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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001999
Report Date: 01/10/2020
Date Signed: 01/10/2020 01:28:24 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:SAUREL-CAMERON, FABIENNE PAULETTEFACILITY NUMBER:
384001999
ADMINISTRATOR:SAUREL-CAMERON, FABIENNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 279-6938
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY:14CENSUS: 0DATE:
01/10/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Fabienne Saurel-CameronTIME COMPLETED:
01:55 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced inspection today. LPA met with Licensee Fabienne P. Saurel-Cameron. The purpose of the inspection was explained to her. There were no children present because the daycare was closed. The operation hours of the daycare are Monday to Thursday from 8:30am to 5:30pm. The facility provides French Immersion program to the children. Per licensee, the children are taken out for field trip around the neighborhood daily from 10:30am to 1:00PM. Licensee owns this 2-level house (or 2-unit house). Licensee lives with her husband and 2 sons on the upper level. The daycare area is located on the lower level (one bedroom, 1 bath, kitchen, living room (exercise room), and a play room (play kitchen room). The daycare areas is entire lower level (unit) except the backyard The off-limit areas are the entire upper level (unit), backyard. LPA toured and inspected the facility for health and safety hazard. The facility was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to the children. The day-care had a fully charged fire extinguisher, working smoke detectors and carbon monoxide (CO) detectors, and First aid supplies available. Per licensee, there is no pet, no firearms or weapons in the hosue. Facility conducts fire drills at lease once every six months and was properly logged. There were plenty of age appropriate children's toys, tables, chairs and learning material, equipment available for children in the day care area and all appeared to be safe for children. Fireplace was blocked. All electrical outlets were covered. Cubbies were available for the children to store their belongings by the main entrance. If there were ill child, Licensee would separate them in a different room while waiting for parent to pick them up. Licensee had current CPR/First Aid training certificate for review during the inspection, it will expire on 9/30/2021. Per licensee, there were no children on special medication. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care facilities and the ADA, available at: http://www.ada.gov/childqanda.htm. All required postings were posted. Children files and roster were reviewed during the inspection. LPA also obtained a copy of the roster from licensee during the inspection.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. A Child Care Provider's Guide to Safe Sleep was provided to licensee during inspection. Notice of site visit was provided. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2020
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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