Health inspection·August 15, 2025

F 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few up and offer assistance. At that moment, [Resident 1] turned and began yelling, ‘I'm so fu***ng tired of this! I'm done! I need to be respected!' The note indicated [Resident 1] explained that she had just showered and was about to dress when she heard a knock on the door. [Resident 1] stated that she said out loud, ‘I'm changing,' but then heard the housekeeper enter the room. [Resident 1] noted that her curtain was fully drawn, covering her. The note indicated [Resident 1] said, ‘Why do they need to come into the room when they see the curtain drawn? I'm fed up. I can't take this anymore.' The note indicated [Resident 1] continued to express her frustration by yelling, repeating herself multiple times, and not responding to redirection attempts. The SSD encouraged the resident to verbalize her feelings and provided emotional support but was unsuccessful in calming her down. The SSD apologized for the incident, assured the resident that her concerns would be followed up on, and asked if she was okay at that moment. The resident, still visibly upset, did not respond to SSD. Instead, she called someone on her phone and began yelling again, repeating the same complaint. When asked again, the resident stated she was ‘fine' and continued yelling on the phone. The SSD exited the room to give her privacy and indicated follow-up is pending. During a review of Resident 1's Progress Note dated 8/12/2025, at 11:16 AM, the note indicated: Resident is still on a phone call, yelling and stating, ‘I'm f**ing tired.'* The note further indicated that the SSD provided the resident with space and privacy to continue her phone call and would continue to follow up. During a review of Resident 1's Progress Note dated 8/12/2025, at 3:34 PM, the Progress Note indicated that the SSD attempted to discuss the earlier incident and provide a follow up, but [Resident 1] declined at the moment and stated she was upset about missing a doctor's appointment. The Note indicated SSD to follow up. During a review of Resident 1's grievance dated 8/12/2025 (time not specified), the grievance form indicated that Resident 1 had a complaint regarding housekeeping [HK 1]. [Resident 1] explained that she was in her room after showering when she heard a knock on the door. [Resident 1] stated that she said aloud, I am changing, but still heard [HK 1] enter her room. The grievance form indicated that the DON, Social Services Director (SSD), and Housekeeping Supervisor were the department heads designated to take action on the concern. The grievance form indicated under Action Taken: The Housekeeping Supervisor was made aware of the incident and a one-on-one in-service training was requested. During a review of Resident 1's Progress Note dated 8/13/2025, at 1:13 PM, the note indicated the following information: [The] SSD met with the resident in her room and inquired about the earlier incident. The resident verbalized, feeling upset with the housekeeper [HK 1] that day. She [Resident 1] stated that she went out for a walk with [RNA 1] and, upon returning, asked for the floor to be dried before entering. She [Resident 1] reported that CNA 4 dried the floor for her and expressed frustration that the housekeeper [HK 1] did not do it instead. The SSD encouraged [Resident 1] to express her feelings and provided emotional support. The SSD explained that the concerns had been reported to the Housekeeping Supervisor and [HK 1] would receive one-on-one training on resident rights and customer service. Additionally, since [Resident 1] had verbalized that she does not want to see him [HK 1], [HK 1] would be reassigned and would no longer be present around [Resident 1's] room or area. [Resident 1] verbalized understanding and agreed with the plan, although she remained visibly upset and angry. When asked if there was anything else that could be done to assist her or make her feel better, the resident did not respond directly but stated, I'm just done with all this shit! I don't know who he thinks he is. I'm done with this place. The SSD encouraged [Resident 1] to continue expressing her feelings and suggested breathing exercises to help her calm down. The SSD also discussed available options and resources for returning to the community. The SSD noted that one-on-one visits would be provided as needed to support Resident 1's emotional and psychosocial well-being. During an (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 555839 If continuation sheet Page 2 of 5 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 555839 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Dreier's Nursing Care Center 1400 West Glenoaks Blvd Glendale, CA 91201 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 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few interview on 8/14/2025, at 1:52 PM, Resident 1 stated that on 8/12/2025, around 10 AM, Resident 1 had just gotten out of the shower. While she was changing and the curtains were closed, Resident 1 heard a knock on the door. Resident 1 stated she called out loudly, I am changing, do not enter. A few minutes later, a housekeeper (HK 1) entered the room, opened the curtain, and looked at her while she was naked. Resident 1 stated that she yelled at him (HK 1) to leave. Resident 1 further stated that a few minutes later (approximately five minutes), [HK 1] returned to the room, pretending he needed to retrieve an extension cord from the wall next to her bed. Resident 1 stated that again, [HK1] opened the curtain and looked at her while she was naked. Resident 1 reported that she informed the facility's social worker [SSD] of the incident within a few minutes and filed a grievance. During the same interview, on 8/14/2025, at 1:52 PM, Resident 1 stated that the next day, on 8/13/2025, when she returned to her room after walking with RNA 1, Resident 1 saw HK 1 mopping the floor inside her room. Resident 1 stated she did not enter the room because HK 1's presence made her uncomfortable. Resident 1 expressed feeling violated, humiliated, and ignored. Resident 1 stated that after reporting the incident, her concerns were dismissed, and she was told she would be