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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
306006560
Report Date:
01/06/2025
Date Signed:
01/06/2025 02:05:56 PM
Document Has Been Signed on
01/06/2025 02:05 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:
DANBROOK CARE HOME
FACILITY NUMBER:
306006560
ADMINISTRATOR/
DIRECTOR:
PONTOY, MARETIES
FACILITY TYPE:
740
ADDRESS:
3359 W ORANGE AVE
TELEPHONE:
(714) 272-1701
CITY:
ANAHEIM
STATE:
CA
ZIP CODE:
92804
CAPACITY:
6
CENSUS:
DATE:
01/06/2025
TYPE OF VISIT:
Prelicensing
ANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
01:05 PM
MET WITH:
Eunice Reyes
TIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Licensing Program Analysts (LPAs) Rose Ruppert and Fred Arias made an announced visit to conduct a pre-licensing visit follow up. The original pre-licensing visit was conducted on 12/30/2024. LPAs were greeted and granted entry into the facility by Administrator Eunice Reyes. Eunice provided a receipt that shows a new electric stove has been purchased and will be delivered on 1/7/2025 to the facility to replace the non-operational stove. The phone line connector has been removed from the living room and no longer an issue.
LPAs conducted the Component Three Orientation with Eunice. Eunice was notified that the final application approval will be issued by the Centralized Applications Bureau in Sacramento.
An exit interview was conducted and a copy of this report was provided to the Licensee.
SUPERVISORS NAME
:
Alisa Ortiz
LICENSING EVALUATOR NAME
:
Fred Arias
LICENSING EVALUATOR SIGNATURE
:
DATE:
01/06/2025
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
01/06/2025
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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