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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407320
Report Date: 07/12/2022
Date Signed: 07/12/2022 02:08:43 PM

Document Has Been Signed on 07/12/2022 02:08 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: 15DATE:
07/12/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:18 PM
MET WITH:Director Tina RobertsTIME COMPLETED:
02:19 PM
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On 07/212/22, at 1:18 p.m., Antonio Almanza, Licensing Program Analysts Conducted an unannounced visit. The purpose of the visit is to clear Plan of Corrections (POCs). LPA met with Director Tina Roberts, explained the purpose of the visit. During today’s visit there were 4 adults providing care and supervision to 15 children in care.

LPA Cleared 17 Plan of Corrections (POC) for violations issued and POC letters were generated and provided to the Director.

During todays visit LPA did not observe any violations.

A copy of this Report (809), Appeal Rights, and Notice of Site Visit (LIC 9213) were provided and explained to the Director Tina Roberts.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2022
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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