transferred to another facility. Resident 1 stated she felt isolated, mistreated, and discriminated against in how her complaint was handled. During the interview, Resident 1 became emotional and began crying. During an interview on 8/14/2025, at 2:14 PM, the Social Services Director (SSD) stated that on 8/12/2025, around 10 AM, she went to Resident 1's room. The SSD reported that Resident 1 was angry because a housekeeper (HK 1) had entered her room on 8/12/2025 without permission while she was changing. The SSD stated that Resident 1 was angry and yelling. The SSD stated she attempted to provide emotional support but was not successful. The SSD stated that she reported the incident the same day to the Director of Nursing (DON) and the Housekeeping Supervisor. The SSD stated that Resident 1 remained angry and upset throughout the day, so she decided to give her space and not disturb her further. The SSD emphasized that staff should not enter any resident's room without permission, in order to respect their rights and dignity. During an interview on 8/14/2025, at 3 PM, RNA 1 stated that on 8/12/2025, at around 10 AM, she heard Resident 1 yelling and expressing anger. Resident 1 reported to her that a housekeeper (HK 1) had entered her room without permission while she was changing. RNA 1 stated that Resident 1 remained upset and angry throughout the day during her shift, from 10:00 AM to 3:00 PM. RNA 1 mentioned that she did not intervene because she saw the SSD and LVN 1 already present in Resident 1's room. RNA 1 further stated that on 8/13/2025, in front of Resident 1's room, Resident 1 observed HK 1 mopping the floor of Resident 1's room. Resident 1 asked HK 1 to dry the floor before she entered the room because the floor was wet. RNA 1 stated HK 1 did not respond and remained standing there, so CNA 4 dried the floor to allow Resident 1 to enter the room. RNA 1 stated that Resident 1 became very angry and upset upon seeing HK 1. During an interview on 8/15/2025, at 3:49 PM, with HK 1, HK 1 stated that he does not understand or speak English. When asked if he understood the phrase I am changing, do not enter the room, he responded that he did not understand. HK 1 stated that on 8/12/2025, at around 9 AM, he noticed that Resident 1 was lying in bed. Around 10:00 AM, he knocked on Resident 1's door. The curtains were closed, and he did not hear a response, so he entered the room. While mopping the floor, the dust pad hit Resident 1's bed. At that point, HK 1 stated he heard Resident 1 yelling. HK 1 stated that he did not understand what Resident 1 was saying, so he left the room. HK 1 further stated that he was not aware of the facility's policy regarding what to do if a resident does not respond after a knock on the door. During the same interview on 8/15/2025, at 3:49 PM, HK 1 stated that on 8/13/2025, while mopping the floor in Resident 1's room, Resident 1 was ambulating with RNA 1. HK 1 stated Resident 1 asked him to do something, but he did not understand. HK (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 555839 If continuation sheet Page 3 of 5 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 555839 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Dreier's Nursing Care Center 1400 West Glenoaks Blvd Glendale, CA 91201 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 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 1 stated, CNA 4 then dried the floor so Resident 1 could enter the room. HK 1 stated that on 8/13/2025, he received an in-service training instructing staff not to enter any resident's room without permission. HK 1 also stated that, as of the time of the interview, his assignment had not changed and he was still assigned to clean Resident 1's room. During an interview on 8/14/2025, at 4:38 PM, the DON stated that on 8/12/2025, around 10 AM, she heard Resident 1 yelling and appearing angry. The DON reported that the SSD informed her that Resident 1 had reported a housekeeper entered her room without permission while she was changing. The DON stated that she did not enter Resident 1's room or inquire further about the incident. She mentioned that throughout the day, she heard multiple instances of Resident 1 being angry. However, she did not speak with Resident 1 about the incident, as she was waiting for her (Resident 1) to calm down before initiating a conversation. The DON acknowledged that Resident 1's yelling and anger represented a change in condition, but staff did not initiate a care plan, complete an SBAR, or monitor Resident 1 for emotional distress. She also confirmed that no psychiatric evaluation was scheduled for the 8/12/2025 incident, and the physician was not notified. The DON stated that no in-service training was provided to housekeeping staff on 8/12/2025 because the training was conducted the following day by the Housekeeping Supervisor. The DON stated she was unsure whether the Housekeeping Supervisor had changed the housekeeper's assignment. The DON emphasized that staff should not enter any resident's room without permission, as it is essential to respect the resident's dignity and rights. The DON stated that she should have initiated a care plan, completed an SBAR, monitored Resident 1 for emotional distress, and provided emotional support on 8/12/ 2025. During an interview on 8/15/2025, at 10:03 AM, LVN 1 stated that she was assigned to Resident 1 on 8/12/2025. LVN 1 stated that sometime between 10 AM and 12 PM, she heard that Resident 1 was very angry and upset. LVN 1 stated that she was informed by the DON that HK 1 had entered Resident 1's room without permission while she was changing. During her shift from 10 AM to 3 PM, LVN 1 stated she observed that Resident 1 appeared upset. However, she did not ask about the reason and did not initiate a care plan or Change of Condition (COC) documentation, as she was under the impression that the DON had already completed the COC and addressed Resident 1's concerns. LVN 1 stated that there is no psychiatric evaluation scheduled for Resident 1 at this time. She added that if a resident is experiencing outbursts of anger or emotional distress, the facility should create a change in condition assessment, develop a care plan, and monitor