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Inspection visit

Routine inspection

PORTOLA PLACELicense 4156010586 citations on this visit
6 citations recorded

Inspector’s narrative

What the inspector wrote

On 09/15/2025, Licensing Program Analyst (LPA) Vado Jaime Vado conducted an unannounced annual required inspection visit. LPA met with the licensee Armand Atienza and explained the purpose of today's visit. There are 2 caregivers in the facility and 4 residents present. This is a two level facility licensed for residents age range of 60 years and over all of which may be non-ambulatory. License is approved for 3 hospice residents. There are 2 hospice residents as of today's inspection visit. The second level of the facility is occupied by private renters. The access door to the second floor is secured so those renters cannot enter the facility. There is a separate entrance for that second floor unit located near the garage of the facility. The physical plant was toured inside and outside of the facility to ensure the safety of the residents. There are no video cameras on site per the caregivers. LPA observed the facility kitchen which is in good repair. Knives are stored and locked per observation made. Perishable and non-perishable food supply in place. There is an additional refrigerator/ freezer in the garage area which carries additional food supplies for resident use. Refrigerator was observed to not meet regulatory standard in terms of cleanliness. Storage shelves and drawers were observed to be sticky and dirty, sticky, needing to be cleaned. Expired food items were observed such as sauces and milk were observed. Also it was observed the facility used of other food containers to store foods that were not intended to be in those containers that were originally for miso dressing and two containers of potato salads. Uncovered vegetables and fruits were also observed. Also in the garage is the laundry area and where the cleaning supplies are primarily stored. LPA also observed cleaning supplies locked beneath the kitchen sink. Continued on next... Page 2 First aid kit is observed as complete with required items stored in the kitchen of the facility. Medications are observed to be locked in the kitchen in a kitchen cabinet adjacent to the refrigerator. LPA observed at least one fire extinguisher in place which are currently within operating range, smoke detector, carbon monoxide detectors are observed in place through out the facility, and central heating. Inspection tag for the extinguisher indicates it was checked on 07/18/2025. Facility is not equipped with fire sprinklers. LPA also observed fire pull stations in the rear and front of the facility. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Water temperature is measured at 121F and increasing during today's inspection. The temperature was adjusted during today's visit and is remeasured at 105F. Also observed in the bathroom is a common hand towel for resident use to use for drying of hands. LPA provided advisory notice that such should not be in place for resident use in order to prevent the spread of illness and other reasons. Linen supplies are observed as in place in a hallway closet. LPA observed all resident rooms as clean, free of odors, and contained all the required furniture per regulatory recommendations. Resident bathrooms are observed as clean and in good worker order. Shower floor is equipped with non-skid mat for resident use. Medications and logs are observed today as current. During today's inspection LPA reviewed 4 resident files. R1 physician's report is not current to within one year and has a dementia diagnosis and there was no other evidence on file reflecting an annual medical visit being conducted but was informed that R1 did have a medical visit and will submit evidence of the visit. Staff files are reviewed and are current. Administrator certificate is observed to be current expiring 06/16/2026. The following updated forms are requested to be submitted to CCLD by 09/22/2025 : • Copy of updated administrator certificate • LIC308 Designation of responsible staff person • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule Report is reviewed with Armand and a copy of the report is provided. Citations are issued on this day on the attached LIC809D pages.

Citations

6 citations recorded*CCLD

What does Type A vs Type B mean?

Type A. Serious citation. Imminent or substantial risk to children. The regulator requires corrective action immediately and may impose a civil penalty.

Type B. Lower-severity citation. Corrective action required, no imminent risk. The regulator monitors compliance on the next visit.

  • 87303(a)Type B

    Maintain facility in clean, safe, sanitary condition

    87303(a) Maintenance and Operation - The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This regulation has not been met as evidenced by: Based on obseravtions made of the refrigerator in the main kitchen, LPA found that the shelves, storage drawers, and storage areas of the refrigerator as dirty, sticky, and needed to be cleaned. This poses as a potential health and safety risk for residents in care.

  • 87303(e)(2)Type A

    Provide resident hot water for personal care

    87303(e)(2) Maintenance and Operation - Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This regulation has not been met as evidenced by: Based on facility observations made during water temperature testing, LPA found that the water temperature in the common bathroom for the facility, the water temerature was tested at 121F and increasing. This poses an immediate health and safety risk to residents in care.

  • 87463(h)Type B

    Annual routine visit with medical professional

    87463(h) - Reappraisals -The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. This regulation has not been met as evidenced by: Based on resident files reviewed, R1's last doctor visit notated on the physician's report is 06/03/2024, which does not meet the annual routine medial visit as outlined in this regulation. This poses an immediate heatlh and safety risk to residents in care.

  • 87465(i)Type A

    Dispose of unused medications with required witness

    87465(i) Incidental Medical and Dental Care - Prescription medications which are not taken with the resident upon termination of services, not returned to the issuing pharmacy, nor retained in the facility as ordered by the resident’s physician and documented in the resident’s record nor disposed of according to the hospice’s established procedures or which are otherwise to be disposed of shall be destroyed in the facility by the facility administrator and one other adult who is not a resident. This regulation has not been met as evidenced by: Based on facility ovservations made, LPA Vado found medications from a prefious resident was not destroyed properly and was being stored in the facility's refrigerator in the main kitchen. This poses an immediate health and safety risk to residents in care.

    Read full inspector narrative
  • 87555(23)Type B

    87555(23) General Food Service Requirements - All readily perishable foods or beverages capable of supporting rapid and progressive growth of micro-organisms which can cause food infections or food intoxications shall be stored in covered containers at appropriate temperatures. This regulation has not been met as evidenced by: Based on observations made of the facility refrigerators, LPA observed uncovered fresh foods such as cantalope, celery, onions, and other fresh vegetables were not covered appropriately. This poses an immediate health and safety risk to residents in care.

  • 87555(b)(8)Type A

    Food quality controls and rejected damaged goods

    87555(b)(8) General Food Service Requirements - All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. This regulation has not been met as evidenced by: Based on observations made of the items in the facility refrigerator in the main kitchen, LPA found several expired items such as milk, barbecue sauce, and other items with past best use by dates. Additionally, LPA observed vegetable with mold and the reusing of containters that were for miso dressing and potato salad to store other food items hat were not originally in those containers. This poses an immediate health and safety risk to residents in care.

FAQ · About this visit

Common questions about this visit

What happened during the September 15, 2025 inspection of PORTOLA PLACE?

This was an inspection of PORTOLA PLACE on September 15, 2025. 6 citations were issued: 3 Type A (serious) and 3 Type B.

Were any citations issued to PORTOLA PLACE on September 15, 2025?

Yes, 6 citations were issued (3 Type A, 3 Type B). The first citation was for: "87303(a) Maintenance and Operation - The facility shall be clean, safe, sanitary and in good repair at all times. Maint..."

What type of inspection was this?

This was an inspection. Inspections are conducted by CCLD as part of their licensing oversight.

SourceView on CCLDView original report

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Data from CCLD public records. Last updated . If you believe any information is inaccurate, report it here.