191290363-2-4-2026-58-CC-BCLD-DQYU69-20260204141800

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191290363
Report Date: 02/04/2026
Date Signed: 02/04/2026 02:18:09 PM

Document Has Been Signed on 02/04/2026 02:18 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	C.S.U.N. ASSOC. STUDENTS CHILDCARE CENTER		FACILITY NUMBER:	191290363
ADMINISTRATOR/ DIRECTOR:	KURPJUWEIT, PEARL M		FACILITY TYPE:	850
ADDRESS:	18343 PLUMMER		TELEPHONE:	(818) 677-2012
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91325
CAPACITY: 136	TOTAL ENROLLED CHILDREN: 136	CENSUS:	DATE:	02/04/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:45 AM
MET WITH:	Lena Blakeney, Director		TIME VISIT/ INSPECTION COMPLETED:	02:45 PM

NARRATIVE

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On 02/04/2026 at 09:25 AM, Licensing program analysts (LPAs) Brittanee Cleveland and Christina Nunez conducted an unannounced case management inspection due to a self-reported incident that occurred at the facility. LPAs met with Lena Blakeney, Director, who guided LPAs on a tour of the facility.

There are 50 children in care and 18 staff.

The incident that occurred on 01/13/2026, was reported to the Department on 02/02/2026, via telephone. The facility did not report the Unusual Incident to the Department within the required 24 hours of occurrence. A Type B deficiency will be issued, as this poses a potential health, safety, and personal rights risk to children in care. LPA requests that Director sends LIC624 for the unusual incident report to be submitted by 02/06/2026.

Information reported to the Department stated that a child was found in the parking lot of the facility without an adult.

This incident occurred in the morning during drop off. Director and Staff #1 stated that child was being dropped of by mother and when mother reached the child’s classroom, the child was not there. Staff #1 stated that mom and child may have been walking in with another family. Due to the time of the incident, child had not been checked in. Staff #1 stated that another parent found the child in the parking lot crying. This parent carried child inside. Child was recovered by receptionist. Staff #2 stated the child’s mom peeked into the classroom asking if child came inside. Staff #2 did not see the child or hear the emergency door close. When the child’s mom returned to the lobby, child was with receptionist. Child was given to mother. Child’s mother stated being concerned about the emergency exit at the end of the hallway. When parent left, the door was tested. Director stated the maintenance came to examine the door. --- Page 1

NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Brittanee Cleveland
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: C.S.U.N. ASSOC. STUDENTS CHILDCARE CENTER	FACILITY NUMBER: 191290363
	VISIT DATE: 02/04/2026

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A new alarm and battery was set. Staff #2 stated that when conducting a recent fire drill, the door alarm did not sound. Staff #1 was unsure if there was a maintenance check, stating that Director takes care of it.

Based on in the information received during the interview and LPAs observations, facility was able to make the necessary adjustments to ensure the safety of children. Child was returned to classroom and parent left after Staff #1 checked on them.

The Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview was conducted and report was reviewed with the director, Lena Blakeney.

-- Page 2

NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Brittanee Cleveland
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/04/2026 02:18 PM - It Cannot Be Edited

Created By: Brittanee Cleveland On 02/04/2026 at 01:55 PM

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: C.S.U.N. ASSOC. STUDENTS CHILDCARE CENTER	FACILITY NUMBER: 191290363
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/04/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/06/2026 Section Cited HSC 101212(d)(1)(C)	1 2 3 4 5 6 7	101212 (d) Upon the occurrence... report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours.. (1) Events reported shall include the following: (C) Any unusual incident...that threatens the physical or ..	1 2 3 4 5 6 7	LPA has requested a LIC624 be submitted by 02/06/2026 to clear deficiency.
	8 9 10 11 12 13 14	emotional health or safety of any child This requirement was not being met as evidenced by: Director did not report the unusal incident by the next business day. This poses a potential health, safety, and personal rights risk to children in care.	8 9 10 11 12 13 14
	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.

	Raul Navarro
NAME OF LICENSING PROGRAM MANAGER:

	Brittanee Cleveland
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/04/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

LIC809 (FAS) - (06/04)

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