191890481-11-21-2025-58-CC-ECAO-DNMRLB-20251121120653

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191890481
Report Date: 11/21/2025
Date Signed: 11/21/2025 12:07:00 PM

Document Has Been Signed on 11/21/2025 12:07 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 CENTER		FACILITY NUMBER:	191890481
ADMINISTRATOR/ DIRECTOR:	JENNIFER MOVSESSIAN		FACILITY TYPE:	850
ADDRESS:	11059 HERRICK ST.		TELEPHONE:	(818) 896-3722
CITY:	PACOIMA	STATE: CA	ZIP CODE:	91331
CAPACITY: 115	TOTAL ENROLLED CHILDREN: 115	CENSUS: 60	DATE:	11/21/2025
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:25 AM
MET WITH:	Jennifer Movessian, Principal		TIME VISIT/ INSPECTION COMPLETED:	12:30 PM

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 11/21/2025, Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced Case Management -Incident visit to the facility. The purpose of the visit was to review self reported incidents that have occurred at the facility. LPA arrived at the facility at 08:25AM and toured the facility with Jennifer Movessian, Principal, there were 60 children in care and 18 staff on arrival. The incident that occurred on 11/20/2025 was reported to the Department on 11/20/2025 via mail. The facility reported the Unusual Incident to the Department within the required 24 hours of the occurrence. Information reported to the Department indicated that while playing, Child #1 pushed Child #2 and caused an injury to Child #2. LPA Calvillo conducted an interview with Staff #1 who witnessed the incident between Child #1 and Child #2 in that the two (2) children were playing and Child #1 was so excited to take a turn that they ran into Child #2 causing an injury to Child #2. The incident that occurred on 10/09/2025 was reported to the Department on 10/09/2025 via telephone. The facility reported the Unusual Incident to the Department within the required 24 hours of the occurrence. Information reported to the Department indicated that during circle time Child #3 was excited and not able to control their body and caused an injury to Child #3. LPA conducted an interview with Staff #1 who witnessed the incident between Child #3 and Child #4 in that Child #3 was excited to participant in a classroom activity that Child #3 was trying to kick a box block and accidentally kicked Child #4 causing an injury. The incident that occurred on 09/02/2025 was reported to the Department on 09/02/2025 via email. The facility reported the Unusual Incident to the Department within the required 24 hours of the occurrence. ---Page 1 of 2 ---

NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025

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: PACOIMA EARLY EDUCATION CENTER	FACILITY NUMBER: 191890481
	VISIT DATE: 11/21/2025

NARRATIVE

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Information reported to the Department indicated that there were two (2) confirmed case of Hand, Foot, and Mouth Disease. LPA conducted an interview with the Principal and they stated that all the cases reported have been cleared.

The incident that occurred on 08/27/2025 via email. The facility reported the Unusual Incident to the Department within the required 24 hours of the occurrence. Information reported to the Department indicated that Child #5 swallowed an object during a group activity. LPA conducted an interview with the Principal in that Staff #2 witnessed Child #5 swallow an object and it was reported to the Parent.

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

NAME OF LICENSING PROGRAM MANAGER: Rita Ramos
NAME OF LICENSING PROGRAM ANALYST: Elicia Calvillo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2025

LIC809 (FAS) - (06/04)

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