Health inspection·December 9, 2025

F 0573 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Let each resident or the resident's legal representative access or purchase copies of all the resident's records. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to provide a copy of requested medical records to the legal representative for one of four sampled residents, (Resident 1), until 22 working days from the date facility received the written request.During record review of Resident 1's admission Record printed on 9/18/25 the record indicated Resident 1 was admitted to the facility on [DATE] and was discharged to an acute care hospital on 5/1/25.During concurrent interview and record review on 8/7/25 at 12:10 p.m. with the Director of Medical Records (DMR), medical record request for Resident 1 dated 5/22/25 and facility's document titled Records Release log dated May 2020 to August 2025 were reviewed. The medical record request indicated that Resident 1's legal representative requested the following medical records: medical records, billing records, photography, charts and writings relating to Resident 1, admission agreements reviews, utilization review committee records, x-rays. The Records Release log indicated the facility released all medical records including billing and therapy notes on 6/26/25. The DMR stated she had been working in her current position for more than a decade, and her understanding was the facility had 30 days to release the medical records from the date of the request. The DMR also stated she learnt about the timeline to process medical requests during an online training, but was unable to recall the name or date of the training.During an interview with the facility Administrator (ADM) on 8/7/25 at 12:35 p.m., ADM stated medical record requests were initially sent to facility's legal department for review. ADM stated legal review usually takes up to 24 hours and the records should be subsequently released within 48 hours of the request.During a review of facility's Policy and Procedures (P&P) titled Medical Record Request Policy, dated 1/2025, the P&P indicated .Upon legal approval, Medical Records staff may release the requested records in accordance with the minimum necessary standard. Page 1 of 3 056381 056381 12/09/2025 Delta View Post Acute 1210 A Street Antioch, CA 94509

F 0732 Post nurse staffing information every day. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to process a record request for Nurse Staff Data for one of four sampled residents, (Resident 1), when Resident 1's representative requested the above information. Nurse staffing data includes facility name, current date, total number of and actual hours worked by the licensed and unlicensed nursing staff directly responsible for resident care per shift including Registered Nurses, Licensed Vocational Nurses, Certified Nursing Assistants and resident census.This failure to provide requested Nurse Staff Data resulted in the requested data not being available to Resident 1's representative.During a record review of admission Record printed on 9/18/25, indicated Resident 1 was admitted to the facility on [DATE] and was discharged to an acute care hospital on 5/1/25.During a concurrent interview and record review on 8/7/25 at 12:10 p.m. with the Director of Medical Records, (DMR), facility's document titled Release of Record log dated May 2025 to August 2025 and Resident 1's representative's record request dated 5/28/25 were reviewed. The record request indicated the facility needed to release daily posted nurse staff data for each day of the 18 months prior to the date of the letter. Facility's log indicated facility received Resident 1's request on 5/28/25 and only released all medical records including billing and therapy notes on 6/26/25. The DMR stated the information request was forwarded to facility's Administrator, (ADM) and the facility legal team. The DMR stated she was not responsible to release facility's Nurse Staffing Data and hence she did not process the request.During an interview on 8/7/25 at 12:35 p.m. with the ADM he stated he was unaware of any requirements to release facility's Nurse Staffing Data information to the public unless requested by the court. The ADM stated no staffing or policy information had been released to the requester.During a review of facility's Policy and Procedures (P&P) titled Medical Record Request Policy dated 01/2025, the P&P indicated, All requests for medical records, whether verbal or written, must be immediately forwarded to the Medical Records department or designated staff. Requests may include subpoenas, court orders, attorney requests, insurance inquiries, or resident/personal representative requests. Residents Affected - Few 056381 Page 2 of 3 056381 12/09/2025 Delta View Post Acute 1210 A Street Antioch, CA 94509

F 0836 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed to be in compliance with the state regulation when they did not provide copies of facility's Policies and Procedures, (P&P), regulatorily required to govern the facility to one of four sampled residents, (Resident 1)'s legal representative upon written request.During a record review of admission Record printed on 9/18/25, indicated Resident 1 was admitted to the facility on [DATE] and was discharged to an acute care hospital on 5/1/25.During a concurrent interview and record review on 8/7/25 at 12:10 p.m. with the Director of Medical Records, (DMR), facility's document titled Release of Record log dated May 2025 to August 2025 and Resident 1's legal representative's record request dated 5/28/25 were reviewed. The record request indicated the facility needed to release, all policies and procedures required by Title 22 California code of Regulations section 72523 including written administrative, management and personnel and patient care policies. The DMR stated the request was forwarded to facility's Administrator, (ADM), and facility's legal team upon receipt. The DMR stated she did not process the request for policy information.During an interview with the facility's ADM on 8/7/25 at 12:35 p.m. the ADM stated was unaware of any requirements to release facility's P&P to the public unless request came from the court. The ADM stated facility had not released any P&P to Resident 1's legal representative.During a review of facility's Policy and Procedures titled Medical Record Request Policy, dated 1/2025, indicated, .All requests for medical records, whether verbal or written, must be immediately forwarded to the Medical Records department or designated staff. Requests may include subpoenas, court orders, attorney requests, insurance inquiries, or resident/personal representative requests. 056381 Page 3 of 3