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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419791
Report Date: 06/08/2023
Date Signed: 06/08/2023 01:12:46 PM

Document Has Been Signed on 06/08/2023 01:12 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:
06/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Adriana GianiTIME COMPLETED:
01:27 PM
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
On 06/08/23 Licensing Program Analyst (LPA) Justin Dorsey, met with Licensee, Adriana Giani for a Case Management - Other. Upon arrival LPA Dorsey observed 4 children with the licensee.

During the inspection the following was observed:
  • Upon arrival LPA Dorsey observed there was an infant sleeping in an infant swing. LPA Dorsey reminded Licensee that banned or recalled sleeping equipment shall not be used by children in care. During the visit LPA Dorsey observed the infant was moved from the swing to a crib. Per licensee she will return the swing to the child's parent.
  • LPA Dorsey observed the child in the infant swing was swaddled.

LPA also informed licensee Dorsey 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. During the visit LPA Dorsey went over and provided the licensee with a copy of PIN 20-24-CCP, LIC 9227, and Infant Safe Sleep Log.

LPA Dorsey read Licensee Giani the report and gave 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: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/08/2023
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 1