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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306003069
Report Date: 11/01/2024
Date Signed: 11/01/2024 11:13:51 AM

Document Has Been Signed on 11/01/2024 11:13 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:PUNZALAN HOMES,INC.FACILITY NUMBER:
306003069
ADMINISTRATOR/
DIRECTOR:		ED/LINDA PUNZALANFACILITY TYPE:
735
ADDRESS:3111 W. DEL MONTE DRIVETELEPHONE:
(714) 535-2407
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 6CENSUS: 6DATE:
11/01/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Nancy Orcino, AdministratorTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry at 8:00 AM by Nancy Orcino, Administrator.

The facility is a six bedroom, three bathroom, level 4g single story building with an approved fire clearance of four ambulatory and two non-ambulatory clients. The facility currently has a census of six clients in care. LPA observed the Orange County Transportation Authority (OCTA) transport a client to Adult Day Program (ADP) at 8:00 AM.

During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperatures in three of three client bathrooms, and testing auditory devices on all exits. There is large outdoor covered patio area with treadmills and all gates were self-closing. The hot water temperatures measured between 109.4 and 110.3 degrees Fahrenheit and smoke and carbon monoxide detectors were operational. The fire extinguisher is charged and was serviced on July 21, 2024. The facility’s last fire drill was conducted on July 8, 2024. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage and reviewed the centrally stored medications. Per review medications are being given as prescribed.

LPA reviewed three of three staff training and fingerprint records and conducted a complete review of client records. Client P&I records were reviewed and were accurate. LPA interviewed alert clients regarding their quality of care and spoke to staff present regarding care provided. At 9:45 AM Clients were observed doing chair exercises in the living room with staff. LPA confirmed that administrator has a current administrator certificate which expires on March 19, 2026.
(Continued on LIC 809-C)
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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,INC.
FACILITY NUMBER: 306003069
VISIT DATE: 11/01/2024
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(Continued from LIC 809)

Licensee had Regional Center Admissions Agreements on file but will need to create Admissions Agreements to comply with Title 22 Regulations for Community Care Licensing. LPA explained this to Administrator and advised for all of the homes to do this under this Licensee.

Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiencies cited on this date. An exit interview was conducted with Nancy Orcino, Administrator and a copy of the report and files reviewed (LIC 858 & LIC 859) and LIC 9102-TV were given at the time of the visit.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2024
LIC809 (FAS) - (06/04)
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