Health inspection·January 7, 2026

F 0806 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to ensure one (1) of four (4) sampled residents (Resident 1) was provided with a breakfast tray that did not contain food that the resident was allergic to. This failure had the potential to result in Resident 1 experiencing an allergic reaction such as anaphylaxis (a severe, whole-body allergic reaction that happens quickly and can be life-threatening).During a review of Resident 1's admission Record, the admission Record indicated the resident was initially admitted to the facility on [DATE] with diagnoses of syncope (fainting or passing out, caused by a temporary lack of blood flow and oxygen to the brain) and collapse (to fall down) and autoimmune thyroiditis (when the immune system mistakenly attacks its own thyroid gland [a small, butterfly-shaped endocrine gland in the front of the neck that produces hormones to control the body's metabolism, energy use, growth, and other vital functions such as heart rate and digestion] causing inflammation [swelling]). Resident 1's admission Record also indicated Resident 1 had multiple allergies with one being to gluten (a protein found in grains like wheat, barley and rye that acts like a natural glue, giving dough its stretchy elastic quality, helping bread rise, and holding foods together). During a review of Resident 1's admission assessment dated [DATE], Resident 1's admission Assessment indicated Resident 1 had an allergy to gluten (a substance present in cereal grains, especially wheat, that is responsible for the elastic texture of dough). During a review of Resident 1's Diet Order and Communication dated 12/21/2025, Resident 1's Diet Order and Communication indicated Resident 1 had a food allergy to gluten.During a review of Resident 1's Care Plan dated 12/22/2025, Resident 1's Care Plan indicated Resident 1 was at risk for nutritional imbalance due to requiring assistance with mobility and having an allergy which included gluten. Resident 1's Care Plan also indicated interventions that included to honor resident's reasonable food preferences and to offer substitutes for meals as needed. During a review of Resident 1's Minimum Data Set (MDS - a resident assessment tool), dated 12/27/2025, the MDS indicated the resident was cognitively intact (ability to think, remember, and reason) with cognitive skills for daily decision making. Resident 1 needed supervision or touching assistance (helper provides verbal cues and/or touching/steadying and/or contact guard assistance as resident completes activity) with walking 10 and 50 feet, chair/bed-to-chair transfers (the ability to transfer from a bed to a chair (or wheelchair), putting on/taking off footwear and lower body dressing (the ability to dress and undress below the waist). Resident 1 needed setup or clean-up assistance (helper sets up or cleans up; resident completes activity) with upper body dressing (the ability to dress and undress above the waist), personal hygiene and eating. During an interview on 1/7/2026 at 7:33 AM with Certified Nursing Assistant 1 (CNA 1), CNA 1 stated on 12/22/2025 Resident 1's breakfast tray contained eggs and sourdough toast and Resident 1 had told him that the resident was allergic to gluten and could not eat what was on the breakfast tray which is the sourdough toast.During an interview on (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: 555338 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 01/07/2026 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)