Health inspection·January 26, 2026

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to report an allegation of resident- to resident abuse to local, state and federal officials (including to the State Survey Agency and adult protective services where state law provides for jurisdiction in long-term care facilities) within two (2) hours, for 2 of 2 sampled residents (Residents 1 and 2) per facility policy. This resulted in a delay of an onsite inspection by the California Department of Public Health (CAPD) to ensure the alleged abuse was investigated, to protect and prevent further abuse of the residents in the facility.Findings:During a review of Resident 1's admission Record, (undated), the admission Record indicated Resident 1 was initially admitted to the facility on [DATE] with diagnoses that included but not limited to chronic respiratory failure (a condition that occurs when the lungs cannot get enough oxygen into the blood or eliminate enough carbon dioxide from the body), unspecified dementia (a progressive state of decline in mental abilities) and peripheral vascular disease (PVD - a slow progressive narrowing of the blood flow to the arms and legs). During a review of Resident 1's History & Physical (H&P), dated 6/9/2025, the H&P indicated Resident 1 did not have the capacity to understand and make decisions. During a review of Resident 1's Minimum Data Set (MDS- a resident assessment tool), dated 12/26/2025, the MDS indicated Resident 1 had modified independent (some difficulty in new situations only) cognitive skills (ability to understand and make decisions) for daily decision making. The MDS also indicated Resident 1 needed setup or clean-up assistance (helper sets up or cleans up; resident completes activity) with eating, oral and personal hygiene and supervision or touching assistance (helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity) with toileting hygiene. During a review of Resident 2's admission Record, (undated), the admission Record indicated Resident 2 was initially admitted to the facility on [DATE] with diagnoses that included unspecified dementia, type 2 diabetes mellitus (DM-a disorder characterized by difficulty in blood sugar control and poor wound healing), and peripheral vascular disease. During a review of Resident 2's H&P, dated 5/10/2025, the H&P indicated that Resident 2 did not have the capacity to understand and make decisions. During a review of Resident 2's MDS, dated 12/12/2025, the MDS indicated Resident 2 with severely impaired cognitive skills for daily decision making. The MDS also indicates Resident 2 was dependent (helper does all of the effort) with oral, personal and toileting hygiene, shower/bathing self and partial/moderate assistance (helper does less than half the effort) with eating. During an interview on 1/23/2026 at 3:21 PM with the Director of Nursing (DON), the DON stated on Wednesday 1/21/2026, she and the Administrator were informed by the Director of Staffing (DSD) regarding an alleged incident between Residents 1 and 2 on Sunday, 1/18/2026, where Resident 2 allegedly slapped Resident 1. The DON also stated she spoke with Certified Nurse Assistant 1 (CNA 1) on 1/21/2026 and CNA 1 stated Resident 1 and Resident 2 allegedly hit each other in the facility's activity room. During an interview on 1/23/2026 at 3:32 PM with the Administrator, the (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 056127 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 056127 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/26/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Live Oak Rehab Center 537 W Live Oak San Gabriel, CA 91776 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)