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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419791
Report Date: 12/16/2022
Date Signed: 12/16/2022 01:43:35 PM

Document Has Been Signed on 12/16/2022 01:43 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:GIANI FAMILY CHILD CAREFACILITY NUMBER:
197419791
ADMINISTRATOR:GIANI, ADRIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 364-2228
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
12/16/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:57 PM
MET WITH:Jorge Giani TIME COMPLETED:
01:50 PM
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License Program Analyst (LPA) Justin Dorsey conducted a Case Management - Other inspection at Giani Family Child Care Home. LPA met with Licensee Adriana Giani and Jorge Giani. The purpose of the visit was to complete a health and safety check.

At the time of inspection there was 4 children with licensee Adriana Giani. Also present in the home was Licensees Spouse Jrge Giani. LPA Dorsey inspected all areas of the home for health and safety compliance. During the visit Adult #1 was not observed to be in the home.

A copy of the report and appeals right were given to the licensee as well as the notice of site visit.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2022
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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