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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407318
Report Date: 12/21/2021
Date Signed: 12/21/2021 10:40:06 AM

Document Has Been Signed on 12/21/2021 10:40 AM - 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:
197407318
ADMINISTRATOR:PEGGY NAIRNFACILITY TYPE:
850
ADDRESS:9213 COLUMBUS AVENUETELEPHONE:
(818) 892-6634
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY: 42TOTAL ENROLLED CHILDREN: 42CENSUS: 10DATE:
12/21/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:26 AM
MET WITH:Director: Susan GlamuzinaTIME COMPLETED:
10:46 AM
NARRATIVE
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On 12/21/2021 at 08:26 a.m., Antonio Almanza, Licensing Program Analysts, conducted an unannounced visit for the purpose of verifying corrections for citations issues on 12/09/2021. During todays visit LPA met with Director Susan Glamuzina and Administrator Tammy Jacquin and toured that facility. During today’s visit there are 1 adults providing care and supervision to 10 children in care.

During today visits corrections have been verified and POC letters were provided for the corrections completed. The facility has 2 deficiencies pending corrections.

During todays visit at 8:39 a.m., Director, Administrator and LPA observed the sing in sheets for the preschool and 1 of 10 children were not signed in.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, there is one Type B deficiency issued (please see LIC 809-D for cited deficiencies). Director was provided a copy of their appeal rights.

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.
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 12/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/21/2021
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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Document Has Been Signed on 12/21/2021 10:40 AM - It Cannot Be Edited


Created By: Antonio Almanza On 12/21/2021 at 09:41 AM
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: 197407318

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/27/2021
Section Cited
CCR
101229.1(b)

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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:
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Director will provide parents with notice of sign in and sign out procedures and provide a copy to LPA via email by 12/27/21.
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Based on observation and records review, 1 of 10 children were not sing in, 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:Mary Ruiz
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 12/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/21/2021


LIC809 (FAS) - (06/04)
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