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Complaint Investigation

Pleasant Hill Post Acute

August 15, 2025 · Pleasant Hill, CA · 1625 Oak Park Boulevard
Citations 14
CMS Rating 4/5
Beds 51
Provider ID 055049
Healthcare Facility
Pleasant Hill Post Acute
Pleasant Hill, CA  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

PLEASANT HILL POST ACUTE in PLEASANT HILL, CA — inspection on August 15, 2025.

Found 14 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF0573
Resident Rights Deficiencies

release of his requested records. MRD was advised to provide the resident DCTM 2's contact number

emailed DCTM 1, who responded on the same day to resident's call, confirmed and clarified specific

DCTM 1 sent Resident 63 a hard copy of all his requested medical records. A review of the facility policy and procedure (P&P) titled, Access to Personal and Medical Records, revised date May 2023, indicated, Each resident has the right to access and/or obtain copies of his or her personal and medical records upon request. A resident may submit his/her request either orally or in writing for access to personal or medical information pertaining to him/her.

The information will be provided in the form and format requested by the resident as long as the records are available in that format. If the format requested by the resident is not available, then the records will be provided in a form and format agreed to by the resident.

The resident may obtain a copy of his or her personal or medical record within two business days of an oral or written request .

055049 08/15/2025

Pleasant Hill Post Acute 1625 Oak Park Boulevard Pleasant Hill, CA 94523

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0578 during a standard health inspection conducted on 2025-08-15.

Category: Resident Rights Deficiencies

The facility was found deficient in the following area: Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0636 during a standard health inspection conducted on 2025-08-15.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0638 during a standard health inspection conducted on 2025-08-15.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Assure that each resident’s assessment is updated at least once every 3 months.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0658 during a standard health inspection conducted on 2025-08-15.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Ensure services provided by the nursing facility meet professional standards of quality.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0679 during a standard health inspection conducted on 2025-08-15.

Category: Quality of Life and Care Deficiencies

The facility was found deficient in the following area: Provide activities to meet all resident's needs.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

discrepancies/conflicts.According to the National Library of Medicine, undated, Medication

duplications, dosing errors, or drug interactions. It should be done at every transition of care in which

five steps: (1) develop a list of current medications; (2) develop a list of medications to be prescribed; (3) compare the medications on the two lists; (4) make clinical decisions based on the comparison; and (5) communicate the new list to appropriate caregivers and to the patient.https://www.ncbi.nlm.nih.gov/

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0759 during a standard health inspection conducted on 2025-08-15.

Category: Pharmacy Service Deficiencies

The facility was found deficient in the following area: Ensure medication error rates are not 5 percent or greater.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0760 during a standard health inspection conducted on 2025-08-15.

Category: Pharmacy Service Deficiencies

The facility was found deficient in the following area: Ensure that residents are free from significant medication errors.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0812 during a standard health inspection conducted on 2025-08-15.

Category: Nutrition and Dietary Deficiencies

The facility was found deficient in the following area: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0813 during a standard health inspection conducted on 2025-08-15.

Category: Nutrition and Dietary Deficiencies

The facility was found deficient in the following area: Have a policy regarding use and storage of foods brought to residents by family and other visitors.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0880 during a standard health inspection conducted on 2025-08-15.

Category: Infection Control Deficiencies

The facility was found deficient in the following area: Provide and implement an infection prevention and control program.

Scope/Severity Level E: pattern, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0912 during a standard health inspection conducted on 2025-08-15.

Category: Environmental Deficiencies

The facility was found deficient in the following area: Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.

Scope/Severity Level B: isolated, no actual harm with potential for minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Federal health inspectors cited PLEASANT HILL POST ACUTE in PLEASANT HILL, CA for a deficiency under regulatory tag F-F0919 during a standard health inspection conducted on 2025-08-15.

Category: Environmental Deficiencies

The facility was found deficient in the following area: Make sure that a working call system is available in each resident's bathroom and bathing area.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 14 deficiencies cited during this inspection of PLEASANT HILL POST ACUTE.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-09-23.

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in PLEASANT HILL, CA, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from PLEASANT HILL POST ACUTE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.