Health inspection·August 6, 2025

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few stated, there was no abuse monitoring that was done on my shift. I did not report allegations of abuse. Resident 1 can continue feeling scared, feeling not safe in the facility. I am not sure if the previous shift reported abuse. I thought they did the report, because when they endorsed it to me, I thought it was being handled. During an interview on 8/6/2025 at 7:54 AM with Director of Nursing (DON), DON stated, Resident 1 went to her appointment on Monday 8/4/2025. We received a call from the medical office. Resident 1 told the Doctor that she does not want to go back to the facility because a man was staring at her in her room. Resident 1 stating a man was staring at her while she was naked Saturday morning (8/2/2025). I did not report it to the survey agency, police department and ombudsman. During a concurrent interview and record review on 8/6/2025 at 8:08 with Administrator (ADM), the facility's policy and procedure (P&P) titled, Elder/ Dependent Adult Abuse, revised 3/22/2024 was reviewed. The P&P indicated the facility will report any reasonable suspicion of a crime against a resident and all alleged violations involving abuse. ADM stated, we did not report it because there was no physical interaction with Resident 1. We did not report the incident to the CDPH, police and Ombudsman. We should have reported it within 2 hours when we were made aware on Monday (8/4/2025). During a concurrent interview and record review on 8/6/2025 at 8:17 AM with DON, the facility's P&P titled, Elder/ Dependent Adult Abuse, revised 3/22/2024 was reviewed. The P&P indicated Report to the State Agency and one or more law enforcement entities for the political subdivision in which the facility is located any reasonable suspicion of a crime against any individual who is a resident of, or is receiving care from, the facility. DON stated, we did not report to the CDPH, police and Ombudsman. During my interview with Resident 1, she was telling stories, and I cannot say which one is real. we did not monitor Resident 1 for abuse allegation and no care plan for abuse allegation. During an interview on 8/6/2025 at 10:38 AM with LVN 1, LVN 1 stated, Monday (8/4/2025) Resident 1 went to her appointment. Resident 1 does not want to go back to the facility. There was a delay for her because they had to wait for the police. There was an alleged abuse complaint. I am not sure when it happened but Resident 1 stated that somebody went to her room and she was naked, the male staff went too close to her. I informed RNS 1. During an interview on 8/6/2025 at 10:45 AM with LVN 1, LVN 1 stated, Resident 1 was saying, she was naked, and somebody just walked in her room and stare at her. I will be embarrassed if someone stares at me, will feel violated or abused. It can affect Resident 1 mentally or psychologically. It is suspicion of abuse because we are not sure, but we should have reported it right away. We should always report abuse to protect the Resident's rights. During an interview on 8/6/2025 at 11:50 AM with RNS 1, RNS 1 stated, I was aware of the abuse allegation from the appointment last Monday (8/4/2025). Resident 1 refused to go back to the facility. Resident 1 told me she does not want any male staff in her room. She wants to call the police, and she wants to go home at that time. During an interview on 8/6/2025 at 11:58 AM with RNS 1, RNS 1 stated, If suspected allegation of abuse was not reported, the Resident might be neglected because the issue was not addressed. We should report to make sure we can protect Resident's Rights. She will not be monitored for allegation of abuse. During a review of the facility's Policy and Procedure (P&P) titled, Elder/ Dependent Adult Abuse, revised 3/22/2024, the P&P indicated the facility will report any reasonable suspicion of a crime against a resident and all alleged violations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property. The P&P also indicated,5. The facility will annually notify covered individuals of their obligations to comply with requirements to ensure reporting of crimes. Each covered individual will:a. Report to the State Agency and one or more law enforcement entities for the political subdivision in which the facility is located any reasonable suspicion of a crime against any individual who is a (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 555338 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 555338 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/06/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brighton Care Center 1836 N. Fair Oaks Ave Pasadena, CA 91103 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete resident of, or is receiving care from, the facility.b. Report immediately, but not later than 2 hours after forming the suspicion, if the events that cause the suspicion result in serious bodily injury, or not later than 24 hours if the events that cause the suspicion do not result in serious bodily injury.10. Reporting/Responsea. A mandated reporter who, in his or her professional capacity, or within the scope of his employment, has observed or has knowledge of an incident that reasonably appears to be abuse or is told by an cider or dependent adult they have experienced behavior, including an act or omission, constituting abuse or reasonably suspects that abuse, will report known or suspected instance of abuse and any reasonable suspicion of a crime to the Administrator. Event ID: Facility ID: 555338 If continuation sheet Page 3 of 3