<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407320
Report Date: 12/09/2021
Date Signed: 12/09/2021 02:25:36 PM

Document Has Been Signed on 12/09/2021 02:25 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: DATE:
12/09/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Director: Susan GlamuzinaTIME COMPLETED:
02:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 12/09/2021 at 8:23 a.m., Antonio Almanza, Licensing Program Analysts, conducted an unannounced visit for the purpose of completing Comprehensive Case Management Report. During todays visit LPA met with Susan Glamuzina, Director, and toured that facility. During today’s visit there are 2 adults providing care and supervision to 7 children in care.

On 12/07/2021 at 12:17 a.m., Antonio Almanza and Lourdes Castellanos, Licensing Program Analysts, conducted an unannounced Comprehensive Case Management visit. LPA’s met with Susan Glamuzina, Director, and toured that facility indoors and outdoors. There were 3 adults providing care and supervision to 8 children. Days and hours of operation are 7 days per week 24-hours per day. LPAs verified the facility phone number is (818) 892-6634. Per Stipulation and Waiver; and Order the facility is on Probation for 3 years effective August 29, 2019.

There is an in-ground swimming pool that is fenced with wrought iron gate. At 1:14 pm LPAs observed the gate is not self-closing and has a padlock on the latch. There are three different locations on the fence surrounding the swimming were the welding’s have eroded due to corrosion and have come loose and as a result the fence is not secure. The walkway areas around the pool is used by children to walk to their designated play areas. Due to the bars coming loose the swimming pool gate is not secure.

The facility has sufficient age appropriate furniture, and equipment including cribs, cots or mats, changing tables and feeding chairs. There is indoor and outdoor activity space for infants that is physically separate. Each crib, mat or cot is occupied by only one infant at a time and cribs are kept free from all loose articles including blankets and pillows and there are no objects hanging above or attached to the crib. LPAs observed two large bottles of hand sanitizer that appeared to be in use next to the infant’s formula on top of a small cabinet where the infant’s formal is kept. Pg 1.
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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-HR CHILDCARE INC.
FACILITY NUMBER: 197407320
VISIT DATE: 12/09/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPAs observed the rug in the infant room were children play is dirty and stained. There are 7 cribs in a small room that has been designated for sleeping. The cribs are placed in rows next to each other and do not have space for staff to stand or walk in-between. LPAs observed the ceiling of the infant sleeping room to have water damage and a dark black spotted area in the corner of the ceiling that looks like mold. There is a crack down the middle of the ceiling from side to side and a hole in the texture. There were 2 staff present in the infant sleeping room during today’s visit. Staff physically check on sleeping infants every fifteen minutes and document any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Individual Infant Sleeping Plan (LIC 9227) is not completed for each infant up to 12 months of age.

The outdoor activity space is not maintained in a safe and clean condition. The playground is covered in artificial turf and has two trees with a circular barrier around them that have screws sticking out within the circle that can be hazardous to children. The areas within the circles of the trees are lower than the artificial turf where infant children play and they can fall into this space. While walking on the playground LPA Lourdes stepped on poop and Director stated that there were no dogs on the premises and was probably cats poop. The area in front of the infant playground and the entrance to the infant playground is used as storage and may pose a hazard to children.



The facility is free of flies, insects and rodents. Facility has one or more functioning smoke detector and carbon monoxide detectors that meet statutory requirements. Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day. During the visit on 12/08/21 LPAs observed the sign in sheet and 1 of 8 parents put the time arrived but did not sign the log. LPA Castellanos reviewed children’s files and observed files were complete with: Identification and Emergency Information (LIC700, Child’s Preadmission Health Evaluation (LIC702), Physician Report (LIC 70, if not enrolled in elementary school), Consent for medical Treatment (LIC627), Immunizations Records (“Blue Cards”, PM286 for non -school-age children), Current Admissions Agreement with signature, Notification of Parents’ Rights (LIC995), Infants Need and Services Plan, Infant Feeding Plan, Personal Rights (LIC613A).
Pg 2.
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
LIC809 (FAS) - (06/04)
Page: 6 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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-HR CHILDCARE INC.
FACILITY NUMBER: 197407320
VISIT DATE: 12/09/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Per Stipulation and Waiver; And Order children’s files have signed acknowledgement of being provided a copy of Stipulation but do not have signed acknowledgement of being provided a copy Accusation. There are no children with a Restricted Health Conditions. LPA Castellanos reviewed staff files and observed Staff 3, and 4 files were missing current Mandated Reporter Training. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption.

