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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407318
Report Date: 08/30/2023
Date Signed: 08/30/2023 11:48:00 AM

Document Has Been Signed on 08/30/2023 11:48 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PENNY AND PEGGY NAIRN 24-HR CHILDCARE INC.FACILITY NUMBER:
197407318
ADMINISTRATOR:TINA ROBERTSFACILITY TYPE:
850
ADDRESS:9213 COLUMBUS AVENUETELEPHONE:
(818) 892-6634
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY: 42TOTAL ENROLLED CHILDREN: 49CENSUS: 10DATE:
08/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Tina Roberts, DirectorTIME COMPLETED:
12:00 PM
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On 08/30/23 at 10:00 AM, Silva Garibyan, Licensing Program Analyst (LPA), conducted an unannounced Annual Required Inspection. LPA met with Tammy Jacquin, Administrator and Tina Roberts, Director, and toured the facility. During today’s visit LPA observed 2 staff providing care and supervision to ten children. LPA verified facility phone number is 818-892-6634.

Due to time constraints the Annual visit will be completed on a future date.

A copy of this Report, Notice of Site Visit, and Appeal rights where explained and provided to the Director Tina Roberts.

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2023
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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