103810193-8-30-2023-04-CC-JPAO-CV7QRK-20230830122404

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103810193
Report Date: 08/30/2023
Date Signed: 08/30/2023 12:24:10 PM

Document Has Been Signed on 08/30/2023 12:24 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 ACADEMY		FACILITY NUMBER:	103810193
ADMINISTRATOR:	ROSHUNDA ICE TAYLOR		FACILITY TYPE:	830
ADDRESS:	4333 N WEST AVE		TELEPHONE:	(559) 960-4942
CITY:	FRESNO	STATE: CA	ZIP CODE:	93705
CAPACITY: 9	TOTAL ENROLLED CHILDREN: 9	CENSUS: 0	DATE:	08/30/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Roshunda ice-Taylor		TIME COMPLETED:	12:30 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 8/30/23, Licensing Program Analyst (LPA) Joe Pacheco conducted an announced pre-licensing inspection and met with Applicant, Roshunda Ice-Taylor. LPA reviewed the reason of the inspection, and a tour of the center was conducted both inside and outside. The center is located at address 4333 N. West Ave. Fresno, CA 93705. This is a new facility, and the applicant is requesting a license for 9 infant children ages 0-2. This program will operate year round from 6:30 AM to 6:30 PM Monday through Friday. This program will operate in one classroom. Applicant is aware to contact the Fresno Community Care Licensing for a change in classrooms and/or change in capacity. Parents will take their children to the lobby and staff will conduct the daily health check and escort them to their classroom. Applicant stated that the center will provide breakfast, AM snack, lunch and a PM snack. Food will be prepared onsite in the kitchen which is inaccessible to children. The knives and sharp utensils are stored in a drawer inside the kitchen. Parents will provide their children with infant formula, diapers and napping sheets. Facility will provide wipes. Staff will utilize the bathroom located at the end of the hallway right outside the classroom. Ill children will be isolated in the Center Director’s office and utilize the staff bathroom. The classroom was observed to be clean and free of toxins. LPA observed that the furniture and equipment appeared to be safe and in good condition. The tall indoor play equipment are anchored to prevent tipping onto children in care. There are enough tables, chairs, mats and plenty of toys for children to play. LPA did not observe any cubbies. LPA also reminded Applicant to not store anything on top of high shelves that could potentially fall on children. There are working smoke detectors that are wired throughout the building and carbon monoxide detectors in in the classroom. LPA reviewed with Applicant, that any future changes to the classrooms are required to ensure that furniture does not tip over on to children, the furniture are to be anchored or situated that tipping does not occur. Classroom changes of furniture shall be situated that 100% visual supervision is always provided to children in care. Room measurements were taken and reviewed with Applicant. The total inside preschool area measured to an approximate 333 square feet which will accommodate the requested capacity of 9 infant children. CONTINUED ON LIC809-C

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Joseph Pacheco
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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FOUNDATIONS SUCCESS ACADEMY	FACILITY NUMBER: 103810193
	VISIT DATE: 08/30/2023

NARRATIVE

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Applicant understands that children's equipment needs to match the capacity she is licensed for. Toys and equipment appear to be age appropriate. There is a total of 1 toilet and 1 sink/hand washing fixture which will accommodate the requested capacity of 9 infant children. Facility will be utilizing a water vendor service to provide drinking water to children in care. Applicant said they will use the water from the service to fill igloo jugs in each classroom. Facility will provide paper cups from a cup dispenser for children to utilize. The igloo jugs and cup dispensers will be taken outside and utilized to provide water during outdoor activities. LPA observed sinks in the facility kitchen that will be utilized for food preparation. 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).
The outside square footage is approximately 675 square feet which will accommodate the requested capacity of 9 infant children. The outdoor play area is gated all around. LPA observed age appropriate toys and play equipment. No high climbing equipment was observed. LPA observed the use of a tarp to provide a shaded rest area. LPA reminded Applicant that visual supervision is to be provided to children in care at all times.
LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
Facility representative 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, 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.

A fire clearance for a capacity of 9 infant children was approved and granted by the Fresno Fire Department on 6/22/23.

The following items must be completed prior to issuing a license:
CONTINUED ON LIC809-C

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Joseph Pacheco
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FOUNDATIONS SUCCESS ACADEMY	FACILITY NUMBER: 103810193
	VISIT DATE: 08/30/2023

NARRATIVE

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Inside Daycare:
1) Anchor refrigerator.
2) Obtain equipment to make water readily available in each classroom.
3) Obtain 9 cubbies and anchor them to prevent tipping.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. Applicant has submitted an IMS plan to the Fresno Regional Office. 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, available at: http://www.ada.gov/childqanda.htm.

Pending a final file review and completion of the above items, a recommendation will be made to license the above facility for the requested capacity of 9 infant children.

LPA reviewed with facility representative the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

The following documents should be posted at the facility:
* PUB 269- Child passenger restraint systems poster 101225(f) Transportation
* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)
* Activity Schedule
* Lead Poisoning brochure

Applicant was informed of the MyChildCarePlan.org site, 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.
CONTINUED ON LIC809-C

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Joseph Pacheco
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FOUNDATIONS SUCCESS ACADEMY	FACILITY NUMBER: 103810193
	VISIT DATE: 08/30/2023

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with Applicant, Roshunda Ice-Taylor.

A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Joseph Pacheco
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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