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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306004663
Report Date: 01/17/2025
Date Signed: 01/17/2025 11:52:29 AM

Document Has Been Signed on 01/17/2025 11:52 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 HOMESFACILITY NUMBER:
306004663
ADMINISTRATOR/
DIRECTOR:		ERLINDA S. PUNZALANFACILITY TYPE:
735
ADDRESS:719 ROANNE STREET, N.TELEPHONE:
(714) 220-2528
CITY:ANAHEIMSTATE: CAZIP CODE:
92801
CAPACITY: 6CENSUS: 4DATE:
01/17/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH: Carlos TiquiaTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Samer Haddadin. made an unannounced visit for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into facility by DSP Carlos Tiquia. AD Nikki Jay along with Mellisa Tyndall joined the inspection shortly after.

The facility is a one-story home with six client bedrooms, two bathrooms, kitchen, dining room, living room, backyard and attached 2-car garage. The garage is used as storage area. LPA observed emergency supplies and water in the garage. The facility has four clients total in which two were present and two were away at day program.

LPA observed smoke detectors/carbon monoxide in common areas and bedrooms; all were tested and operational. Client bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each client comfortably. Client bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, and shower was free of mold/mildew.

Water temperature measured in first restroom at 107.3 and 110.8 F degrees in the second restroom. Bath towels, and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards and doorways were free of obstructions.

First aid kit had all the required elements including bandages, tweezers, thermometer, and scissors. Kitchen was inspected and appliances were operational. LPA observed the facility had a two-day supply of perishables and a seven-day supply of non-perishable food was available as required by regulations. LPA observed sharps and knives locked in a kitchen cabinet. LPA also observed toxin substances secured and locked and were inaccessible to clients in kitchen cabinet.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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
FACILITY NUMBER: 306004663
VISIT DATE: 01/17/2025
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Fire extinguisher was fully charged with last inspected on May 6th, 2024. The facility’s last emergency drill was conducted on December 16th ,2024 and AD conducts drills quarterly. The backyard was observed to have a shaded seating area and space for activities. Emergency exits are also cleared and free of obstruction.

Based on today’s visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted, and a copy of this report was provided to AD.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Samer Haddadin
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2025
LIC809 (FAS) - (06/04)
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