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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364845697
Report Date: 04/07/2025
Date Signed: 04/07/2025 02:49:15 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/24/2025 and conducted by Evaluator Aman Lama
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20250224104421
FACILITY NAME:ZHOU FAMILY CHILD CAREFACILITY NUMBER:
364845697
ADMINISTRATOR:SHAOBIN ZHOUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 274-4832
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91701
CAPACITY:14CENSUS: 4DATE:
04/07/2025
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Shaobin ZhouTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Uncleared adults have access to day care children in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Aman Lama arrived at the facility to conclude a complaint investigation regarding the above allegation received by the department on 02/24/2025. LPA was given access to the facility by licensee, Shaobin Zhou. LPA discussed the purpose of the visit, took census, and toured the facility. LPA met with the licensee, to further discuss the complaint allegations, and to deliver findings. A language interpreter was used for this inspection, to ensure licensee understood the findings and information provided.

It was alleged uncleared adults have access to day care children in care. During the investigation, LPA made observations, reviewed relevant documentation, and conducted interviews with pertinent parties. LPA investigated the allegations and gathered the following information:

See LIC 9099C for more details..................
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 09-CC-20250224104421
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ZHOU FAMILY CHILD CARE
FACILITY NUMBER: 364845697
VISIT DATE: 04/07/2025
NARRATIVE
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Allegedly, the licensee is renting two rooms upstairs to adults who do not have a criminal record clearance.

During the tour of the facility on 02/26/2025, LPA toured the off-limit upstairs area, including bedrooms. While touring, LPA observed some bedrooms were locked and other bedrooms had the doors open. LPA observed the licensee having to open the locked rooms with a key. Licensee stated the all the bedrooms belonged to the three adult residents listed on the LIC279. LPA asked the licensee about three additional adults who were listed on the facility roster. Licensee stated out of the three, one adult only came to help, and two of the additional adults no longer live in the home.

LPA received and reviewed written correspondence dated October 5, 2024, where the licensee confirmed the three individuals were living in the home prior to receiving fingerprint clearance on October 8, 2024.

According to Regulation 102370(d)(1); All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (1) obtain a California criminal record exemption as required by the Department…. Per the documentation reviewed by LPA, this was not met.

Therefore, based on documentation reviewed and interviews conducted, the department has determined the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, are being cited on the attached LIC9099D. See LIC9099-D for deficiencies.

LPA Aman Lama informed the licensee, Shaobin Zhou to provide a copy of this licensing report dated April 7, 2025, that documents any Type A citation(s) to parents/guardians of all children currently enrolled, or newly enrolled by the next business day or the next day the child(ren) is(are) in care. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification and kept on file for 12 months from the date of this report.

A Civil Penalty has been assessed during this inspection. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 09-CC-20250224104421
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ZHOU FAMILY CHILD CARE
FACILITY NUMBER: 364845697
VISIT DATE: 04/07/2025
NARRATIVE
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LPA Aman Lama informed Licensee Shaobin Zhou that this report dated April 7, 2025, document(s) (1) Type A citation(s) which shall be posted for 30 consecutive days as there is(are) immediate risk(s) to the health, safety, or personal rights of children in care.

Exit interview was conducted with licensee, Shaobin Zhou.

A copy of this report, Notice of Site Visit, and Appeal Rights were provided. A notice of site visit must remain posted for 30 consecutive days.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 09-CC-20250224104421
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ZHOU FAMILY CHILD CARE
FACILITY NUMBER: 364845697
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/08/2025
Section Cited
CCR
102370(d)(1)
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(d) All individuals subject to a criminal record review pursuant to H&S Code Section 1596.871 shall prior to working/residing/orvolunteering in a licensed facility:(1)Obtain a California clearance or a criminal record exemption as required by the department.
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Licensee agrees to write an understanding of fingerptint clearances and the importance of criminal reocrd review prior to working, residing or volunteering in the home. This is due to the department no later than the POC due date.
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This was not met as evidenced by: Based on licensees own admission and review of documentation, 2 adults were residing in the home without fingerprint clearances. This poses an immediate health/safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4