSD stated, Rough handled during care means they were changing you or wiping you and the staff were acting careless. It can affect the Resident by making them feel sad, emotional, psychological, and their entire well-being. During a record review of facility's policy and procedure (P&P) titled, Patient Rights revised 2/2021, the P&P indicated, federal and state laws guarantee certain basic rights to all residents of this facility. These rights include the residents' right to:> A dignified existence.> Be treated with respect, kindness, and dignity.> Privacy and confidentiality. During a record review of facility's P&P titled, Dignity revised 2/2021, the P&P indicated, each resident shall be cared for in a manner that promotes and enhances bis or her sense of well-being, level of satisfaction with life, and feelings of self-worth and self-esteem. The P&P also indicated the facility supports dignity and respect for residents by honoring resident goals, choices, preferences, values and beliefs. Event ID: Facility ID: 055376 If continuation sheet Page 3 of 3