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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845994
Report Date: 03/09/2023
Date Signed: 03/09/2023 09:21:28 AM

Document Has Been Signed on 03/09/2023 09:21 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:ZHONG FAMILY CHILD CAREFACILITY NUMBER:
364845994
ADMINISTRATOR:ZHONG,XIAOMENGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 848-6105
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
03/09/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Xiaomeng ZhongTIME COMPLETED:
09:30 AM
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On 3/9/2023, LPA Claudia Caywood and LPM Gilbert Sena conducted a case management to document the delivery of an amended report dated 01/24/23. The amended report was delivered 2/3/23. During today's visit, LPA toured the inside and met with Xiaomeng Zhong.

No deficiencies cited.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Claudia Caywood
LICENSING EVALUATOR SIGNATURE: DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/09/2023
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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