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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004012
Report Date: 09/22/2021
Date Signed: 09/30/2021 03:43:08 PM

Document Has Been Signed on 09/30/2021 03:43 PM - It Cannot Be Edited

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:AU P'TIT MONDE, INC.FACILITY NUMBER:
384004012
ADMINISTRATOR:GOLTSER, SALIMAFACILITY TYPE:
850
ADDRESS:1100 DIVISADERO STREETTELEPHONE:
(415) 374-1876
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94115
CAPACITY: 50TOTAL ENROLLED CHILDREN: 0CENSUS: 29DATE:
09/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Karina Cherfouni, Salima GoltserTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Andrea Medlin met with staff, and later director, for this required annual licensing visit. Purpose of visit explained. Facility operates a preschool program. There are 29 children present during the visit. Days and hours of operation: Monday-Friday 8:00AM-5:30PM. The facility has multiple fully charged fire extinguishers that meet the minimum requirements, smoke detectors, and carbon monoxide (CO) detectors in facility. Children's bathrooms inspected; all toilets and hand washing facilities are in safe and sanitary operating condition. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present. Per director, there are no firearms or weapons on site. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible. Variety of age appropriate toys and materials for children is available. Classrooms are set up for child care and furniture and equipment for children is present. Facility provides snacks and meals. Adequate first aid supplies are available. Sick children will be separated from the group while waiting for parents to pick up. Outdoor play area inspected for health and safety hazards. The areas used for outdoors is completely gated. Outdoor activity space surfaces are free of hazards. Facility has posted all the required licensing forms in a prominent accessible location: License, Parent's Rights (LIC 995), and Emergency Disaster Plan (LIC 610). Due to time limitations and conducting a simultaneous visit here, a return visit will be conducted at a later date to review staff and children's files.

This report is reviewed with director 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

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Andrea Medlin
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2021
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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