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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419791
Report Date: 08/10/2022
Date Signed: 08/11/2022 03:19:23 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/02/2022 and conducted by Evaluator Justin Dorsey
COMPLAINT CONTROL NUMBER: 12-CC-20220802082355
FACILITY NAME:GIANI FAMILY CHILD CAREFACILITY NUMBER:
197419791
ADMINISTRATOR:GIANI, ADRIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 364-2228
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY:14CENSUS: 10DATE:
08/10/2022
UNANNOUNCEDTIME BEGAN:
01:48 PM
MET WITH:Adriana GianiTIME COMPLETED:
04:09 PM
ALLEGATION(S):
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Uncleared adult living on day care premises.
INVESTIGATION FINDINGS:
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On 08/10/22 Licensing Program Analyst (LPA) Justin Dorsey conducted a complaint investigation at the facility to deliver complaint investigation findings. LPA met with Licensee Adriana Giani, who allowed LPA to tour of the facility. Upon arrival LPA observed 10 children with Licensee and Assistant #1.

During this investigation, LPA received documents related to this investigation, which included the facility children’s roster. LPA also interviewed the licensee, assistant #1, neighbors and children of the program. According to interviews it was found that Adult #1 would access the homes bathroom/shower, side of the home and front yard. At the time LPA delivered the complaint investigation findings the RV in the front of the home was moved. Based on information obtained, interviews with relevant complaint parties, licensee, and children the allegation are deemed SUBSTANTIATED and a citation will be issued. A finding of substantiated means that allegations were valid because the preponderance of the evidence standard has been met. A type A citation and $500 immedate civil penalty was issued on 08/10/22 under Complaint Control Number 12-CC-20220727091516.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 12-CC-20220802082355
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GIANI FAMILY CHILD CARE
FACILITY NUMBER: 197419791
VISIT DATE: 08/10/2022
NARRATIVE
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Applicant advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met civil penalties per violation will be assessed.

LPA Dorsey was unable to deliver findings due to Assistant #1 demanding LPA Dorsey leave the home. LPA Dorsey emailed LIC 809, Notice of Site Visit, Appeal Rights and LIC 9224 to Licensee Giani.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2