Health inspection·August 13, 2025

F 0847 Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse. Level of Harm - Minimal harm or potential for actual harm Based on interview and record review, the facility failed to ensure the admission Coordinator (AC) was aware that residents and their representative can rescind the facility's arbitration (a private process where disputing parties agree that one or several other individuals can make a decision about the dispute after receiving evidence and hearing arguments) agreement (a written contract in which two or more parties agree to settle a dispute out of court) within 30 days after obtaining the signature for two of three sampled residents (Residents 2, and 5 ).These failures could potentially result in the residents and residents' representatives not knowing or understanding what an arbitration agreement is and potentially causing feelings of doubt and confusion.Findings:During a review of Resident 2's admission Record, the admission Record indicated the facility admitted Resident 2 on 6/12/2025, with diagnoses including metabolic encephalopathy (your brain is having trouble processing information due to a chemical imbalance in your blood), diabetes mellitus (DM-a disorder characterized by difficulty in blood sugar control and poor wound healing) and pneumonia (an infection/inflammation in the lungs).During a review of Resident 2's History and Physical (H&P), dated 6/29/2025, the H&P indicated Resident 2 had capacity to understand and make decisions.During a review of Resident 2's Resident-Facility Arbitration Agreement, dated 6/16/2025, the Resident-Facility Arbitration Agreement indicated Resident Representative 1 (RR1), signed the agreement on 6/16/2025.During a review of Resident 5's admission Record, the admission Record indicated the facility admitted Resident 5 on 8/8/2025, with diagnoses including unspecified (unconfirmed) encephalopathy (damage or disease that affects the brain), abnormal posture (how you hold your body when you are standing, sitting, or moving), and unspecified visual loss (a partial or complete inability to see clearly).During a review of Resident 5's H&P, dated 8/9/2025, the H&P indicated Resident 5 did not have the capacity to understand and make decisions.During a review of Resident 5's Minimum Data Set (MDS- a resident assessment tool), dated 8/13/2025, the MDS indicated Resident 5's cognitive (mental action or process of acquiring knowledge and understanding) skills for daily decisions were severely impaired.During a review of Resident 5's Resident-Facility Arbitration Agreement, dated 8/11/2025, the Resident-Facility Arbitration Agreement indicated RR 2, signed the agreement on 8/11/2025.During an interview on 8/12/2025, at 1:47 p.m., with the AC, the AC stated she (AC) explained the arbitration agreement as a document that if ever the resident or resident representative decides to sue the facility that it will be done in front of a mediator (neutral third party who facilitates communication and negotiation between individuals or groups in a dispute) instead of in front of the judge or courthouse. The AC stated she (AC) then generates the packet and the resident or the representative signs it. The AC stated she (AC) did not know residents or their representative can make changes after signing the arbitration agreement.During an interview on 8/12/2025, at 2 p.m., with the AC, the AC stated she did not know if residents or their representative can rescind (take back or cancel) their signature on the arbitration agreement.During an interview on 8/13/2025, at 10:23 a.m., with the Administrator Residents Affected - Few Page 1 of 2 056148 056148 08/13/2025 Casitas Care Center 10626 Balboa Blvd. Granada Hills, CA 91344

F 0847 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few (ADM), the ADM stated residents, and resident representatives can rescind their signature within 30 days after signing the arbitration agreement. The ADM stated the AC is responsible for the residents' arbitration agreement. The ADM stated it is important to inform the residents, and their representative, of what arbitration agreement is and that they can rescind the agreement within 30 days after signing the arbitration agreement. The ADM stated that the residents and resident representatives have the right to be fully informed before allowing them to sign the arbitration agreement.During a review of facility's policy and procedure (P&P), titled, Arbitration, dated 1/2025, the P&P indicated, The facility will present the agreement and explain the agreement in a form and manner that is understood by the resident or resident's representative and the resident or resident's representative is to acknowledge that they understand the agreement. The agreement must grant the right to rescind the agreement within 30 calendar days of signing it. Advise the residents or residents' representatives that they have the right to rescind the agreement within 30 days of execution. Advice they can rescind the agreement by giving written notice to any of the following: Administrator, Director of Nursing, Admissions and/or Social Services Department. 056148 Page 2 of 2