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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002088
Report Date: 01/16/2020
Date Signed: 01/16/2020 01:13:58 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:SFUSD - PUBLIC MONTESSORI SCHOOL (EES)FACILITY NUMBER:
384002088
ADMINISTRATOR:KEENER, LINDSEYFACILITY TYPE:
850
ADDRESS:2340 JACKSON STREETTELEPHONE:
(415) 749-3544
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94115
CAPACITY:88CENSUS: 43DATE:
01/16/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Lindsey KeenerTIME COMPLETED:
10:40 AM
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Licensing Program Analyst (LPA) Andrea Medlin met with principal for this case management visit. Purpose of the visit is due to a self reported unusual incident. On 1/10/2019, it was reported that a parent witnessed a staff person (S1) kiss her child's cheek while picking up. Parent reported the incident to the school staff. As a result, an internal investigation was conducted by SFUSD. The staff person was placed on leave, never returned, and was terminated.

This was an isolated incident and it appears facility took appropriate action.

This report is reviewed with principal and a copy of this report must be made available for public review upon request.

Notice of site visit posted and shall remain posted for 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
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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