Health inspection·December 19, 2025

F 0607 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few had her arm raised with a clenched fist, and Resident 2 was yelling you have my wheelchair; I will kill you. Resident 1 stated she believed Resident 2 was going to hit her. Resident 1 stated she felt threatened, scared, and unsafe. Resident 1 stated she then reported the incident to LVN 1. On 12/1/25 at 1313 hours, an interview was conducted with LVN 1. LVN 1 stated Resident 1 informed her of an alleged incident involving Resident 2 allegedly occurring on 11/16/25. LVN 1 further stated Resident 1 said Resident 2 blocked the entrance to Resident 1's room and began to scream and yell at Resident 1. At some point, Resident 2 lifted her arm and made a fist. Resident 1 reported having felt uncomfortable and threatened as she believed Resident 2 was going to hit her. LVN 1 stated she reported the alleged incident to the Administrator (facility's Abuse Coordinator). Medical record review for Resident 2 was initiated on 12/1/25. Resident 2 was admitted to the facility on [DATE]. Review of Resident 2's H&P examination dated 9/8/25, showed Resident 2 had no capacity to understand and make decisions. Review of Resident 2's Care Plan Report revised 9/24/25, showed Resident 2 had a diagnosis of schizophrenia. The care plan showed Resident 2 had the potential to be verbally aggressive related to psychosis manifested by verbal aggression towards others. On 12/1/25 at 1445 hours, an interview was conducted with the Administrator. The Administrator verified he was the facility's Abuse Coordinator. The Administrator stated he was unaware of the abuse allegation made by Resident 1 against Resident 2 for the incident on 11/16/25. The Administrator further stated he was unaware Resident 1 reported feeling uncomfortable and threatened as she believed Resident 2 was going to hit her. The Administrator stated if he was aware, he would have reported the alleged incident to the state agency and conducted an investigation specific to Resident 1's allegation of abuse. b. On 12/1/25 at 1230 hours, an interview was conducted with Resident 1. Resident 1 stated a second incident with Resident 2 occurred during the evening of 11/26/25. Resident 1 stated she was out on pass and returned to the facility at approximately 1745 hours. Resident 1 stated she attempted to utilize the elevator at which time she observed Resident 2 in the hallway. Resident 1 stated Resident 2 began to yell and curse at Resident 1. Resident 1 stated Resident 2 claimed Resident 1 had her wheelchair. Resident 1 stated Resident 2 threatened to cut her into pieces. Resident 1 stated she felt threatened and unsafe. Resident 1 stated Resident 3 (who lived across the hall from Resident 1) witnessed Resident 2 threaten her. Additionally, Resident 1 stated she spoke to the DON regarding the incident. On 12/1/25 at 1352 hours, an interview was conducted with the DON. The DON stated on Thanksgiving (11/27/25) day, Resident 1 informed her Resident 2 yelled at Resident 1. The DON stated Resident 1 alleged Resident 2 yell she was Jesus Christ and would strike Resident 1 down with lightning. Resident 1 also alleged Resident 2 stated she would cut Resident 1 into pieces. The DON stated Resident 1 informed her she felt unsafe. The DON was asked if she felt this incident was potential resident to resident mental/verbal abuse. The DON stated no, Resident 2 was cognitively impaired and had not intended to cause Resident 1 any harm. The DON was asked if the Administrator was aware of the alleged incident, to which the DON replied, yes. Medical record review for Resident 3 was initiated on 12/1/25. Resident 3 was admitted to the facility on [DATE]. Review of Resident 3's H&P examination dated 8/30/25, showed Resident 3 had the capacity to understand and make decisions. On 12/3/25 at 1025 hours, an interview was conducted with Resident 3. Resident 3 stated Resident 2 frequently yelled and screamed while in the hallway. Resident 3 stated approximately three weeks ago while he was in the hallway, he heard Resident 2 threaten to cut off Resident 1's head. On 12/1/25 at 1445 hours, an interview was conducted with the Administrator. The Administrator verified he was the facility's Abuse Coordinator. The Administrator stated he was unaware of the abuse allegations made by Resident 1 against Resident 2 for the incidents on 11/16/25 and 11/26/25. The Administrator further stated he was unaware Resident 1 (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 555103 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 555103 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/19/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE French Park Care Center 600 E Washington Avenue Santa Ana, CA 92701 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 0607 Level of Harm - Minimal harm or potential for actual harm reported feeling uncomfortable and threatened as she believed Resident 2 was going to hit her. The Administrator stated if he was aware, he would have reported the alleged incident to the state agency and conducted an investigation specific to Resident 1's allegation of abuse. Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 555103 If continuation sheet Page 3 of 3