<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494792
Report Date: 04/07/2023
Date Signed: 04/07/2023 11:51:18 AM

Document Has Been Signed on 04/07/2023 11:51 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 & 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: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 16DATE:
04/07/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director/Owner Peggy NairnTIME COMPLETED:
09:37 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 4/07/2023 at 9:00 AM, Antonio Almanza, Licensing Program Analyst (LPA) were at the licensed facility conducting an alternate inspection when the deficiency listed below was observed. LPA observed 16 children and 3 staff providing care and supervision to children in care.

LPA observed the sign in sheet for the Little Critters classroom. There were 10 children in the classroom and 3 of 10 children were not singed in for the day. Child 1 was singed in at the facility 8:37 AM and there is no signature. Child 2 does not have a time of arrival or signature. Child 3 arrived at the facility at 8:10 AM and does not have signature.

The following Type B violation is being cited during today's inspection (see LIC 809Ds), Under Title 22 Regulations, Division 12, Chapter 1, section 101229.1 Sign In and Sign Out (a) In addition to the sign-in procedure requirement of Section 101226.1(b), the licensee shall develop, maintain, and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.

A copy of this Report, Notice of Site Inspection, Appeal Rights, Confidential Names List (LIC 811) were given and explained to the Director/Owner Peggy Nairn.
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/07/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 04/07/2023 11:51 AM - It Cannot Be Edited


Created By: Antonio Almanza On 04/07/2023 at 11:00 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 & PEGGY NAIRN 24 HOUR CHILDCARE, INC
FACILITY NUMBER: 197494792

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/28/2023
Section Cited
CCR
101229.1(b)(1)

1
2
3
4
5
6
7
Sign In and Sign Out (1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.
This Requirement is not met as evidenced by:

1
2
3
4
5
6
7
Director agrees to provide staff with memo providing staff with instructions for the person who signs the child in/out shall use his/her full legal signature and shall record the time of day
8
9
10
11
12
13
14
Based on observation, interview and record review, 3 of 10 children enrolled were not singed in, which poses a potential Health or Safety, or personal rights risk to persons in care.

8
9
10
11
12
13
14
Director will provide LPA copy of staff signing off on receipt of memo.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Betty Bell
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 04/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/07/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2