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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415600927
Report Date: 05/02/2022
Date Signed: 05/03/2022 09:49:51 AM


Document Has Been Signed on 05/03/2022 09:49 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:HOPKINS MANOR PACIFIC CORPORATIONFACILITY NUMBER:
415600927
ADMINISTRATOR:ABAN, RICARDOFACILITY TYPE:
740
ADDRESS:1235 HOPKINS AVENUETELEPHONE:
(650) 368-5656
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94062
CAPACITY:88CENSUS: DATE:
05/02/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Travis Wyckoff and Jay RockeyTIME COMPLETED:
02:45 PM
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On this day at 1400 hours, Regional Manager (RM) VIvien Helbling, Licensing Program Manager (LPM) Julio Montes, Licensing Program Analyst (LPA) Jaime Vado met with Property Owner, Wendy Wong, Application Consultant, Laura Farrall, Attorney's Joel Goldman, Jay Rockey, Jake Reinhardt, and Licensee Travis Wyckoff. Due to technical difficulties Travis and Jay attended via telephone. This meeting was primarily conducted on Microsoft Teams.

The purpose of today's meeting is to discuss the status of the license and application status regarding the change of management and change of ownership. It was discussed that the property owners, Wendy Wong and Olive Manalastas, do have stipulation orders in place that limit their abilities to apply for a new facility/and or apply as a management company. Further details are needed to be reviewed regarding their ability to apply as the management company for the facility. As of now due to these discoveries those applications will be on hold. Due to this it is discussed that the operations of the facility is expected to be continued under the current licensee Travis Wyckoff. Due to the property being owned by Wendy and Olive, and the facility remaining licensed by Travis at this time, they are requested to work together and develop a plan on how both parties will work keep the facility in operation within Title 22 regulations. It is also discussed that the facility still needs to provide a proper 60 closure notice due to the change in facility status as the intention of the facility is to close under the current license and a new license is in the process of being approved. The intent of the notice to to provide the notice to the Department and the families of this change in the license. Lastly, it is requested that the lease back agreement is to be received. These plans are expected to be provided to the Department by Wednesday May 4, 2022.

This meeting concluded with no citations issued at this time.
SUPERVISOR'S NAME: Julio MontesTELEPHONE: (650) 266-8811
LICENSING EVALUATOR NAME: Jaime VadoTELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:
DATE: 05/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/02/2022
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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