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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407320
Report Date: 04/11/2022
Date Signed: 04/11/2022 03:14:25 PM

Document Has Been Signed on 04/11/2022 03:14 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
CCLD Regional Office, 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: 15CENSUS: 11DATE:
04/11/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:03 PM
MET WITH:Director John CrismonTIME COMPLETED:
03:20 PM
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On 4/11/22 at 02:27 p.m., Antonio Almanza, Licensing Program Analysts, conducted an unannounced visit for the purpose of clearing Plan of Corrections (POCs) for citations issues on 03/25/2022. LPA met with the Director John Chrismon, explained the purpose of the visit, and toured that facility. During today’s visit there were 2 adults providing care and supervision to 11 infant children in care.

Due to time restraints and the facility being short staffed as a result of the Day program Director being out sick, LPA has notified the Director, that a follow up visit will be conducted to provide a full report for the site visit conducted today 4/11/22.

A copy of this Report (809) and LIC 9213 Notice of Site Visit was provided to the Director John Chrismon. Director was advised that LIC 9213 Notice of Site Visit is required to be posted for 30 days.
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2022
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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