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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 415601140
Report Date: 09/04/2024
Date Signed: 09/04/2024 09:05:32 AM


Document Has Been Signed on 09/04/2024 09:05 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
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:HOPKINS MANORFACILITY NUMBER:
415601140
ADMINISTRATOR:RICARDO ABANFACILITY TYPE:
740
ADDRESS:1235 HOPKINS AVETELEPHONE:
(510) 390-8078
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94062
CAPACITY:88CENSUS: 81DATE:
09/04/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:42 AM
MET WITH:Quennie Ramos, Medtech and Caregiver and Susan Roquel, HR Manager, and Ricardo Aban, Executive DirectorTIME COMPLETED:
09:15 AM
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On September 4, 2024, Licensing Program Analysts(LPAs) John Calandra and Kiran Jain arrived at the facility to deliver an Amended report that was written on August 1, 2024. LPAs Calandra and Jain were greeted by Quennie Ramos, Medtech and Caregiver. Susan Roquel, HR Manager and Ricardo Aban, Executive Director joined the visit later.

An exit interview was conducted. This report was reviewed with Susan Roquel, HR Manager and a copy of the report left at the facility.
SUPERVISOR'S NAME: Andrea MedlinTELEPHONE: (650) 266-8811
LICENSING EVALUATOR NAME: John CalandraTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/04/2024
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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