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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810193
Report Date: 09/20/2023
Date Signed: 09/20/2023 11:39:51 AM

Document Has Been Signed on 09/20/2023 11:39 AM - 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FOUNDATIONS SUCCESS ACADEMYFACILITY NUMBER:
103810193
ADMINISTRATOR:ROSHUNDA ICE TAYLORFACILITY TYPE:
830
ADDRESS:4333 N WEST AVETELEPHONE:
(559) 960-4942
CITY:FRESNOSTATE: CAZIP CODE:
93705
CAPACITY: 9TOTAL ENROLLED CHILDREN: 9CENSUS: 0DATE:
09/20/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Roshunda Ice-TaylorTIME COMPLETED:
12:00 PM
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On 9/20/23 Licensing Program Analyst (LPA) Joseph Pacheco conducted an announced prelicensing inspection. LPA met with Applicant, Roshunda Ice-Taylor. LPA explained the reason for the inspection and toured the facility inside and outside. On 8/30/23 LPA conducted a prelicensing inspection of the facility and noted corrections that needed to be made prior to licensure. During today's inspection, LPA verified the following items have been corrected:

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.

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

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: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2023
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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