Director reports that staff have received training. Per Stipulation, LPA is unable to verify that Staff are provided 24 hours of quarterly training on applicable Tittle 22 Regulations, including Mental Health Assessment, Client Behaviors, Personal Rights, Care and Supervision, and Medication; records of staff receiving training are not available for review. On 12/07/21, There was not a clear written statement of the administrative responsibility and authority delegated to the child care center director and a copy of this written statement has been given to the child care center director and was not made available to the Department on 12/07/21. LPA was able to determine that staff in the facility are working more than eight (8) hours per day, Staff 5 has reported that she sometimes works more than 8 hours per day because she does not have someone to relieve her. LPAs did not observe the following items posted in a location were parent in the Infant Center can see them: Personal Rights Form LIC-613A, Child Care Center Notification of Parents' Rights Poster PUB 393.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations and Health & Safety Code, the following deficiencies are being cited: four (4) Type As and eleven (11) type Bs and civil penalty (please see LIC 809-D for cited deficiencies and BG for civil penalty). Director was provided a copy of their appeal rights.

Upon receipt of a Type A violation, licensee shall post and provide copies of this licensing report to 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. A copy of LIC 9224 was given to Susan Glamuzina.

A copy of this report was explained and provided to Director Susan Glamuzina and Administrator Tammy Jacquin. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. Pg 3.
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
LIC809 (FAS) - (06/04)
Page: 12 of 12
Document Has Been Signed on 12/09/2021 02:25 PM - It Cannot Be Edited


Created By: Antonio Almanza On 12/08/2021 at 06:57 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: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type A
12/10/2021
Section Cited
CCR
101238(e)(1)

1
2
3
4
5
6
7
101238 Buildings and Grounds (e)(1) Fences shall... gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate...

This Requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee will make the pool area inaccessible and have the gate fixed to be in compliance with Title 22 regualtions, by 12/10/21.
8
9
10
11
12
13
14
Based on observation The Licensee did not make sure the gate to the swimming pool is self-closing, which poses an immediate Health and Safety, and personal rights risk to persons in care.
8
9
10
11
12
13
14
Request Denied: Appeal Not Submitted Timely
Type A
12/10/2021
Section Cited
CCR101238(e)

1
2
3
4
5
6
7
101238 Buildings and Grounds (e) All licensees shall ensure the inaccessibility of pools... bodies of water, through a pool cover or by surrounding the pool with a fence.

This Requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee will make the area around the pool inaccessible and will have the iron bars fixed/welded back on to the gate in order for the gate to be secure, by 12/10/21.
8
9
10
11
12
13
14
Based on observation, The Licensee did not make sure the fencing around the pool is secure, LPAs observed the welding on 3 different location of the fence with rust and eroded making the rods loose, which poses an immediate Health and Safety, and personal rights risk to persons in care.
8
9
10
11
12
13
14
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 Ruiz
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2021


LIC809 (FAS) - (06/04)
Page: 3 of 12
Document Has Been Signed on 12/09/2021 02:25 PM - It Cannot Be Edited


Created By: Antonio Almanza On 12/08/2021 at 07:12 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: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type A
12/09/2021
Section Cited
CCR
101238

1
2
3
4
5
6
7
101238 Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
All cribs will be removed from sleeping room and the Director will contact a licensed professional to come out and repair the water damage and remove the mold. Director will provide proof of the work performed to LPA by 12/11/21
8
9
10
11
12
13
14
Based on observation the ceiling of the infant sleeping room has water damage and there appears to be mold in the corner of the ceiling, which poses an immediate Health and Safety, and personal rights risk to persons in care.
8
9
10
11
12
13
14
Director has been advised to create an account with Guardian in order to be able to monitor the facilities associations.
CCR

1
2
3
4
5
6
7
1
2
3
4
5
6
7
All cribs will be removed from sleeping room and the Director will contract a licensed professional to come out and repair the water damage and remove the mold. Director will provide proof of the work performed to LPA by 12/11/21.

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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 Ruiz
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2021


LIC809 (FAS) - (06/04)
Page: 11 of 12
Document Has Been Signed on 12/09/2021 02:25 PM - It Cannot Be Edited


Created By: Antonio Almanza On 12/08/2021 at 07:37 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: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type B
12/14/2021
Section Cited
CCR
101227

1
2
3
4
5
6
7
101227 Food Services (19) All food shall be protected against contamination.



This Requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director will provide staff with instructions on proper storage of formula and disinfectant supplies. Director will provide proof of staff notified by providing a written notice with staff signatures by 12/14/21.
8
9
10
11
12
13
14
Based on observation, LPAs observed two large hand snaitizers next to the infant formula, which poses a potential Health or Safety, or personal rights risk to persons in care.

