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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407320
Report Date: 08/26/2022
Date Signed: 08/26/2022 03:51:01 PM

Document Has Been Signed on 08/26/2022 03:51 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
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:
197407320
ADMINISTRATOR:PEGGY NAIRNFACILITY TYPE:
830
ADDRESS:9213 COLUMBUS AVENUETELEPHONE:
(818) 892-6634
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY: 15TOTAL ENROLLED CHILDREN: 21CENSUS: 9DATE:
08/26/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:06 PM
MET WITH:Director Tina RobertsTIME COMPLETED:
04:05 PM
NARRATIVE
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On 08/26/2022 at 1:03 PM, Antonio Almanza, Licensing Program Analyst (LPA), were at the licensed facility conducting an alternate inspection when the deficiencies listed below were observed.

Deficiencies observed:

At 1:03 PM LPA observed 9 infants and 4 teachers providing care and supervision. LPA observed the infant room with 6 cribs. At 1:18 PM, LPA observed all 6 cribs occupied and two teachers carrying 2 infants in their arms. One infant was sleeping in the arms of a teacher and the other infant was being fed a bottle; that infant appeared to be falling asleep while drinking the bottle. There was another infant standing against the gate to the infant sleeping room.

The infant room only has space to accommodate 6 cribs. Due to the facility not being able to accommodate the needs of 9 infants in care 3 infants where sent home. At 2:58 PM the third child was picked up from the facility.

During todays visit the facility is not equipped with appropriate furniture and equipment to meet the needs of the 9 children in care. The facility is not providing the infant children safe and comfortable accommodations and equipment.

During today’s visit Two Type A violations are being cited under Title 22 Regulations, Division 12, Chapter 1, of the California Code of Regulations: 101439 Infant Care Center Fixtures, Furniture, Equipment and Supplies (b) The infant care center shall be equipped with appropriate furniture and equipment including, but not limited to, cribs, cots or mats; changing tables; and feeding chairs; 101223 Personal Rights (a)(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 08/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/26/2022
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
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: 197407320
VISIT DATE: 08/26/2022
NARRATIVE
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*** 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.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

A copy of this report, Appeal Rights (LIC9058) and Notice of Site Visit were reviewed and provided to the Director Tina Roberts.

Director Tina Roberts Disagrees with this report.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 08/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/26/2022 03:51 PM - It Cannot Be Edited


Created By: Antonio Almanza On 08/26/2022 at 03:35 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: 197407320

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/26/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/26/2022
Section Cited
CCR
101439(b)

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101439 (b) Infant Care Center Fixtures, Furniture, Equipment and Supplies - The infant care center shall be equipped with appropriate furniture and equipment including, but not limited to, cribs, cots or mats; changing tables; and feeding chairs.
This Requirement is not met as evidenced by:
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Director will provide an updated plan of Operation on how they will make sure the facility is admitting infants and able to meet their needs based on equipment in the facility.
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Based on observation and interview, The Licensee does not have enough cribs for 9 infants in care today , which poses an immediate Health and Safety, and personal rights risk to persons in care.
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Type B
08/26/2022
Section Cited
CCR101223(a)(2)

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101223 (a)(2) Personal Rights - To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This Requirement is not met as evidenced by:
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Director will provide an updated plan of Operation on how they will make sure the facility is admitting infants and able to meet their needs by providing them safe and comfortable accommodations based on equipment in the facility.
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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:Rita Ramos
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 08/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/26/2022


LIC809 (FAS) - (06/04)
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