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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810192
Report Date: 08/10/2023
Date Signed: 08/10/2023 02:09:13 PM

Document Has Been Signed on 08/10/2023 02:09 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FOUNDATIONS SUCCESS ACADEMYFACILITY NUMBER:
103810192
ADMINISTRATOR:ROSHUNDA ICE TAYLORFACILITY TYPE:
850
ADDRESS:4333 N WEST AVETELEPHONE:
(559) 960-4942
CITY:FRESNOSTATE: CAZIP CODE:
93705
CAPACITY: 51TOTAL ENROLLED CHILDREN: 51CENSUS: 0DATE:
08/10/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Roshunda Ice-Taylor - ApplicantTIME COMPLETED:
02:15 PM
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On 8/10/23 Licensing Program Analyst (LPA) Joseph Pacheco arrived at the facility to conduct an announced prelicensing inspection. LPA met with Applicant, Roshunda Ice-Taylor and toured the inside and outside of the facility. Upon arrival, LPA observed that the facility was not in a condition to begin providing care and supervision to children. LPA observed minor repairs under way and there was no play equipment observed in the outdoor activity areas. LPA and Applicant walked through the facility and LPA provided technical assistance on what needs to be done in order for the facility to be licensed. LPA advised for all furniture that can be tipped over to be anchored. LPA informed Applicant where child safety gates or child locks need to be placed in order to make areas of the facility inaccessible. LPA informed Applicant that another prelicensing inspection will need to be scheduled at a future date. LPA informed Applicant that the facility will be expected to be set up and ready to go both inside and outside at the time of the next inspection in order to prevent further delays for licensure. Applicant stated she understood and will ensure the facility is ready to provide care and supervision at the time of a future prelicensing appointment.
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2023
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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