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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020766
Report Date: 06/21/2024
Date Signed: 06/21/2024 04:29:47 PM

Document Has Been Signed on 06/21/2024 04:29 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ZHOU FAMILY CHILD CAREFACILITY NUMBER:
198020766
ADMINISTRATOR/
DIRECTOR:		FENG XIUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 392-2100
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
06/21/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:40 PM
MET WITH:Feng Xiu ZhouTIME VISIT/
INSPECTION COMPLETED:
04:40 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 6/21/2024 at 3:40 pm Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced Proof of Correction (POC) inspection to ensure the deficiencies cited on 6/12/2024 during a Case Management visit have been corrected. A COVID risk assessment was conducted. LPA met with Licensee, Feng Xiu Zhou and observed 6 children in care with Licensee and 1 additional adult. Licensee's son translated the report in Chinese for the Licensee.

During the visit LPA, was provided a receipt dated 6/14/2024 for the purchase of a fire extinguisher and a Certificate for Mandated Reporter Training completed on 6/21/2024 by Licensee’s spouse who assist with the children and will expire in 2 years.

LPA cleared the deficiencies on this date and issued Proof of Correction (POC) clearance letter during the visit.

At this time, the facility is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given to Licensee and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Feng Xiu Zhou.


Page 1 of 1
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2024
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