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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419791
Report Date: 10/09/2024
Date Signed: 10/09/2024 01:24:10 PM

Document Has Been Signed on 10/09/2024 01:24 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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:GIANI FAMILY CHILD CAREFACILITY NUMBER:
197419791
ADMINISTRATOR/
DIRECTOR:		GIANI, ADRIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 364-2228
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
10/09/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Adriana Giani, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On Wednesday, October 9, 2024, Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced annual inspection and met with licensee Adriana Giani who granted access and guided LPA Rivera on a tour of the facility.

During this inspection, 4 children (2 infants and 2 preschool) were present. Family members residing in the home was discussed with licensees and are background cleared. Operating hours are Monday to Friday, 6:30 a.m. to 6:00 p.m., and care for children ages 0 to 12 years.

All areas identified on the facility sketch were inspected by LPA Rivera. This is a single home which consists of three bedrooms, three bathrooms, kitchen, living room, den (daycare room) garage, and front and backyard.

Areas that are accessible to children and identified on the facility sketch include: den (daycare room) and bathroom located in the daycare room.

Areas off limits to children include: three bedrooms and 2 bathrooms, kitchen, and garage. LPA observed the bedroom doors to be closed. LPA observed a gate barrier in place to prevent children entering the kitchen area.

LPA Rivera inspected the facility for safety, comfort, cleanliness, ventilation and working phone (cell phone and land line). For ventilation, LPA observed central AC/heater and vents located on the ceiling. LPA Rivera observed the furniture, children’s materials, and sleeping mats to be age appropriate and in good condition. LPA observed 3 cribs and observed one crib occupied by child #2. LPA observed the cribs to be free from bumper pads, pillows, blankets, toys, pacifiers and hanging items.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2024
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GIANI FAMILY CHILD CARE
FACILITY NUMBER: 197419791
VISIT DATE: 10/09/2024
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LPA observed cleaning compounds items and knives/sharp object stored inside the laundry room located at the end of the kitchen and observed the door closed. LPA observed a gate barrier between living room and kitchen making it inaccessible for children to enter the kitchen. LPA observed filtered water. Licensee provides the meals and LPA informed if food is brought from children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. During this visit licensee stated currently has no children with food allergies or prescribed or non-prescribed medication. For ill isolation area, the living room is utilized.

LPA Rivera asked if there are any pets, poisons, firearms, weapons, or bodies of water. Licensee stated she has two dogs and two cats, no poisons, no bodies of water no firearms, or weapons. LPA did not observe, firearms, weapons nor bodies of water. LPA observed two dogs (mixed dog and Pitbull), and the wading pool with no water. Licensee was advised that if any poisons (ex; drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.



LPA Rivera entered the bathroom and observed the toilet, running water, hand soap and paper towels. Inside the bottom cabinet, LPA did not observe items that can pose a potential hazard to children and observed the cabinet with a childproof lock.

LPA Rivera observed the required 2A10BC fire extinguisher located in the kitchen and the valve on the green area indicating fully charged. LPA observed the service tag dated 8/11/23. LPA reminded licensee the fire extinguisher must be serviced annually or show proof of purchased receipt within the year. LPA observed carbon monoxide detector and the smoke detector located in the daycare room. LPA Rivera tested the carbon monoxide and the smoke detector. Carbon and smoke detectors are operable. LPA observed the first aid kit complete with band aids, gauzes, adhesive bandages, and antiseptic wipes and located in the daycare room. LPA observed the last emergency drill conducted on 10/2/24.

LPA inspected the outdoor area (backyard) used by children for safety, comfort and cleanliness, LPA observed the patio to be fenced all around and the side gates closed. LPA did not observe any children playing outside. LPA observed the play equipment to be age appropriate, in safe condition, free of sharp, no loose or pointed parts. LPA observed a shed with the doors closed.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GIANI FAMILY CHILD CARE
FACILITY NUMBER: 197419791
VISIT DATE: 10/09/2024
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LPA observed licensee Adriana Giani American Heart Association Pediatric First Aid/ CPR certification dated 6/21/23 and has proof of immunization against Pertussis, MMR, and Influenza declination. Licensee has completed the child abuse mandated reporting training dated 9/13/23.

LPA observed license, Pub 394 Notification of Parents Rights, children facility roster and children files. Licensee stated the sleep logs are not completed on the daily basis due to child has a variable schedule and hour only comes for few hours and when present does not sleep,

The following was also discussed with the licensee:

1. The following items are zero tolerance by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both

2. Pediatric First Aid and CPR: American Heart Association or American Red Cross or Emergency Medical Services Authority (EMSA) approved in Pediatric First Aid and CPR must be present. Certification must be renewed every two years.

3. Licensee was informed that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

4. In the absence of the licensee a qualified adult must be present, supervising the children; a qualified adult is an individual who has a valid and current Pediatric first aid/ CPR-adult-child- infant certification (EMSA approved), a valid criminal record clearance associated to the facility license, immunization's (MMR, TDAP, TB and Influenza or Influenza declination), AB 1207 Child Abuse Mandated Reporter Certificate.

5. A current roster of children enrolled must be available and maintained for a period of 3 years, even after children are no longer attending the facility.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GIANI FAMILY CHILD CARE
FACILITY NUMBER: 197419791
VISIT DATE: 10/09/2024
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18. Dog(s) and/or pets are recommended to be isolated from children in care.

19. No, no infant walkers, no Johnny jumpers, no saucer chairs, and any other item that falls into this category is not permitted in the facility.



20. LIC 126 Checklist for Family Child Care provided and reviewed.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee Adriana Giani was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPA discussed the safe sleep regulations with licensee Adriana Giani and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee Adriana Giani 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GIANI FAMILY CHILD CARE
FACILITY NUMBER: 197419791
VISIT DATE: 10/09/2024
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7. The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

8. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

9. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing (refer to LIC 624B).

10. Fire and safety drills must be performed every six (6) months and documented for review by the Department.

11. Smoking is prohibited in the family childcare home.



12. Children and staff records must be maintained and updated as needed and be available for review by the Department.

13. Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.

14. Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.



15. The facility license number must be on all advertisements, publications, or announcements with the intent to attract clients.

16. Isolation for Ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).

17. Liability Insurance was discussed; LPA advised licensee to review Title 22 Regulation 102417(m)(1) for additional information.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GIANI FAMILY CHILD CARE
FACILITY NUMBER: 197419791
VISIT DATE: 10/09/2024
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Licensee Adriana Giani was informed of the MyChildCarePlan.org website; 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.

Licensee Adriana Giani confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies given. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted, and report was reviewed with the licensee Adriana Giani.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024
LIC809 (FAS) - (06/04)
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