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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191890481
Report Date: 08/22/2024
Date Signed: 08/22/2024 12:58:12 PM

Document Has Been Signed on 08/22/2024 12:58 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:PACOIMA EARLY EDUCATION CENTERFACILITY NUMBER:
191890481
ADMINISTRATOR/
DIRECTOR:		SUSAN HANFACILITY TYPE:
850
ADDRESS:11059 HERRICK ST.TELEPHONE:
(818) 896-3722
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY: 115TOTAL ENROLLED CHILDREN: 115CENSUS: 41DATE:
08/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:05 AM
MET WITH:Jennifer Movsessian, PrincipalTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Lilia Hernandez conducted an unannounced case management inspection on 08/22/2024 due to a self reported incident that occurred at the facility. LPA arrived at the facility at 8:05AM and met with Jennifer Movsessian, Principal. There were 41 children and 15 staff present upon arrival.

The incident that was reported to the facility on 08/12/2024 occurred on 08/08/2024, and was reported to the Department on 08/12/2024, via email. The facility reported the Unusual Incident to the Department within the required 24 hours of occurrence.

Information reported to the Department indicated that Staff #1 may or may not have violated the personal rights of Child #1 while in care.

LPA conducted interviews with Staff #1 through Staff #4, Child #1, and Child #2. LPA also obtained a copy of the facility roster and written statements regarding this incident.

Based upon information LPA received from the interviews conducted today, additional information is needed to determined if the personal rights of Child #1 were violated.

There were no deficiencies cited during today’s inspection.

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 Jennifer Movsessian, Principal.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Lilia Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
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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