415601140-3-20-2024-14-AS-KHOS-D3QGP8-20240326053043

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 415601140
Report Date: 03/20/2024
Date Signed: 03/20/2024 03:33:00 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
01/12/2024 and conducted by Evaluator Jaime Vado

PUBLIC

COMPLAINT CONTROL NUMBER: 14-AS-20240112085327

FACILITY NAME:	HOPKINS MANOR		FACILITY NUMBER:	415601140
ADMINISTRATOR:	WU, LULIN		FACILITY TYPE:	740
ADDRESS:	1235 HOPKINS AVE		TELEPHONE:	(510) 390-8078
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94062
CAPACITY:	88	CENSUS: 76	DATE:	03/20/2024
		UNANNOUNCED	TIME BEGAN:	02:55 PM
MET WITH:	Administrator - Ricardo Aban		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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- Facility is unsanitary
- Facility is unkempt
- Facility staff does not ensure the facility is free of hazards

INVESTIGATION FINDINGS:

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On 03/20/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced complaint investigation visit to deliver findings regarding the allegations received. LPA met with the administrator Ricardo Aban.

During the investigation LPA conducted interviews and made facility observations. LPA observed the kitchen area during a meal time, and after, and there were no observations of rodents, or other pests. The facility is contracted with a pest control company regularly who visit twice a month going back several years as a precaution to prevent any pests or rodents. LPA observed the way excess meals are stored for residents as covered and labled with names. Bathrooms were inspected and did not see it as unkempt. Interviews show that there is a cleaning schedule in place and LPA observed staff cleaning the kitchen post lunch being served and there are janitor services in place. In regards to the facility free of hazards, it was referenced that there was construction and maintenance. LPA observed outside area under maintenance as being roped off with yellow caution tape and two contractors were in the area. The tools and supplies were pushed to the sides and out of residents way. Construction materials were observed as well stored under a sheltered area along the sides of the facility out of walkways. These allegations are unsubstantiated based on observations and interviews conducted.

Based on these observations, the above allegations are UNSUBSTANTIATED.
Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are unsubstantiated at this time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: April Cowan	TELEPHONE: (650) 266-8865
LICENSING EVALUATOR NAME: Jaime Vado	TELEPHONE: (559) 476-9353
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024

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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