380504776-12-16-2024-05-CC-JTSE-DBZTXA-20241216140650

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380504776
Report Date: 12/16/2024
Date Signed: 12/16/2024 02:07:11 PM

Document Has Been Signed on 12/16/2024 02:07 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 BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	NIHONMACHI LITTLE FRIENDS SUTTER SITE		FACILITY NUMBER:	380504776
ADMINISTRATOR/ DIRECTOR:	INAMASU, CATHY		FACILITY TYPE:	850
ADDRESS:	1830 SUTTER STREET		TELEPHONE:	(415) 922-4060
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94115
CAPACITY: 91	TOTAL ENROLLED CHILDREN: 63	CENSUS: 50	DATE:	12/16/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:00 AM
MET WITH:	Executive Director, Dawn Mokuau		TIME VISIT/ INSPECTION COMPLETED:	02:20 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 12/16/2024, at approximately 11:00AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Executive Director, Dawn Mokuau (D1) and explained the purpose of the visit. Present during the visit was D1, 11 staff members, one parent volunteer, and 60 preschool age children. The facility is operating within staffing and ratio requirements on this day. LPA and D1 inspected the facility for any health or safety hazards. The facility operates in three classrooms: Wakaba, Peace Garden, and Jyumoku. LPA observed fully charged fire extinguishers that are at least size 2A10BC to be present. There is a fire alarm system running throughout the facility. There is an operational carbon monoxide detector present. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care. Electrical outlets are covered or blocked by furniture to be inaccessible. Lofts are secured with railings to ensure the safety of children. Non-slip rugs are used in each classroom. LPA observed there to be age-appropriate toys and learning materials present. Furniture was observed to be free of rough or sharp edges. Children have access to art activities, blocks, and manipulatives. Children have access to cubbies that are labeled with their names. Per D1, children nap on cots that are provided by the facility. Sheets are provided by the facility, and bedding is brought from home. Bedding is taken home once a week for cleaning, or as needed. Water bottles are brought from home and refilled at the facility. Per D1, the facility provides breakfast, lunch, and snacks for children in care. Food is stored separately from detergents and pesticides. Medication and creams are stored appropriately and labeled. LPA observed the outdoor play area to be enclosed by a barrier that is at least four feet high. There is resilient padding in the form of rubber flooring. Children have access to age-appropriate toys and equipment such as blocks. D1 stated that children who do not meet the recommended age requirement for certain toys and equipment have alternatives available for them. Due to the rain, children were not using the outdoor play area during the visit. There are no pools or other similar bodies of water present. Firearms and weapons are not stored at the facility. Continued on Page Two

Ali Zebila	TELEPHONE: (650) 266-8817
Jonathan Tse	TELEPHONE: (650) 464-4927
	DATE: 12/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

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 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NIHONMACHI LITTLE FRIENDS SUTTER SITE	FACILITY NUMBER: 380504776
	VISIT DATE: 12/16/2024

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

Page Two
LPA reviewed 10 staff files, 10 children’s files, and facility records. LPA observed all staff members to have current Pediatric First Aid/CPR training completed. LPA did not observe any current Mandated Reporter Training certificates. LPA informed D1 that a deficiency would be cited on this day. D1 stated that they understood. Staff qualifications and immunization records are available for review. Children’s files were observed to be complete and included LIC9224 (Acknowledgment of Receipt of Licensing Forms). LPA observed all required postings to be posted and accessible for review in the facility’s sign-in area. Children are signed in with paper sign-in/out sheets.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a
maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Continued on Page Three

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NIHONMACHI LITTLE FRIENDS SUTTER SITE	FACILITY NUMBER: 380504776
	VISIT DATE: 12/16/2024

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

Page Three
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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

See LIC809-D for deficiency cited today regarding Mandated Reporter Training. Appeal rights were provided and explained. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Executive Director, Dawn Mokuau and Site Supervisor Naomi Miura.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 12/16/2024 02:07 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NIHONMACHI LITTLE FRIENDS SUTTER SITE	FACILITY NUMBER: 380504776
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/16/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 0 out of 10 staff files reviewed which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/06/2025
	Plan of Correction
1 2 3 4	Licensee shall have all staff members complete Mandated Reporter Training (Child Care Providers) and submit proof of completion to LPA via email by due date of 1/6/2025.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Ali Zebila	TELEPHONE: (650) 266-8817
Jonathan Tse	TELEPHONE: (650) 464-4927
	DATE: 12/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4