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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306002361
Report Date: 02/11/2025
Date Signed: 02/11/2025 01:31:32 PM

Document Has Been Signed on 02/11/2025 01:31 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:PUNZALAN HOMES INCFACILITY NUMBER:
306002361
ADMINISTRATOR/
DIRECTOR:		ERLINDA S. PUNZALANFACILITY TYPE:
735
ADDRESS:2655 W. ROME AVENUETELEPHONE:
(714) 821-5677
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 6CENSUS: 3DATE:
02/11/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Annie Lorenzo, Administrator Designee (AD)TIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Rose Ruppert made an unannounced Case Management and Plan of Correction Visit for an annual conducted on February 3, 2025. LPA was greeted and granted entry and met with Administrator Designee (AD) Annie Lorenzo.

LPA observed that the three of three medication cabinets had newly installed locks and were secured. LPA cleared this deficiency.

LPA also amended the LIC 809-D to reflect the Plan of Correction (POC) for PRN administration and documentation. LPA spoke with Administrator, Melissa Punzalan via phone to provide a staff in-service training on Medication and PRN administration and documentation. LPA has requested documentation be emailed by the Plan of Correction date of February 18, 2025.

An exit interview was conducted with Annie Lorenzo, Administrator Designee and a copy of the report, the amended LIC 809-D and the Cleared Plan of Correction letter for the medication locks were given at the time of the visit.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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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