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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 385601045
Report Date: 04/24/2025
Date Signed: 04/24/2025 01:55:55 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/05/2024 and conducted by Evaluator Yi Sam Jian
COMPLAINT CONTROL NUMBER: 14-AS-20241205100317
FACILITY NAME:PORTOLA GARDENSFACILITY NUMBER:
385601045
ADMINISTRATOR:GREGORY K BOGARTFACILITY TYPE:
740
ADDRESS:350 UNIVERSITY STTELEPHONE:
(415) 337-1587
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY:104CENSUS: 92DATE:
04/24/2025
UNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Greg BogartTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff engaged in inappropriate sexual behavior in resident's room.
Facility staff are not meeting resident's hygiene needs.
INVESTIGATION FINDINGS:
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On 04/24/2025, Licensed Program Analyst (LPA) Yi Sam Jian arrived at the facility to deliver an amended copy of LIC9099. LPA met with administrator Greg Bogart and explained the purpose of the visit.
Regarding the allegation that Staff engaged in inappropriate behavior in resident's room, the department was provided with video evidence showing a female staff lowering her pant in the presence of a male staff while inside the resident’s room. Regarding the allegation that facility staff was not meeting the resident’s hygiene needs: The Service Plan dated 12/06/2024 indicates that the resident was to receive full assistance with bathing on a daily basis. No shower assistance was logged on 12/06/2024-12/07/2024.
Based on interviews and document review during the course of the investigation, the department determined that the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. The deficiency is cited in accordance with California Code of Regulations, Title 22 Division 6, Chapter 8 and is noted on the attached LIC 9099-D.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: April CowanTELEPHONE: (650) 416-9499
LICENSING EVALUATOR NAME: Yi Sam JianTELEPHONE: 916-268-3959
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 14-AS-20241205100317
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PORTOLA GARDENS
FACILITY NUMBER: 385601045
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/25/2025
Section Cited
CCR
87468.1(a)(1)
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7
Personal Rights requirement: Residents in all residential care facilities for the elderly shall…be accorded dignity in their personal relationships with staff
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The Licensee/Administrator shall develop and implement a plan to ensure that staff do not engage in inappropriate conduct in resident’s room. A copy of the plan must be submitted to CCL by 04/25/2025. Failure to correct this deficiency by due date may result in a civil penalty
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This requirement is not met as evidenced by: Based on video evidence showing two staffs engaging in inappropriate conduct inside the resident’s room. This serious violation poses an immediate health and safety risk to residents in care.
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Type B
04/29/2025
Section Cited
CCR
87468(a)(4)
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Personal rights requirement: To care, supervision, and services that meet their individual needs
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Administrator agreed to submit proof of correction with a written plan outlining how this violation will be avoided in the future to licensing office by 04/29/2025. Failure to correct this deficiency by due date may result in a civil penalty.
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This requirement was not met, as evidenced by file reviews and interviews indicating that the documentation in the shower log was inconsistent with the bathing schedule outlined in the Service Plan. This violation poses a potential health, safety or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: April CowanTELEPHONE: (650) 416-9499
LICENSING EVALUATOR NAME: Yi Sam JianTELEPHONE: 916-268-3959
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/05/2024 and conducted by Evaluator Yi Sam Jian
COMPLAINT CONTROL NUMBER: 14-AS-20241205100317

FACILITY NAME:PORTOLA GARDENSFACILITY NUMBER:
385601045
ADMINISTRATOR:GREGORY K BOGARTFACILITY TYPE:
740
ADDRESS:350 UNIVERSITY STTELEPHONE:
(415) 337-1587
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY:104CENSUS: 92DATE:
04/24/2025
UNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Greg BogartTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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2
3
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9
Facility staff are not safeguarding resident's belongings.
Facility staff are not preventing the facility from being malodorous.
INVESTIGATION FINDINGS:
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Regarding the allegation that facility staff are not safeguarding resident's belongings, interviews and file reviews revealed that the facility has procedures in place for labeling personal items and safeguarding belongings. The facility has a process for reimbursing or replacing lost items. Facility provided receipt of payment for loss of personal belongings.
Regarding the allegation that facility staff are not preventing the facility from being malodorous, interview and facility tour by the LPA confirmed that the facility follows a regular cleaning schedule and maintains acceptable cleanliness standards.
The Department has investigated the above allegations. The allegations are UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: April CowanTELEPHONE: (650) 416-9499
LICENSING EVALUATOR NAME: Yi Sam JianTELEPHONE: 916-268-3959
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3