191890253-12-21-2023-33-CC-MJAA-CYQSV4-20231221131208

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191890253
Report Date: 12/21/2023
Date Signed: 12/21/2023 01:12:17 PM

Document Has Been Signed on 12/21/2023 01:12 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	NISHI HONGWANJI CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	191890253
ADMINISTRATOR:	SUSAN MUKAI		FACILITY TYPE:	850
ADDRESS:	815 E. FIRST ST		TELEPHONE:	(213) 687-4585
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90012
CAPACITY: 45	TOTAL ENROLLED CHILDREN: 45	CENSUS: 14	DATE:	12/21/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	12:54 PM
MET WITH:	Susan Mukai, Director		TIME COMPLETED:	01:25 PM

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On December 21, 2023, Licensing Program Analysts (LPAs) Monique Ayala and Staicy Perry conducted an unannounced case management inspection for an Action Level Exceedance (ALE) detected in a water fixture in the facility. LPA met with facility director, Susan Mukai, during the visit. Also present in the facility were 14 day care children and 3 teachers/staff. Facility was within ratio & capacity. A COVID 19 risk assessment was conducted prior to entering the facility.

Analyst reviewed new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.

Facility provided facility sketch and required forms LIC 9276, LIC999 and LIC9275 to LPA on 01/03/23.

On 12/04/2023, the Department received notification from the State Water Resources Control Board

(SWRCB), Division of Drinking Water (DDW). The SWRCB report indicated the facility was inspected and samples were collected on 10/14/2023. Faucets and drinking fountain reported with 5.5 ppb or greater lead exceedance levels were as follows:

C – Sink Faucet In Sunshine Classroom (5.800 UG/L) – Faucet currently not in use

E- Sink Faucet in Kitchen (8.400 UG/L)- Faucet currently not in use

F- Sink Faucet in Kitchen (9.600 UG/L)- Faucet currently not in use

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: NISHI HONGWANJI CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191890253
	VISIT DATE: 12/21/2023

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F30- Sink Faucet in Kitchen (6.200 UG/L)- Faucet currently not in use

Director stated that the facility was using the kitchen faucets for food preparation prior to the discovery of its lead level exceedance. The classroom faucet was used for hand washing and drinking prior to the discovery of its lead level exceedance. Per director the faucets were replaced within 2 weeks of lead level exceedances. The facility is currently waiting for the state to retest the faucets.

Grant funding will be available for testing and remediation of lead to the Child Care Centers that qualify. To make a determination of eligibility, refer to PIN 21-04-CCP. For Lead Testing and Prevention Information, including additional resources please visit

https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

Based on the LPA’s observations and records reviews, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

Director was advised to review PIN 21-21-CCP.

Exit interview conducted and report was reviewed with the facility representative, Director Susan Mukai along with appeal rights. A notice of site visit was also provided and must remain posted for 30 days.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/21/2023 01:12 PM - It Cannot Be Edited

Created By: Monique Jessica Ayala On 12/21/2023 at 01:04 PM

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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: NISHI HONGWANJI CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 191890253
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/21/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/21/2023 Section Cited CCR 101700.3(b)(1)	1 2 3 4 5 6 7	California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 0.5 ppb or greater..., before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Per director the faucets with lead level exceedances have been replaced. Per director the facility is currently waiting for the state to come and retest the faucets.
	8 9 10 11 12 13 14	Based on record review, the licensee did not comply with the directive above, as three outlet (outlet used for food preparation and drinking) out of five outlets tested with an Action Level Exceedance (ALE). This poses an immediate Health and Safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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:

Ana Chico

LICENSING EVALUATOR NAME:

Monique Jessica Ayala

LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

LIC809 (FAS) - (06/04)

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