<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 354414413
Report Date: 03/29/2023
Date Signed: 03/29/2023 11:59:13 AM


Document Has Been Signed on 03/29/2023 11:59 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:LAWRENCE, DESIREEFACILITY NUMBER:
354414413
ADMINISTRATOR:LAWRENCE, DESIREEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 484-8209
CITY:HOLLISTERSTATE: CAZIP CODE:
95023
CAPACITY:14CENSUS: 0DATE:
03/29/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Desiree LawrenceTIME COMPLETED:
11:45 AM
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
Licensing Program Analyst (LPA) Deanna Villagrana and Licensing Program Manager (LPM) Mary Segura conducted a scheduled informal office meeting at the San Jose Regional Office with Licensee Desiree Lawrence to discuss issues and citations issued on 03/02/2023.

On 03/02/2023, LPA arrived to the home and observed nine day care children with licensee and her daughter Evangelina Lawrence. LPA asked the ages of children. There were four infants and five preschool children present. LPA reviewed files and requested birthdays of children who did not have a file. It was determined that licensee had five infants and four preschool children. Licensee was out of ratio. LPA observed a razor in a drawer in the bathroom which children use. LPA did not observe a working smoke detector, carbon monoxide detector, a current fire drill log, current Mandated Reporter certificates for licensee and her daughter, two children did not have files, several children's files were not complete and missing immunization records or needed to be updated, a current roster, an Individual Infant Sleeping Plan and a Infant Safe Sleep log for infants in care. When LPA and licensee completed reading the report and signing, LPA overheard licensee tell her daughter to go pick up a child from school. LPA observed daughter walk out of the home. Licensee came back into the kitchen where LPA was completing report and asked if the daughter had left the home. Licensee stated yes. LPA explained she was over capacity and could not be left alone with nine children. LPA explained the capacity when a licensee does not have an assistant present.

LPM Mary Segura, explained that if there are continued serious deficiencies cited against the facility including but not limited to citations for staying in ratio and capacity and hazardous items accessible to children, the license may be referred to legal for possible administrative action, which could include revocation of the facility license. The facility will be monitored more frequently to ensure that the facility is maintaining compliance with Title 22 regulations. Licensee was provided a copy of the regulations regarding Staffing Ratio and Capacity, Safe Sleep regulations and maintaining safety equipment including but not limited to smoke and carbon monoxide detectors.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:
DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/29/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LAWRENCE, DESIREE
FACILITY NUMBER: 354414413
VISIT DATE: 03/29/2023
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
26
27
28
29
30
31
32
LPM Mary Segura discussed the requirements of AB 633 with Desiree Lawrence and provided her with the AB 633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and she understands the requirements.
Copies of this report must be provided to parents/guardians of children currently in care at this Facility and to parents/guardians of children newly enrolled at this Facility during the next 12 months.
SUPERVISOR'S NAME: Mary SeguraTELEPHONE: (408) 324-2152
LICENSING EVALUATOR NAME: Deanna VillagranaTELEPHONE: (408) 335-9890
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2