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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004012
Report Date: 08/07/2024
Date Signed: 08/07/2024 04:15:42 PM

Document Has Been Signed on 08/07/2024 04:15 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:AU P'TIT MONDE, INC.FACILITY NUMBER:
384004012
ADMINISTRATOR/
DIRECTOR:		GOLTSER, SALIMAFACILITY TYPE:
850
ADDRESS:1100 DIVISADERO STREETTELEPHONE:
(415) 374-1876
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94115
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 36DATE:
08/07/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Director, Karima CherfouniTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On 8/7/2024, at approximately 2:00PM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Director Karima Cherfouni (D1) and explained the purpose of the visit. Present during the visit was D1, seven staff, and 36 preschool age children. The facility is in compliance with staffing and ratio requirements on this day. The facility’s hours of operation are from 8:00AM to 5:30PM.

LPA and D1 inspected the facility for any health or safety hazards. The facility is equipped with fully charged fire extinguishers that are size 2A10BC. There is a combination smoke and carbon monoxide detector system running throughout the facility. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care. Electrical outlets are childproof and do not require covers.

LPA observed the classrooms to contain age-appropriate toys and learning materials. Furniture was observed to be age-appropriate and free of rough or sharp edges. Children nap on cots that are provided by the facility and cleaned daily. Children bring bedding from home and take it back once a week for cleaning. The facility prepares all food for children, including breakfast, lunch, and snacks. Children’s medication is stored in a central location. Children bring water bottles from home and the facility refills them as needed.

LPA observed the outdoor play areas. The facility has a waiver for scheduled use of the front and back outdoor play areas due to limited outdoor space. LPA observed the facility to be in compliance with the waiver on this day. LPA observed the waiver to be posted and available for review.

The front outdoor play area was observed to contain age-appropriate play structures and woodchips for cushioning. LPA observed the back outdoor play are to contain age-appropriate toys and equipment. Water is available for children as needed. Shade is available via trees or the building. LPA discussed maintaining all equipment in good repair with D1. D1 stated that they understood. Both outdoor play areas are enclosed by a fence that is at least four feet high. There are no pools or other similar bodies of water present in the facility.
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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2024
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: AU P'TIT MONDE, INC.
FACILITY NUMBER: 384004012
VISIT DATE: 08/07/2024
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LPA reviewed five staff files, five children’s files, and facility records. LPA observed there to be at least one staff member with current Pediatric First Aid/CPR training. LPA observed all staff files to contain current Mandated Reporter Training and immunization records. LPA observed children’s files to be complete. LPA advised that medical assessments shall be signed by the child’s physician. D1 stated that they understood. LPA observed all required postings to be posted and accessible for review in the main hallway of the facility. The facility last conducted an emergency drill on 4/5/2024. Emergency drills are documented and available for review with the required postings.

The facility tested its fixtures for lead before the deadline of 1/1/2023 and found no exceedances of lead in the fixtures tested. The facility is in compliance with lead testing requirements as of 8/7/2024. LPA discussed the requirement to test fixtures for lead every five years. D1 stated that they understood.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a
maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: AU P'TIT MONDE, INC.
FACILITY NUMBER: 384004012
VISIT DATE: 08/07/2024
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LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

No deficiencies were cited during today’s visit on 8/7/2024. See LIC9102-TV for technical violation issued today regarding equipment and toys. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Karima Cherfouni.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
LIC809 (FAS) - (06/04)
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