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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407320
Report Date: 04/14/2022
Date Signed: 04/14/2022 02:51:27 PM

Document Has Been Signed on 04/14/2022 02:51 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
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: 7DATE:
04/14/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:31 PM
MET WITH:Director Susan GlamuzinaTIME COMPLETED:
03:05 PM
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On 4/14/22 at 10:50 a.m., Antonio Almanza, Licensing Program Analysts, conducted an unannounced follow up visit to the visit conducted on 04/11/22. The purpose of the visit is to clear Plan of Corrections (POCs) for citations issues on 03/25/2022. LPA met with the Director Susan Glamuzina, explained the purpose of the visit, and toured that facility. During today’s visit there were 2 adult providing care and supervision to 7 infant children.

Corrections for 2 violations have been cleared and POC letters were provided for this violation. The facility has not corrected the following 4 violations by the POC due date. The following violations are being cited under Title 22 Regulations, Division 12, Chapter 1, of the California Code of Regulations, and Health & Safety Code (please see LIC 809-Ds for cited deficiencies).

1. 101215.1(d) Child Care Center Directors Qualifications and Duties, The child care center director, or the substitute director as specified in (f) below, shall be on the premises during the hours the center is in operation. Based on observation and records review, The Licensee does not have a Director assigned to the Facility During all hours of operation. During todays visit when LPA arrived to the Center their was no Director on site. The Director was at the Columbus location assisting the teacher of the preschool classroom.

2. 101215.1(c) Child Care Center Directors Qualifications and Duties, The child care center director shall be responsible for the operation of the center, for compliance with regulations, and for communications with the Department... The Licensee does not have an actual Director During the Day, Evening, and Night programs. The Assigned Directors during these times, are classroom teachers, and are assigned to classrooms.

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SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2022
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
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: 04/14/2022
NARRATIVE
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3. Per Stipulation; Waiver and Order, 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. The records that have been submitted to the RO do not meet the training requirements of the Stipulation.

4. Per Stipulation no employee shall work more than eight (8) hours per day. Director did not provide a Mitigation Plan 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. Staff are reporting that they are working overtime and sometimes do not have someone to relieve them for breaks.

On 04/11/2022 while LPA conducted a visit at the facility the following violations were observed. These violations are being cited under Title 22 Regulations, Division 12, Chapter 1, of the California Code of Regulations, and Health & Safety Code (please see LIC 809-Ds for cited deficiencies).

1. While conducting the site visit LPA called the facility phone in the presence of the Director and the Director verified the facility phone and the number being dialed. LPA had phone on speaker and Director was able to hear that the facility phone number was not in service. During today visit LPA has also verified the phone with the Director and called the number while on speaker and the Director is able to hear that the phone number is not in service. In case of an emergency agencies and parents and will not be able to make contact with the facility which poses an immediate Health and Safety, and personal rights risk to persons in care. During todays phone is operating.

2. At 10:32 am LPA entered the Infant classroom and observed the teacher standing in the doorway of the infant sleeping room supervising two sleeping infants in their cribs while supervising two older infants that were walking around the classroom. One infant was on the other side of the infant sleeping room, next to the changing station and the other infant was walking around the classroom. The staff is not providing direct supervision to the 2 infants and would not be able to prevent an accident or redirect the infants from getting into an accident while standing at the doorway of the infant sleeping room.



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SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2022
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
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: 04/14/2022
NARRATIVE
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3. When LPA conducted the Walk through of the facility after 2:27 p.m. LPA observed 2 adults providing care and supervision to 11 infant children. Not all infants were sleeping. Director was assigning in classroom and had to return to maintain ratios.

4. LPA requested copies of Personnel Roster, Facility Sketch and Plan of Operations. LPA was only provided copies facility Sketch.

**In addition; 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 (809 & 809Ds), Notice of Site Visit, and Appeal Rights were explained and provided to the Director Susan Glamuzina. This report shall be made available to the public upon request.




