385601045-11-4-2025-14-AS-BCHN-DP23MT-20251203172248

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 385601045
Report Date: 09/05/2025
Date Signed: 11/04/2025 03:09:51 PM

Unsubstantiated

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
04/30/2025 and conducted by Evaluator Yi Sam Jian

COMPLAINT CONTROL NUMBER: 14-AS-20250430161305

FACILITY NAME:	PORTOLA GARDENS		FACILITY NUMBER:	385601045
ADMINISTRATOR:	GREGORY K BOGART		FACILITY TYPE:	740
ADDRESS:	350 UNIVERSITY ST		TELEPHONE:	(415) 337-1587
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94134
CAPACITY:	104	CENSUS: 97	DATE:	09/05/2025
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Gregory Bogart		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

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- Staff are not meeting resident's medical needs.
- Staff isolates resident.
- Resident is not provided with adequate dining accommodations.

INVESTIGATION FINDINGS:

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THIS IS AN AMENDED REPORT FROM AN ORIGINAL REPORT DATED 09/05/2025.

On 11/04/2025, Licensed Program Analyst (LPA) Yi Sam Jian arrived at the facility to deliver an amended copy of LIC9099. LPA met with administrator Gregory Bogart and explained the purpose of the visit.

During the visit on 09/05/2025, LPA interviewed R1’s emergency contact, and collected documents. Regarding the allegation that the staff are not meeting resident's medical needs. Interviews with both the R1 and R1’s personal friend revealed conflicting and contradictory informations, indicating that the reported issues were related to an external medical center and a different facility, not the current facility.
Continued onto LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Yi Sam Jian
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 14-AS-20250430161305

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
	VISIT DATE: 09/05/2025

NARRATIVE

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THIS IS AN AMENDED REPORT FROM AN ORIGINAL REPORT DATED 09/05/2025.

Regarding the allegation that the staff isolate resident, during the investigation, interviews with multiple residents provided statements that contradicted this allegation. Residents interviewed reported that they were free to socialize, participate in communal activities, and dine with others without restriction. No reported incident of resident experiencing or observing any form of intentional isolation by staff. Observations conducted during the visit did not reveal any evidence of inappropriate seclusion. Facility staff reported that meals may occasionally be served in residents’ rooms based on medical needs or personal preference, but there is no policy or practice of isolating residents.

Regarding the allegation that the Resident is not provided with adequate dining accommodations, interviews conducted with multiple residents revealed statements that contradicted this allegation. Residents interviewed expressed satisfaction with the dining services, including food quality, accessibility, and the overall dining experience. LPA observed the dining area and found it to be clean, organized, and appropriately set up for resident use.

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. Report is reviewed with administrator and a copy is provided.

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Yi Sam Jian
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2025

LIC9099 (FAS) - (06/04)

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