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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 385601045
Report Date: 01/07/2025
Date Signed: 01/07/2025 12:45:12 PM

Document Has Been Signed on 01/07/2025 12:45 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:PORTOLA GARDENSFACILITY NUMBER:
385601045
ADMINISTRATOR/
DIRECTOR:
GREGORY K BOGARTFACILITY TYPE:
740
ADDRESS:350 UNIVERSITY STTELEPHONE:
(415) 337-1587
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY: 104CENSUS: 91DATE:
01/07/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:36 AM
MET WITH:Greg Bogart, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 1/7/2025, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of conducting a case management to follow up on multiple changes within the facility, including an increase in capacity request and a change of license. LPA was greeted by Executive Director, Greg Bogart. LPA and staff toured the facility and inspected resident bedrooms pertaining to the capacity increase request. There are currently 91 residents residing in the facility which is within the current capacity. LPA confirmed count on resident census documentation. The facility's request is to update several bedrooms on the second floor to house ambulatory residents and allow additional double occupancy bedrooms. LPA inspected the non-ambulatory and bedridden portions of the facility and found no concerns or over capacity.

San Francisco Fire Department is scheduled to conduct a fire inspection on 1/8/2025. Four rooms currently used as offices and storage space will be converted back into resident use if fire clearance is approved. Additional licensing inspection may follow to confirm resident room accommodation requirements are met. Executive Director will contact LPA upon completion and the fire inspection clearance report to be provided.

LPA and Executive Director discussed the plans for change of ownership and sale of the facility. Executive Director stated that the facility is in the process but has not finalized the sale. LPA was provided a copy of the notification letter sent out to residents and families dated 11/29/2024. The letter indicates that the change of ownership will occur on or around 12/31/2024. LPA requested for documentation of the company having notified Community Care Licensing of the intent to change ownership/sell the facility. LPA to conduct follow up visit once documentation is received.

No deficiencies cited during visit.
SUPERVISORS NAME: Andrea Medlin
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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