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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407318
Report Date: 01/28/2025
Date Signed: 01/31/2025 10:09:54 AM

Document Has Been Signed on 01/31/2025 10:09 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/
DIRECTOR:
TINA ROBERTSFACILITY TYPE:
850
ADDRESS:9213 COLUMBUS AVENUETELEPHONE:
(818) 892-6634
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY: 42TOTAL ENROLLED CHILDREN: 40CENSUS: 11DATE:
01/28/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Maria Castro and Tammy JacquinTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 1/28/2025 Licensing Program Analyst (LPA) Suzette Ornelas conducted an unannounced case management inspection for the purpose of obtaining further information for the unusual incident report reported on 1/23/2025. Upon arrival LPA was greeted by Facility Representatives, Tammy Jacquin and Maria Castro and observed 10 children and 3 staff.

According to the unusual incident report reported on 1/23/2025 on 1/22/2025, the children were playing in the Pooh Bears yard. Child 1 (C1) was standing on a fencing that is 2 feet tall. C1 was redirected by Staff 1 (S1) and C1 sat down. C1 once again was asked to get off the fencing however, this time C1 fell back and hit the back of their head against a wall and obtained a laceration. S1 called Staff 2 (S2) via walkie talkie to inform them about the incident and S2 contacted 911. The fire fighters arrived and checked C1 vitals and they stated that C1 was not a serious risk so the firefighters asked if Parent 1 (P1) was able to pick up C1 and transfer C1 to the hospital. Staff 3 (S3) proceeded to contact P1 who picked up C1. S3 accompanied P1 and C1 to the hospital where C1 received 5 stitches on their head. Doctors note was provided on 1/22/2025 stating that C1 is able to return to care.

During todays inspection, LPA conducted interviews with the staff present during the incident, C1, took pictures of the location where child obtained the injury.

Staff confirmed that child returned to care the next day.

At this time no deficiencies are being cited.

A copy of this report and a notice of site visit. 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. Exit interview was conducted with Facility Representative, Maria Castro.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/28/2025
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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