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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494792
Report Date: 03/30/2022
Date Signed: 03/30/2022 02:16:07 PM

Document Has Been Signed on 03/30/2022 02:16 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 & PEGGY NAIRN 24 HOUR CHILDCARE, INCFACILITY NUMBER:
197494792
ADMINISTRATOR:NAIRN, PEGGYFACILITY TYPE:
850
ADDRESS:10036 OLD DEPOT PLAZA ROADTELEPHONE:
(818) 652-7618
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 24DATE:
03/30/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Peggy Nairin TIME COMPLETED:
02:45 PM
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On 03/30/2022 Licensing Program Analyst (LPA) Laticia Thompson and V. Wheatley (LPA) conducted an unannounced Case Management Inspection regarding an Unusual Incident Report that was submitted to the Department by the facility on 03/25/2022 The incident was reported to the facility by a parent that involved a 3 year old child. LPA's met with Licensee/Director Peggy Nairin.

LPA's was guided on a tour of the Preschool. Upon arrival LPA's observed 18 children supervised by 2 staff members on the playground area.

LPA's conducted interviews with licensee and staff. LPA's obtained, activity schedule, staff and children rosters. Based on the information provided this incident requires further review.

An exit interview was conducted and a copy of this report was provided to Peggy Nairn.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2022
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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