380504889-5-7-2024-05-CC-JTSE-D5326Y-20240507170755

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380504889
Report Date: 05/07/2024
Date Signed: 05/07/2024 05:08:13 PM

Document Has Been Signed on 05/07/2024 05:08 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		FACILITY NUMBER:	380504889
ADMINISTRATOR/ DIRECTOR:	CATHY INAMASU		FACILITY TYPE:	840
ADDRESS:	1700 SUTTER STREET		TELEPHONE:	(415) 346-5064
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94115
CAPACITY: 70	TOTAL ENROLLED CHILDREN: 62	CENSUS: 53	DATE:	05/07/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:45 PM
MET WITH:	Co-Site Manager, Kristen Jeong		TIME VISIT/ INSPECTION COMPLETED:	05:25 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 5/7/2024, at approximately 2:45PM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with co-site manager, Kristen Jeong (D1). LPA explained the purpose of the visit. Present during the visit were five staff members and 53 school-age children. The facility is in compliance with staffing and ratio requirements on this day. The facility’s operating hours are from Monday to Friday, 2:00PM to 6:00PM. The facility operates from 1:00PM to 6:00PM on Wednesdays. LPA inspected the facility for any health or safety hazards. LPA observed the facility to be in clean and orderly condition. There are two fully charged fire extinguishers that are at least size 2A10BC. There is an operational carbon monoxide detector present in the facility. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care. There are age-appropriate toys and learning materials present. Furniture is age-appropriate and free of rough or sharp edges. The facility provides dry snacks and fruit for children in care. Drinking water is available for children through a water service that is delivered every other month. Children bring water bottles from home and refill them at the facility. There are paper cups available for children if water bottles are not available. Children are afforded privacy in the bathrooms via bathroom stalls. There are five sinks and eight toilets available that are operational. LPA observed the outdoor play area to be free of debris and other loose articles. Children have access to age-appropriate toys and equipment. First aid kits are available and accessible when children are outdoors. Drinking water is accessible. Continued on Page Two

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NIHONMACHI LITTLE FRIENDS	FACILITY NUMBER: 380504889
	VISIT DATE: 05/07/2024

NARRATIVE

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LPA reviewed five staff files, six children’s files, and facility records. LPA observed there to be at least one staff member with current First Aid/CPR training. All staff members present have current Mandated Reporter Training. Staff qualifications are available for review. All children’s files were observed to be complete. Children’s emergency cards are stored separately to be accessible in the case of an emergency. LPA observed required postings to be posted and accessible for review. LPA advised that PUB269 shall be posted.

The facility conducted lead water sampling on 12/7/2023, past the due date of 1/1/2023. There were no exceedances of lead in the tested fixture. The fixture is used to wash fruit for children. Drinking water is provided from an outside source. See LIC809-D for deficiency cited and cleared today regarding timely lead water testing.

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 referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.
Continued on Page Three

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NIHONMACHI LITTLE FRIENDS	FACILITY NUMBER: 380504889
	VISIT DATE: 05/07/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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) 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 and cleared today regarding lead water testing. Appeal rights were provided and explained to D1. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Kristen Jeong.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/07/2024 05:08 PM - It Cannot Be Edited

Created By: Jonathan Tse On 05/07/2024 at 04:38 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
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NIHONMACHI LITTLE FRIENDS	FACILITY NUMBER: 380504889
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/07/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. 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 by testing its fixtures for lead past the deadline of 1/1/2023 which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/21/2024
	Plan of Correction
1 2 3 4	The facility tested its fixtures for lead and did not have any exceedances of lead. This deficiency shall be cited and cleared the same day of the visit, 5/7/2024.

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.

SUPERVISOR'S NAME:

Ali Zebila

LICENSING EVALUATOR NAME:

Jonathan Tse

LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

LIC809 (FAS) - (06/04)

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