8
9
10
11
12
13
14
Request Denied: Appeal Not Submitted Timely
Type B
12/10/2021
Section Cited
CCR101223(a)(2)

1
2
3
4
5
6
7
101223 Personal Rights (a)(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

This Requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee will replace the rug or have it cleaned and provide proof to LPA by 12/10/21.
8
9
10
11
12
13
14
Based on observation, LPAs observed the rug used for infant to play on is dirty with stains, which poses a potential Health or Safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
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 Ruiz
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2021


LIC809 (FAS) - (06/04)
Page: 8 of 12
Document Has Been Signed on 12/09/2021 02:25 PM - It Cannot Be Edited


Created By: Antonio Almanza On 12/08/2021 at 07:50 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: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type B
12/14/2021
Section Cited
CCR
101439.1

1
2
3
4
5
6
7
101439.1 Infant Care Center Sleeping Equipment (g) Cribs, mats or cots shall be arranged so as to provide a walkway and work space between the cribs...

This Requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director will ensure that the space between the cribs provide a walkway and work space between the cribs. Director will provide written statement of how the facility will ensure that this regulation as adhered to by 12/14/21.
8
9
10
11
12
13
14
Based on observation, LPAs observed the cribs in the sleeping room in rows pushed up against each other without any space between, which poses a potential Health or Safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
Request Denied: Appeal Not Submitted Timely
Type B
12/13/2021
Section Cited
CCR101419.2(b)(2)

1
2
3
4
5
6
7
101419.2 Infant Needs and Services Plan (b) (2) Infants up to 12 months of age shall have a completed Individual Infant Sleeping Plan [LIC 9227 (3/20)], which is incorporated by reference. (A) This plan shall be signed and dated by the infant’s authorized representative.
This Requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director will have parents complete Infant Sleeping Plan LIC 9227 by 12/13/2021.
8
9
10
11
12
13
14
Based on records review, the Licensee does not have LIC 9227 on file for each infant under 12 months, which poses a potential Health or Safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
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 Ruiz
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2021


LIC809 (FAS) - (06/04)
Page: 2 of 12
Document Has Been Signed on 12/09/2021 02:25 PM - It Cannot Be Edited


Created By: Antonio Almanza On 12/08/2021 at 08:08 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: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type B
12/13/2021
Section Cited
CCR
101238.2(d)(2)

1
2
3
4
5
6
7
101238.2 Outdoor Activity Space (d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.
This Requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director will have the areas backfilled and the screws removed to avoid injuries to children in care, by 12/13/21.
8
9
10
11
12
13
14
Based on observation LPAs observed two trees with a circular barrier lower than the turf around with screws sticking out, which poses a potential Health or Safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
Request Denied: Appeal Not Submitted Timely
Type B
12/14/2021
Section Cited
CCR101238(d)

1
2
3
4
5
6
7
101238 Buildings and Grounds (d) General permanent or portable storage space shall be available for the storage of the center's equipment and supplies.

This Requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director will have all the items removed from in front of the playground and placed in general or portable storage, by 12/14/21
8
9
10
11
12
13
14
Based on observation LPAs observed the area in front of the playground used as storage space, which poses a potential Health or Safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
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 Ruiz
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2021


LIC809 (FAS) - (06/04)
Page: 9 of 12
Document Has Been Signed on 12/09/2021 02:25 PM - It Cannot Be Edited


Created By: Antonio Almanza On 12/08/2021 at 08:23 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: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type B
12/14/2021
Section Cited
CCR
101229.1(b)

1
2
3
4
5
6
7
101229.1 Sign In and Sign Out (b) The person who brings the child to, and removes the child from, the center shall sign the child in/out.

This Requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director will provide parents with notice of sign in and sign out procedures and provide a copy to LPA by 12/14/21.
8
9
10
11
12
13
14
Based on observation and records review, 1 0f 8 infants did not have a signature for the sing in, which poses a potential Health or Safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
Request Denied: Appeal Not Submitted Timely
Type B
12/13/2021
Section Cited
CCR1596.8595

1
2
3
4
5
6
7
Health and Safety Code 1596.8595 Posting ... reports to be provided to parents orguardian ... Per Stipulation and Waiver; and Order, licensee is required to provide all parents with a copy of Stipulation and Accusation and signed acknowledgement of being provided a copy.
This Requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director has been advised that per stipulation parents are to provide both Stipulation and accusation. Director will provide Accusation and get signed acknowledgement by 12/13/2021.
8
9
10
11
12
13
14
Based on observation and records review, The Licensee did not provide parents accusation and signed acknowledgement is not on file. LPAs observed children's files with parents signing off on receiving Stipulation but not the accusation, which poses a potential Health or Safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
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 Ruiz
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2021


LIC809 (FAS) - (06/04)
Page: 4 of 12
Document Has Been Signed on 12/09/2021 02:25 PM - It Cannot Be Edited


