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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407318
Report Date: 10/02/2024
Date Signed: 10/04/2024 09:49:51 AM

Document Has Been Signed on 10/04/2024 09:49 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PENNY AND PEGGY NAIRN 24-HR CHILDCARE INC.FACILITY NUMBER:
197407318
ADMINISTRATOR/
DIRECTOR:		TINA ROBERTSFACILITY TYPE:
850
ADDRESS:9213 COLUMBUS AVENUETELEPHONE:
(818) 892-6634
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 13DATE:
10/02/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Maria Gina Castro/Ana GallegosTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
NARRATIVE
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On 10/2/2024 Licensing Program Analysts (LPAs) Suzette Ornelas and Roberto Luque Avila made an unannounced visit for the purpose of conducting an initial investigation and observed the following deficiency. LPA met with Director, Maria Gina Castro who guided LPAs on a tour.

LPAs toured the facility and observed 13 children in care supervised by 3 staff.

LPAs observed that Staff 5 (S5) who is present Monday through Friday from approximately 8am to 2pm as fingerprint cleared but not associated to the facility. S5 was observed on Guardian to have been separated on 1/1/2023. According to Staff 2 (S2), S5 has been working at the day care for over 5 days.

During todays visit, the Director was able to associate S5 to the facility as on 10/1/2024.

Facility was cited type A deficiencies and an immediate civil penalty of $500.00
See LIC809D

Licensee was advised upon receive of this report, the report must be posted along with the notice of site visit for 30 days for parents to view. Licensee must inform the parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC 9224 Acknowledgement of Receipt of Licensing Reports. If the Licensee fails to comply $100.00 civil penalty shall be assessed for each family enrolled and in attendance. Exit interview conducted with the licensee and a copy of this report was provided along with the appeal rights.

Exit interview was conducted and a copy of this report and notice of site visit was provided to Director, Ana Gallegos.

SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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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Document Has Been Signed on 10/04/2024 09:49 AM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!


Created By: Suzette Ornelas On 10/02/2024 at 01:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PENNY AND PEGGY NAIRN 24-HR CHILDCARE INC.
FACILITY NUMBER: 197407318

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
10/02/2024
Section Cited
CCR
101170(e)(2)

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CRIMINAL RECORD CLEARANCE
All individuals are subject to a criminal record review prior to working. Individuals must be fingerprint cleared and associated to the facility. This requirement is not
met as evidenced by:
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Director associated S5 during todays visit. Deficiency was cleared.
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Based on interviews and records reviews, S5 was not associated to the facility. This poses an immediate risk to
the health and safety of children 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:Raul Navarro
LICENSING EVALUATOR NAME:Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2024


LIC809 (FAS) - (06/04)
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