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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000176
Report Date: 02/03/2021
Date Signed: 02/04/2021 07:41:36 AM

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 INTERNATIONAL LA PEROUSEFACILITY NUMBER:
384000176
ADMINISTRATOR:VERONIQUE BAUMBACHFACILITY TYPE:
850
ADDRESS:755/765 ASHBURY STREETTELEPHONE:
(415) 661-5232
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94117
CAPACITY:96CENSUS: DATE:
02/03/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Veronique BaumbachTIME COMPLETED:
04:21 PM
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On February 3, 2021, Licensing Program Analyst (LPA) Cowan met with site director Veronique Baunbach for an unannounced Case Management visit. Due to Covid-19 State of Emergency, this visit was done via telephone call. This visit is to respond to a self-report by site director to Child Protective Services.

Director reports that a substitute teacher witnessed a lead teacher abuse a child in care. LPA discussed the incident with director. During the visit, director stated that the teacher has been temporarily removed by the CEO of Human Relations and an internal investigation is currently being conducted. LPA has requested for facility to share the results of the internal investigation with Licensing.

LPA discussed Licensing Reporting Protocols with director, making sure to report all Unusual Incidents to Licensing by phone within 24 hours and submitting an LIC 624 to Licensing within 7 days.

This report is emailed to site director with a request for reply demonstrating receipt.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2021
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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