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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197407811
Report Date: 04/02/2021
Date Signed: 04/02/2021 02:01:00 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/16/2021 and conducted by Evaluator Antonio Almanza
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20210216141411
FACILITY NAME:PENNY AND PEGGY NAIRN 24 HOUR CHILD CARE INC.FACILITY NUMBER:
197407811
ADMINISTRATOR:PEGGY & PENNY NAIRNFACILITY TYPE:
850
ADDRESS:15300 DEARBORNTELEPHONE:
(818) 892-6635
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY:25CENSUS: 0DATE:
04/02/2021
UNANNOUNCEDTIME BEGAN:
01:42 PM
MET WITH:Peggy NairnTIME COMPLETED:
02:05 PM
ALLEGATION(S):
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Allegation: Neglect/Lack of Supervision
INVESTIGATION FINDINGS:
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Due to the Governor’s Proclamation of State of Emergency, On 04/02/2021 at 1:42 pm, Licensing Program Analyst (LPA) Antonio Almanza conducted a Tele-Conference at PENNY AND PEGGY NAIRN 24 HOUR CHILD CARE. for the purpose of concluding complaint investigation. LPA met with the Direrctor/Owner Peggy Nairn and explained the purpose of the inspection. During the course of the investigation, LPA conducted interviews, and obtained evidence in regard to Allegation: Child was bitten while in care.

The Reporting Party (RP) is reporting that Child 1 (C1) was bitten while in care on the cheek and on the forearm while at the facility and was not provided with a written or verbal report of the incidents. RP is stating that in November 2020 C1 was Bitten on the cheek by another child in care. RP asked Staff 4 (S4) what happened and was told by S4 that they forgot to give a report. RP is reporting that C1 was bitten on the forearm. RP States the incident happened “probably January 26” and noticed the bite mark while showering C1. The following day RP notified S4. Rp is reporting that when inquired about the bite, “they said he was bitten but not sure when or where it happened”.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 30-CC-20210216141411
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PENNY AND PEGGY NAIRN 24 HOUR CHILD CARE INC.
FACILITY NUMBER: 197407811
VISIT DATE: 04/02/2021
NARRATIVE
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Facility staff are reporting that the RP was notified both verbally and in writing about C1 being bitten on the cheek. Staff 4 (S4) and Staff 5 (S5) are reporting that on 01/27/2021 RP was picking up C1 and present when C1 was bitten on the cheek and was provided a written report. S4 and S5 are reporting that they were in the room and were supervising the children when the incident occurred and S4 observed the incident. The facility and Rp have provided a copy of the written report with RP signature that was created for the incident that happened on 01/27/2021.

Staff are reporting that C1 was bitten on forearm on 02/10/2021. Staff 4 and Staff 6 are reporting that the incident was recorded, and RP was notified of the incident verbally during pick up and in writing the following day (02/11/2021). S4 and S5 are reporting that the teacher (Staff 3) who was supervising and witnessed C1 get bitten on the forearm left early on the day of the incident and was unable to write the report, but RP was notified of the incident during pick up.

Staff 3 (S3) reported that on the day of the incident S3 was supervising children in the playground when C1 was bitten by another child in the playground. S3 stated she heard C1 winning so she separated the children. S3 is stating that S3 did not observe C1 get bitten on the forearm. S3 did not see the bite mark because C1 was wearing long sleeves. S3 did not see the child that could have bitten C1 because there were four children around C1. S3 is stating that she found out C1 was bitten because she was asked by S4 if she witnessed the incident. S3 states she did not check the child after RP complaint and did not see the bite marks. After considering available information, S3 was not providing adequate visual supervision to see the child get bitten and attend to the bite sustained by C1.

Based on available information and evidence obtained over the course of the investigation it was revealed that on 02/10/2021 Staff 3 was supervising children in the playground when C1 was bitten on the forearm but S3 did not witness the incident. S3 was made aware of the incident when question by S4 about it. Based on LPAs observation and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California code of Regulations, Title 22, Division 12 & Chapter 1), are being cited on the attached LIC9099D.


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SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 30-CC-20210216141411
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PENNY AND PEGGY NAIRN 24 HOUR CHILD CARE INC.
FACILITY NUMBER: 197407811
VISIT DATE: 04/02/2021
NARRATIVE
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The Director/Owner Peggy Nairn was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. A copy of the licensing report (LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. **In addition; A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months. The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

There is one Type A deficiency being cited during today’s visit. An Exit Interview was conducted, a copy of this Report, Notice of Site Visit and Appeal Rights were explained and emailed to Director/Owner Peggy Nairn. It has been explained that a reply to the email shall be considered a substitute for the hard-copy signature


















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SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 30-CC-20210216141411
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PENNY AND PEGGY NAIRN 24 HOUR CHILD CARE INC.
FACILITY NUMBER: 197407811
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/02/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/05/2021
Section Cited
CCR
101229
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101229 Responsibility for Providing Care and Supervision: No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
This Requirement is not met as evidenced by:
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Director will provide written statement of how she plans to make sure staff are providing visual supervision to children in care.
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Based on observation, interview and record review, Staff 3 stated that did not observe or know that C1 got bitten while playing with four other children, which poses an [immediate or potential] Health [and or] Safety, [and or] personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 4