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SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2022
LIC809 (FAS) - (06/04)
Page: 2 of 7
Document Has Been Signed on 04/14/2022 02:51 PM - It Cannot Be Edited


Created By: Antonio Almanza On 04/14/2022 at 12:55 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: 04/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/23/2022
Section Cited
CCR
101215.1(d)

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101215.1(d) Child Care Center Directors Qualifications and Duties, The child care center director, or the substitute director as specified in (f) below, shall be on the premises during the hours the center is in operation.
This requirement is not met as evidenced by:
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Licensee will submit an updated Personnel Record Lic500 demonstrating that there is a Director During the hours the Child Care Center is in operation.
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Based on observation and records review, The Licensee does not have a Director assigned to the Facility During all hours of operation, which poses a potential Health or Safety, or personal rights risk to persons in care.
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Type B
04/23/2022
Section Cited
CCR101215.1(c)

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101215.1(c) Child Care Center Directors Qualifications and Duties,The child care center director shall be responsible for the operation of the center, for compliance with regulations, and for communications with the Department...

This requirement is not met as evidenced by:
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Licensee will make sure to have a Director assigned to the Evening and Night programs that is not in the classroom as a teacher. Licensee will provide copy of Personnel Roster with proper staffing for the facility during the programs.
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Based on interviews, The Licensee does not have a Director During the Evening and Night progrmas, which poses a potential Health or Safety, or personal rights risk to persons 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:Lisa Rios
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 04/14/2022 02:51 PM - It Cannot Be Edited


Created By: Antonio Almanza On 04/14/2022 at 01:00 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: 04/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/23/2022
Section Cited
CCR
101216(e)

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101216(e) Personnel Requirements, 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.1596.881 and 1596.882 of the Health and Safety Code Personnel Requirements (l) All personnel shall be informed of their rights… Staff 5 is reporting that she has worked more than 8 hours.
This requirement is not met as evidenced by:
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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 4/23/22.
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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.
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Type B
04/23/2022
Section Cited
CCR101216(l)

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101216(l) 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:
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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 day.
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Based on records review staff have been working more than 8 hours, which poses a potential Health or Safety, or personal rights risk to persons in care.
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Director will provide LPA with copy of the Mitigation Plan 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 4/23/22
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:Lisa Rios
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/14/2022 02:51 PM - It Cannot Be Edited


Created By: Antonio Almanza On 04/14/2022 at 01:03 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: 04/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/14/2022
Section Cited
CCR
101224(a)

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101224(a) Telephones, All child care centers shall have working telephone service on the premises.

This requirement is not met as evidenced by:
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During todays visit the phones are working.
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Based on LPAs observations and the Director onsite on 04/11/22 verified the phone is diconected, which poses an immediate Health and Safety, and personal rights risk to persons in care.
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Type A
04/14/2022
Section Cited
CCR101429(a)(1)

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101429(a)(1) Responsibility for Providing Care and Supervision for Infants, Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.
This requirement is not met as evidenced by:
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Licensee will make sure have proper staffing in the facility at all times in order to provide children proper direct visual observation and supervision by a staff person at all times.
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Based on LPAs observations on 04/11/22 LPA observed 1 teacher stading in doorway supervising 2 sleeping infants in cribs and 2 infants walking around the clasrrom, which poses an immediate Health and Safety, and personal rights risk to persons in care.
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Licensee will submit Personnel Roster demonstrating proper staffing at all times by 04/23/22
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:Lisa Rios
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 04/14/2022 02:51 PM - It Cannot Be Edited


Created By: Antonio Almanza On 04/14/2022 at 01:17 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: 04/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/23/2022
Section Cited
CCR
101200(c)(1)

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101200(c)(1) Inspection Authority of the Department, (c) The Department has the authority to inspect, audit... care center records… (1) The licensee shall ensure... for the examination of all records relating to the operation of the child care center.
This Requirement is not met as evidenced by:
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Licensee will provided copies of the requested documents to LPA by 04/23/22
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Based on observation, interview and record review, The lIcensee did not make Plan of Operation, personel Roster facility Sketch availbe, which poses a potential Health or Safety, or personal rights risk to persons 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:Lisa Rios
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


LIC809 (FAS) - (06/04)
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