the resident for emotional distress for 72 hours. LVN 1 stated that no care plan or COC was initiated for Resident 1 on 8/12/2025. During an interview on 8/15/2025, at 11:05 AM, the Housekeeping Supervisor stated that he was informed about the incident by the Social Services Director (SSD) on 8/12/2025. He was told that HK 1 had entered Resident 1's room without permission while she was changing. He stated that he provided in-service training to HK 1 on 8/13/2025. Despite this, HK 1 was assigned again to Resident 1's room on both 8/13/2025 and the afternoon of 8/14/2025. During an interview on 8/15/2025, at 12:28 PM, CNA 2 stated that she was assigned to Resident 1 on 8/12/2025, from 7 AM to 3 PM. Around 9:30 AM to 10 AM, she assisted Resident 1 with a shower and helped her return to her room. Later, between 10 AM and 10:30 AM, CNA 2 stated she heard Resident 1 yelling and noticed that she appeared upset. CNA 2 stated that Resident 1 reported to her that housekeeping had entered the room without permission while she was changing. CNA 2 added that Resident 1 remained very upset and angry for the rest of the day, from 10 AM to 3 PM on 8/12/2025. During a review of the facility's Policy and Procedure titled Dignity, revised February 2021, the P&P indicated that: Each resident shall be cared for in a manner that promotes and enhances their sense of well-being, satisfaction with life, and feelings of self-worth and self-esteem. Residents are to be treated with dignity and respect at all times. Staff are expected to knock (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 555839 If continuation sheet Page 4 of 5 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 555839 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/15/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Dreier's Nursing Care Center 1400 West Glenoaks Blvd Glendale, CA 91201 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 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete and request permission before entering a resident's room. During a review of the facility's Policy and Procedure titled Quality of Life - Accommodation of Needs, revised November 2010, the P&P indicated that the facility's environment and staff behaviors are directed toward assisting residents in maintaining and/or achieving independent functioning, dignity, and well-being. The P & P indicated to accommodate individual needs and preferences, staff attitudes and behaviors must support residents in maintaining independence, dignity, and well-being to the extent possible and in accordance with the residents' wishes. Staff shall interact with residents in a manner that accommodates their physical or sensory limitations, promotes communication, and preserves their dignity. During a review of the facility's Policy and Procedure titled Resident Rights, revised February 2021, it was indicated that:Employees shall treat all residents with kindness, respect, and dignity.Federal and state laws guarantee certain basic rights to all residents of this facility. These rights include the resident's right to:Be treated with respect, kindness, and dignity.Be free from abuse, neglect, misappropriation of property, and exploitation.Privacy and confidentiality.Voice grievances to the facility or to another agency that hears grievances, without discrimination, reprisal, or fear of retaliation.Have the facility respond to his or her grievances. During a review of the facility's document titled Job Description - Social Services, dated 2023, the P&P indicated that the duties and responsibilities of Social Services include:Assisting residents and their families with emotional problems, including anxieties and stress caused by illness and admission to the facility, difficulties coping with residual physical disabilities, fears related to helplessness and death, and the need for institutional and specialized care.Interpreting the social, psychological, and emotional needs of the resident and/or family to the medical staff, attending physician, and other members of the resident care team.Assisting in obtaining resources from community social, health, and welfare agencies to meet the needs of the resident.Providing consultation to staff members, community agencies, and others in efforts to address the needs and problems of residents through the development of social service programs.Demonstrating the ability to seek out new methods and principles and a willingness to incorporate them into existing social services. During a review of the facility's Policy and Procedure titled Care Plan, revised in March 2022, the P&P indicated that: A comprehensive, person-centered care plan that includes measurable objectives and timetables to meet the resident's physical, psychosocial, and functional needs is developed and implemented for each resident. The interdisciplinary team (IDT), in conjunction with the resident and his/her family or legal representative, develops and implements this care plan. The comprehensive, person-centered care plan:Includes measurable objectives and timeframes.Describes the services to be furnished in order to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being.Includes the resident's stated goals upon admission and desired outcomes.Builds on the resident's strengths.Reflects currently recognized standards of practice for identified problem areas and conditions.Services provided or arranged by the facility and outlined in the care plan must be delivered by qualified personnel. Care plan interventions are selected only after thorough data gathering, proper sequencing of events, careful consideration of the relationship between the resident's problem areas and their causes, and relevant clinical decision-making.Whenever possible, interventions should address the underlying source(s) of the problem areas, not just the symptoms or triggers. Resident assessments are ongoing, and care plans are revised as new information becomes available or as the resident's condition changes.The interdisciplinary team reviews and updates the care plan:When there has been a significant change in the resident's condition.When the desired outcome is not met. Event ID: Facility ID: 555839 If continuation sheet Page 5 of 5