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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003069
Report Date: 10/26/2022
Date Signed: 10/26/2022 04:23:47 PM

Document Has Been Signed on 10/26/2022 04:23 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
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:PUNZALAN HOMES,INC.FACILITY NUMBER:
306003069
ADMINISTRATOR:ED/LINDA PUNZALANFACILITY TYPE:
735
ADDRESS:3111 W. DEL MONTE DRIVETELEPHONE:
(714) 535-2407
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 6CENSUS: 6DATE:
10/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Linda PunzalanTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA was screened for symptoms of Covid-19 and granted entry. LPA met with Administrator Linda Punzalan, her Administrator's certificate expires on 12/2/2022. LPA explained the reason for the visit. LPA and Administrator toured the facility. Facility has 7 bedrooms (1 is for staff), 3 bathrooms (1 is for staff), living room, dining room and a 2 car detached garage. The garage is kept locked and inaccessible to clients. The garage is used to store supplies. LPA observed the kitchen is clean and organized. LPA observed a 2 day perishable and a 7 day nonperishable food supply on hand. LPA observed the ktichen stove lights unassisted. Knives and sharp objects are kept locked in a kitchen drawer. Cleaning supplies are kept locked under the kitchen sink. LPA observed medications are kept locked in a kitchen cabinet. The fire extinguisher in the kitchen is fully charged. LPA observed both bathrooms are clean and operational. Hot water measured 104.1 degrees Fahrenheit in both bathrooms. Hot water temperature was adjusted during the visit. LPA inspected the client rooms. All client rooms had the required furnishings, bed linens and storage space. LPA inspected the first aid kit and it contained all the required items. Smoke detectors and carbon monoxide detects tested operational. LPA observed the fireplace in the living room is screened and inaccessible to clients. No obstacles or hazards observed inside of the facility. LPA and Administrator toured the backyard. There is a covered patio with tables and chairs for the clients to sit outside. No bodies of water observed. The exit gates on each side of the house are operational. No obstacles or hazards observed in the backyard. LPA consulted with the Administrator concerning continued Covid-19 mitigation and reporting requirements. No deficiencies observed during the visit. No deficiencies are being cited as a result of this visit. An exit interview was conducted and a copy of the report provided.
SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2022
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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