191290363-5-28-2026-58-CC-DDOG-DUHL4Y-20260528082616

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191290363
Report Date: 05/27/2026
Date Signed: 05/28/2026 08:26:32 AM

Document Has Been Signed on 05/28/2026 08:26 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:	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: 68	CENSUS: 48	DATE:	05/27/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:36 AM
MET WITH:	Lena Blakeney, Director		TIME VISIT/ INSPECTION COMPLETED:	04:30 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 05/27/2026, Licensing Program Analysts (LPA) Dawn Dowling and Samantha Barba conducted an unannounced Case Management -Incident inspection to follow up on an incident that was reported to the department. LPA arrived at the facility at 09:48 AM and met with Lena Blakeney, Director, who guided LPA on a tour of the facility, census was conducted, there were 48 children being supervised by 18 staff as follows: Classroom # 120- 6 Children and 3 staff Classroom #130- 8 Children and 3 staff Classroom #150 and #160 were outside play with 26 children and 18 staff Classroom #140- 8 children and 4 staff The incident was reported to Community Care Licensing on 04/06/2026 via email. The facility reported the Unusual Incident to the Department within the required 24 hours of occurrence. The incident occurred on 04/03/2026. Incident: A child spat in the presence of children/teachers and spat on staff. Page 1

NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Dawn Dowling
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026

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: 05/27/2026

NARRATIVE

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During today's inspection, interviews were conducted with one child, three staff, parent, observation of child #1 was conducted. LPAs obtained the following documentation: Associated Student California State University Northridge Children's Center Parent Handbook 2025-2026, A.S. CSUN Children's Center Parent Meeting Notes, May 27, 2026, Meeting Sign-In-Sheet , Reviewed Child #1 file and reviewed Staff #3 file.

Staff interviewed, indicates that child#1 no longer displays spitting behavior. Staff are supporting child#1 in providing guidance and support during the transition period when child #1 is having difficulties.

Parent interviewed, indicates parent comes in twice a week from thirty minutes to an hour to observe child #1 in the classroom. School has provided parent with support, guidance and coaching for child #1 by giving parent puppets to model for child #1 about spitting and inappropriate behavior. Parent indicates that child# 1 was receptive to puppets and has not demonstrated any spitting behaviors since the incident. School has provided parent with an outside resource of Child and Family Guidance Center which provides assistance and resources for families by offering parenting classes, working with children, supporting families in getting children accessed.

To prevent future incidents, staff and parent have implemented having parent monitor child #1 two times during the week, observing inside the classroom and outside through observation windows and school has provided child #1 with additional staff to assist child #1 during transition times occurs.

Based on interviews conducted and documentation obtained, this unusual incident with child spitting has not occurred since the incident was reported. Child #1 is given additional support from the staff, parent and parents are awaiting response from the Child and Family guidance Center on resources that will assist child #1.
It has been determined that there were no deficiencies in compliance found, no citations are being issued.

A Notice of Site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Lena Blakeney, Director

NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Dawn Dowling
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/27/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026

LIC809 (FAS) - (06/04)

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