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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407812
Report Date: 03/28/2022
Date Signed: 03/30/2022 02:14:50 PM

Document Has Been Signed on 03/30/2022 02:14 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 HOUR CHILD CARE INC.FACILITY NUMBER:
197407812
ADMINISTRATOR:PEGGY & PENNY NAIRNFACILITY TYPE:
840
ADDRESS:15300 DEARBORNTELEPHONE:
(818) 892-6635
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: DATE:
03/28/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:12 AM
MET WITH:Director: Gloria AvinaTIME COMPLETED:
10:43 AM
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On 03/28/2022 at 8:28 a.m., Licensing Program Analyst (LPA) Antonio Almanza conducted an unannounced Case Management Visit at the Probationary Licensed Facility. During today’s visit LPA met with the Director, Gloria Avina, explained the purpose of the visit and toured that facility. During today’s visit there were 1 adults providing care and supervision to 3 children in care.

During the visit, LPA made observations, reviewed files and interviewed staff. Due to time constraints, LPA will return to provide the facility with the Case management visit report. On 03/30/22, LPA provided Director Gloria Avina with a copy of this Report and notice of site visit.
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2022
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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