<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101576
Report Date: 08/30/2023
Date Signed: 09/06/2023 03:11:47 PM

Document Has Been Signed on 09/06/2023 03:11 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 DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CHERESTAL, CAROLINE FAMILY CHILD CAREFACILITY NUMBER:
376101576
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
08/30/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Caroline CherestalTIME COMPLETED:
03:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On August 30, 2023 at 12:55 PM, Licensing Program Analyst (LPA) Sherlynn Banas, conducted an announced Pre-Licensing inspection for Caroline Cherestal (Applicant). Upon arrival, LPA met with applicant and Pierre Louis Julien (husband). The two story home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water in the home, no fireplace, and the staircase is barricaded. There is a working phone at the facility. Applicant states that there are no weapons in the home. Applicant states that they have sufficient financial resources to sustain the license. CPR and First Aid expire on March 19, 2025. Preventative health practices course was completed on April 8, 2023, which includes lead poison prevention training. Mandated reporter training was completed on August 8, 2023, and expires on August 8, 2025. Staff immunization requirements were met. Required documents have been posted. Applicant rents the home. The applicant has toys and equipment available.

Applicant will be using the following rooms for childcare: Living room, bathroom downstairs, and the yard outside. Off-limits areas include kitchen, dining room, garage, and are inaccessible using a child lock.The garage will also be off limits and is kept inaccessible through the use child lock. Applicant has a backyard available for outdoor activities. Since it is a big yard, the gate will be installed for children’s safety. The other small yard behind the dining area is also inaccessible by a child lock. Verification of control of property is on file. Property owner/Landlord notification and consent are on file.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2023
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CHERESTAL, CAROLINE FAMILY CHILD CARE
FACILITY NUMBER: 376101576
VISIT DATE: 08/30/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. The new provider packet was reviewed with the applicant including information on child abuse and unusual incident reporting. LPA provided information regarding the YMCA Resource center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and applicant discussed Shaken Baby Syndrome and California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA, Sherlynn Banas reviewed COVID-19 guidelines with Applicant and provided COVID-19 resources.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CHERESTAL, CAROLINE FAMILY CHILD CARE
FACILITY NUMBER: 376101576
VISIT DATE: 08/30/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
If no IMS provided:
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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

If a facility is providing IMS:
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 Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

The following corrections are needed prior to the issuance of the license:
Install gate by the backyard.Once all corrections are made and proof is sent to licensing a license for 8 children may be granted. Applicant understands that proof of corrections must be submitted to Licensing within 30 days or the application may be denied. Applicant understands that she must obtain landlord consent to care for more than 6 children. Applicant agreed to comply with all regulations and laws governing family child-care homes.

Exit interview conducted and report was reviewed with the Caroline Cherestal. Appeal Rights was also provided to the Applicant.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3