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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701403
Report Date: 12/13/2021
Date Signed: 12/13/2021 11:42:30 AM

Document Has Been Signed on 12/13/2021 11:42 AM - 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:GREEN BEANS PRESCHOOLFACILITY NUMBER:
376701403
ADMINISTRATOR:LOUISE KRISTOFFERSONFACILITY TYPE:
850
ADDRESS:3975 FRONT STREETTELEPHONE:
(858) 945-2302
CITY:SAN DIEGOSTATE: CAZIP CODE:
92103
CAPACITY: 26TOTAL ENROLLED CHILDREN: 26CENSUS: 17DATE:
12/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Louise Kristofferson, Facility DirectorTIME COMPLETED:
11:45 AM
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On December 13, 2021 at 8:55 AM, Licensing Program Analyst (LPA), Marie Hernandez conducted an unannounced required annual inspection of the facility. LPA met with the Facility Director, Louise Kristofferson. The Director accompanied LPA during the inspection of the facility including the play yard. Present during the inspection are seventeen children with five staff.

There was a least one qualified lead teacher in each classroom. The appropriate ratios and capacity were observed. The furniture and equipment are in good condition; free of sharp, loose, or pointed parts. The drinking water is readily accessible to children during the inspection. The disinfectants, cleaning solutions, and other hazardous items are inaccessible to children via latches, locks and/or placed up on high surfaces. No bodies of water was observed during the inspection. The Director states there are no firearms or weapons present at this facility. All toilets and hand washing facilities are in good repair and sanitary. Breakfast, lunch and snacks are provided by the facility. All storage containers for solid waste have tight-fitting covers that are kept on, and in good repair. Outdoor play area is fully fenced and contains sufficient amount of cushioning with rubber to absorb a fall. The sign in/sign out sheets are maintained. All required documents are posted. Children’s files were reviewed for medical assessment. Present staff (during inspection) criminal record clearances, records were reviewed and contained documentation of educational background, training, and/or experience. All present staff members on site had current CPR/First Aid certification. Immunization records per SB792 was reviewed and in compliance. Mandated reporter certificates per AB1207 were reviewed and in compliance. Last fire drill was conducted and documented on 12/01/2021 . Incidental Medical Services – IMS was discussed. The facility currently does not provide any IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Marie Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 12/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GREEN BEANS PRESCHOOL
FACILITY NUMBER: 376701403
VISIT DATE: 12/13/2021
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The carbon monoxide detector was tested and in good working order. The restrooms were clean and in good working order during the inspection.

No deficiencies observed in the areas inspected during today's visit. The NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS. LPA observed Director post notice of site visit.

To access our Regulation and Forms please use our WEBSITE: www.cdss.ca.gov
Community Care Licensing Duty Line: (619) 767-2248, Monday through Friday, from 8:00 AM to 5:00 PM.

An exit interview was conducted and a copy of the report was discussed and provided to the Facility Director.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Marie Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021
LIC809 (FAS) - (06/04)
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