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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419791
Report Date: 03/22/2023
Date Signed: 03/22/2023 11:52:38 AM

Document Has Been Signed on 03/22/2023 11:52 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, 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: 6DATE:
03/22/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Adriana GianiTIME COMPLETED:
12:07 PM
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On 10/24/22 Licensing Program Analyst (LPA) Justin Dorsey, met with Licensee, Adriana Giani for a Case Management - Other. Upon arrival LPA Dorsey observed 6 children with the licensee.

During the inspection the following was observed:
  • LPA Dorsey observed cribs in the home with blankets and pillows. Per licensee when children are in the cribs sleeping there are no blankets, pillows, toys or bottles in the crib.

LPA Dorsey issued a Technical Violation and went over and emailed a copy of Safe Sleep PIN 20-24-CCP, Infant Safe Sleep Log and LIC 9227 to the licensee. LPA Dorsey read Licensee Giani the report and emailed licensee a copy of the LIC 809, Notice of Site Visit and Appeal Rights.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2023
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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