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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 385601045
Report Date: 07/18/2025
Date Signed: 07/18/2025 11:50:13 AM

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
05/02/2025 and conducted by Evaluator Yi Sam Jian
COMPLAINT CONTROL NUMBER: 14-AS-20250502104955
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: DATE:
07/18/2025
UNANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:Gregory BogartTIME COMPLETED:
12:14 PM
ALLEGATION(S):
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-Resident was not accorded dignity in their relationship with staff and other residents
INVESTIGATION FINDINGS:
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On 07/18/2025 Licensing Program Analysts (LPAs) Yi Sam Jian met with staffing coordinator, Lea Salazar, to conduct a complaint investigation. Purpose of visit explained. Administrator, Gregory Bogart arrived later during the visit. LPA gathered information relevant to allegations. LPA conducted staff interviews.

Regarding the allegation that Resident was not accorded dignity in their relationship with staff and other residents, multiple staff confirmed the comment was made and found it inappropriate. Staff's comment and lack of understanding regarding resident dignity and privacy policies constitute a violation of residents’ personal rights. Based on interviews and file reviews during the course of the investigation it was determined that the preponderance of evidence standard has been met, therefore the allegations above 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. Report is reviewed with administrator and a copy is provided.
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: 07/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025
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-20250502104955
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: 07/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/28/2025
Section Cited
CCR
87468.1(a)(1)
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Personal Rights requirement: Residents in all residential care facilities for the elderly shall…be accorded dignity in their personal relationships with staff, residents
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The Administrator shall develop and implement a plan to ensure all staff fully understand and uphold residents’ right to dignity in interactions with staff and resident. A copy must be submitted to CCL by the POC due date. Failure to comply may result in a civil penalty.
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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: 07/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025
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
05/02/2025 and conducted by Evaluator Yi Sam Jian
COMPLAINT CONTROL NUMBER: 14-AS-20250502104955

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: DATE:
07/18/2025
UNANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:Gregory BogartTIME COMPLETED:
12:14 PM
ALLEGATION(S):
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Resident was denied the rights to file a complaint
INVESTIGATION FINDINGS:
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Regarding the allegation that a resident was denied the right to file a complaint, resident interviews revealed no instances where residents were prevented from exercising this right.

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: 07/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025
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