Created By: Antonio Almanza On 12/08/2021 at 08:32 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: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type B
12/13/2021
Section Cited
CCR
101216(e)

1
2
3
4
5
6
7
101216 Personnel Requirements (e) All personnel shall be given on-the-job training... Per Stipulation Licensee shall provide 24 hours of quarterly training and keep a record of staff who attend such training and make records available to Licensing.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee shall comply with the Stipulation and Waiver; and Order, and provide the 24 hours of training to staff and submit a copy of the records of staff who attended the training on required subjects, to LPA by 12/13/2021.
8
9
10
11
12
13
14
Based on observation and records review, The Licensee does not have records available for the 24 hours of quarterly training, which poses a potential Health or Safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
Per Stipulation Licensee shall provide 24 hours of quarterly training to staff on mental health assessments, client behaviors, personal rights, care and supervision, and medication and keep a record of staff who attend such training and make records available to Licensing.
Request Denied: Appeal Not Submitted Timely
Type B
12/13/2021
Section Cited
CCR101215.1(c)(1)

1
2
3
4
5
6
7
101215.1 Child Care Center Directors Qualifications and Duties (c)(1) There shall be a clear written statement of the administrative responsibility and authority delegated to the child care center director.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee shall provide a clear written statement of the adminstrative responsibility and authority delgated to the child care center director and provide a copy to LPA by 12/13/2021
8
9
10
11
12
13
14
Based on record reviews there is no a clear written statement of the administrative responsibity and authority delegated to the child care center director which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
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 Ruiz
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2021


LIC809 (FAS) - (06/04)
Page: 5 of 12
Document Has Been Signed on 12/09/2021 02:25 PM - It Cannot Be Edited


Created By: Antonio Almanza On 12/08/2021 at 08:42 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: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type B
12/09/2021
Section Cited
CCR
101223(b)(2)

1
2
3
4
5
6
7
101223 Personal Rights (b)(2) The center shall post a copy of the LIC 613A (9/96) in a prominent, publicly accessible area in the center.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director will post Personal Rights Form LIC-613A where parents can have access to it during pick up and dropp off.
8
9
10
11
12
13
14
Based on Observation a copy of the LIC 613A is not posted in a prominent, publicly accessible area of the center, which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Request Denied: Appeal Not Submitted Timely
Type B
12/09/2021
Section Cited
CCR101218.1(c)

1
2
3
4
5
6
7
101218.1 Admission Procedures and Parental and Authorized Representative's Rights
(c) The licensee shall post the PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster in a prominent, publicly accessible area in the child care center at all times.
his requirement is not met as evidenced by:
1
2
3
4
5
6
7
Director will post PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster where parents access to it during pick up and drop off.
8
9
10
11
12
13
14
Based on Observation a copy of the PUB 393 (8/02), Child Care Center Notification of Parents' Rights Poster is not posted in a prominent, publicly accessible area of the center, which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
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 Ruiz
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2021


LIC809 (FAS) - (06/04)
Page: 10 of 12
Document Has Been Signed on 12/09/2021 02:25 PM - It Cannot Be Edited


Created By: Antonio Almanza On 12/08/2021 at 08:56 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: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type B
12/11/2021
Section Cited
HSC
1596.8662(b)(1)

1
2
3
4
5
6
7
1596.8662 Availability of information regarding detecting...training for mandated... employee of a licensed child day care facility; proof of completion. (b) (1) a ...employee of a licensed child day care facility shall complete the mandated reporter training.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Staff will complete the child care provider Mandated Reporter Training and director will provide LPA a copy by 12/11/2021.
8
9
10
11
12
13
14
Based on LPA review of staff files, Staff 2, 3, and 4 files do not have Mandated Reporter training, which poses a potential Health or Safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
Request Denied: Appeal Not Submitted Timely
Type B
12/14/2021
Section Cited
CCR101216(l)

1
2
3
4
5
6
7
101216 Personnel Requirements (l) All personnel shall be informed of their rights pursuant to Sections 1596.881 and 1596.882 of the Health and Safety Code.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Per Stipulation no employee shall work more than eight (8) hours per day. The director shall immediately ensure that no staff is working more than 8 hours per.

LPA is requesting copy of time cards for November up to date.

8
9
10
11
12
13
14
Based on Interviews Staff 5 is reporting that she has worked more than 8 hours due to not having another staff relieve her, which poses a potential Health or Safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
Director will provide LPA with copy of this staff schedule for november up to today and provide plan of operations demonstrating how the facility will ensure to be fully staffed at all times and that no employee shall work more than eight (8) hours per day by end of day 12/14/21.
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 Ruiz
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2021


LIC809 (FAS) - (06/04)
Page: 7 of 12