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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384000176
Report Date: 10/19/2022
Date Signed: 10/19/2022 12:48:09 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/12/2022 and conducted by Evaluator Nathan Garcia
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20221012161857

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: 69DATE:
10/19/2022
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Christophe DerentyTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Criminal Record Clearance
INVESTIGATION FINDINGS:
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On 10/19/2022, in response to the above allegation, Licensing Program Analysts (LPA), Garcia made an unannounced initial complaint visit and to deliver findings to the Lycee Francais International La Perouse facility. LPA was granted entry by the receptionist. LPA explained to the director about the purpose of the visit. To investigate the allegations, LPA observed with the director around the facility and there are 8 teachers in total supervising 69 children in all 4 pre school classrooms.

LPA obtained pertinent document such as LIC 500. LPA conducted interviews with director of licensing, and director of the school.

During inspection, LPA performed site observations and conducted interviews with the licensee. LPA also met staff members and based on the information gathered, and examined, and all the parties involved were contacted and interviewed. It has been confirmed that an adult at the school does not have fingerprint clearance.

Based on LPA observations, interviews and record review(s), the preponderance of evidence standard has been met, therefore the above allegations are founded to be substantiated.

Licensee was cited for the uncleared adult, please refer to LIC 9099D

License was issued a civil penalty of $500, please refer to LIC 421BG

Appeal rights was discussed with the licensee

“The Notice of Site Visit” shall be posted for 30 days.

Failure to maintain postings as required, will result in an immediate $100 civil penalty.

A copy of this report and the “Notice of Site Visit” and the licensee's “Appeal Rights” was given to the licensee,

Exit interview conducted and report was reviewed with the licensee, Christophe De Renty.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20221012161857
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 PEROUSE
FACILITY NUMBER: 384000176
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/20/2022
Section Cited
HSC
101170(e)
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101170(e) Criminal Record Clearance: All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
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Director has agreed to get the adult employee at the center will be fingerprinted by set due date of 10/20/2022.
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Based on observation, interview and record review, the licensee did not comply with the section cited above by not having fingerprint clearance, which poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3