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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005273
Report Date: 02/03/2020
Date Signed: 02/03/2020 03:40:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LYCEE FRANCAIS DE SAN FRANCISCO (PS)FACILITY NUMBER:
214005273
ADMINISTRATOR:ELIANE STORME, DIRECTORFACILITY TYPE:
850
ADDRESS:100 EBBTIDE AVENUE, BUILDING 5TELEPHONE:
(415) 661-5232
CITY:SAUSALITOSTATE: CAZIP CODE:
94965
CAPACITY:83CENSUS: 46DATE:
02/03/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Director, Eliane StormeTIME COMPLETED:
03:55 PM
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Licensing Program Analyst (LPA), Cindy Interiano conducted a Required - 1 year inspection and met with Director, Eliane Storme. Purpose of the inspection was explained to the Director. Program operates in Building 5 on the Lycee Francais Elementary School site. Program operates M-F, 7:45a-6p, following the school calendar with an optional Summer camp. Program operates in 4 PreK classrooms: Petite Section (Room 502), Moyenne Section (Room 501), La Petite Ecole A (Room 512), and La Petite Ecole B (Room 513). Program also uses the Multi-Purpose room (Room 511) for indoor gross motor skills and napping. Present during the inspection was Director and 5 Staff supervising 46 PreK children. Program is in compliance with Staff:Child ratios and all Adults have criminal record clearance. LPA and Director inspected facility indoors and outdoors for Health and Safety Hazards. Classrooms have age appropriate toys and equipment. Cubbies, hooks, and bins are used to store children’s belongings. Each classroom has a restroom area with 2 toilets and 2 sinks. Additional sinks are in each classroom. Restrooms are kept clean, in good repair and maintained with adequate supplies. Staff use separate restrooms, which are maintained off limits. Napping equipment is properly stored. Program provides daily snacks and children either bring their own meals or purchase a meal via a food vendor. Facility has a fully supplied Emergency kit and emergency supplies, which are maintained inaccessible to children.
Medications are maintained in child’s assigned classroom and kept with Guardian consent form, Doctor’s prescription and a log (when administered). Facility has a functioning telephone, is equipped with an industrial fire alarm system with carbon monoxide detector inside each classroom and fire extinguishers throughout the facility. Last emergency disaster drill was conducted on 12/13/19 and is properly logged. Discipline policy is mainly redirection.

See Page 2. . .
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2020
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: LYCEE FRANCAIS DE SAN FRANCISCO (PS)
FACILITY NUMBER: 214005273
VISIT DATE: 02/03/2020
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Outdoor play area is adjacent to the Multipurpose room. Outdoor play area is free of debris and hazardous items and is completely fenced in. Sandbox is covered daily. A daily sweep is conducted by staff of the outdoor play area prior to the children going out for outdoor play. All outdoor toys and equipment are age appropriate and in good repair. Program also periodically uses the ‘courtyard,’ adjacent to the Moyenne Section classroom. Drinking water is readily available outdoors and indoors. All mandatory postings are posted in the hallway area. Sign in/out sheet was reviewed and was complete and up-to-date. Staff and Children's files are up-to-date and complete, including adult immunization.

During the inspection,
*Incidental Medical Services (IMS) policy was discussed.
*Director was reminded about having all Staff and Volunteers provide proof of immunization against influenza, pertussis, and measles or qualifies for an exemption.
*Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare.
*Director was reminded about Mandated Reporter Training available on CCLD website
(www.ccld.ca.gov or www.mandatedreporterca.com)
*Director was advised of the new Lead Bill (effective 01/01/19), requiring Facilities to distribute a two-page flyer to Guardians with information on lead poisoning facts
*Director was reminded about the Provider Information Notices (PINs) on CCLD website.

***No deficiencies were cited against the facility under CCR,Title 22, Div. 12, Ch. 1. ***

>This report and rights to comment and appeal were discussed with Director. This report must be available in the facility for public review. Notice of site inspection was posted.
Director was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2