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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701403
Report Date: 08/30/2023
Date Signed: 08/30/2023 12:54:04 PM

Document Has Been Signed on 08/30/2023 12:54 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
MISSION VALLEY, 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: 32TOTAL ENROLLED CHILDREN: 23CENSUS: 29DATE:
08/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH: Louise KristoffersonTIME COMPLETED:
01:10 PM
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On 8/30/2023, at 9:50am, Licensing Program Analyst (LPA), Vicky Williamson conducted an unannounced annual required inspection. LPA met with Director, Louise Kristofferson and disclosed the purpose of the inspection. LPA toured the inside and outside of the facility. This is a full day program. Day and hours of operation are Monday - Friday, 7:30am - 5:30pm. The following ratios were observed: One (1) teacher and one (1) aide were observed reading books to eight (8) children (ages 18 months - 36 months). Director stated that 21 daycare children were visiting the library across the street from the facility with two (2) teachers. At 11:15am the children visiting the library returned to the facility.

Furniture and equipment are in good condition. Playground equipment is in safe condition. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. High-climbing equipment has sufficient cushioning. Toilet and hand-washing equipment are in safe and sanitary operating condition. Floors in the facility are clean and safe. Kitchen, food preparation and storage areas are clean, free of litter/rubbish and free of rodents. Solid waste storage containers have tight-fitting covers and are in good repair. Disinfectants, cleaning solutions and other hazardous items are made inaccessible to children.

Director stated there are no bodies of water on the premises. LPA did not observe any bodies of water during time of inspection. Director stated there are no firearms or ammunition allowed or stored on the premises. Filtered drinking water is available both indoors and outdoors. Facility provides breakfast, lunch and snack. Menus are posted weekly. Facility has functioning carbon and smoke detectors that meet statutory requirements. The last fire/disaster drill was conducted and documented on 7/16/2023.

A review of staff records on this date indicates facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions.

See LIC 809 Continuation...

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
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)
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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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GREEN BEANS PRESCHOOL
FACILITY NUMBER: 376701403
VISIT DATE: 08/30/2023
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Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides 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 Child Care Center. 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.

Capacity and limitations as specified on the license are being maintained. Children are under supervision, including visual supervision, of a teacher at all times. Facility maintains a ratio of one teacher supervising no more than 12 children in care. Toddler option ratio of one teacher supervising no more than six children in care is being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at off-site activities. The name of the child care center director or fully - qualified teacher designated to act in the director’s absence has been reported to the Department. The person who signs the child in/out of the facility shall use their full legal signature and record the time of day.



LPA reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child and medical assessment. LPA reviewed a sample of staff files and immunization records for pertussis and measles were complete. Current documentation for mandated reporter training certification was expired for Director, Staff #1 (S1) and, Staff #2 (S2).

This facility provides Incidental Medical Services – IMS, however there are no children that require medication at this time. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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.

LPA and Director discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, mandated reporter training, and California Megan’s Law (www.meganslaw.ca.gov).

See LIC 809C Continuation...

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
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
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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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GREEN BEANS PRESCHOOL
FACILITY NUMBER: 376701403
VISIT DATE: 08/30/2023
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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations,deficiencies were cited. See LIC 809D.

An exit interview was conducted with Director, Louise Kristofferson, and a copy of this report, Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit is required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Vicky Williamson
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)
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Document Has Been Signed on 08/30/2023 12:54 PM - It Cannot Be Edited


Created By: Vicky Williamson On 08/30/2023 at 11:48 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: GREEN BEANS PRESCHOOL
FACILITY NUMBER: 376701403

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in 1 out of 29 persons as mandated reporter training certification for Director expired on 7/12/23, Staff #1 expired on 6/21/23 and Staff #2 expired on 7/23/23, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/05/2023
Plan of Correction
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Director stated mandated reporter training for herself, Staff #1 and Staff #2 will be completed, no later than 9/5/23.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME:Tulam Vu
LICENSING EVALUATOR NAME:Vicky Williamson
LICENSING EVALUATOR SIGNATURE:
DATE: 08/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/30/2023


LIC809 (FAS) - (06/04)
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