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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203810223
Report Date: 08/08/2022
Date Signed: 08/08/2022 03:32:39 PM

Document Has Been Signed on 08/08/2022 03:32 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MADISON STATE PRESCHOOLFACILITY NUMBER:
203810223
ADMINISTRATOR:NORA GUILLENFACILITY TYPE:
850
ADDRESS:109 STADIUM RDTELEPHONE:
(559) 675-4630
CITY:MADERASTATE: CAZIP CODE:
93637
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: DATE:
08/08/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Brenda NaranjoTIME COMPLETED:
03:45 PM
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On August 8, 2022, Licensing Program Analyst (LPA) C Brannon conducted an announced prelicensing inspection and met with Brenda Naranjo, ECE Specialist. This return inspection is to ensure all items listed were corrected.

The following items were corrected:
Inside Daycare:

1) Anchor shelving units and bookshelves in the classrooms
2) Anchor the play kitchen components. ยท

Outside Play Area:
1) Remove all four trikes with missing rubber grip handle bar covers.
2) The kindergarten exterior wall faces the outside play yard. The exterior wall has a missing/exposed wooded area.

Pending a final file review and completion of above items, a recommendation will be made to license the above facility for the requested capacity of 24 preschool children.

Exit interview conducted and report was reviewed with Brenda Naranjo.

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: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2022
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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