In the final vineyard scene, Steve's "assistants" wear the slave girl outfit worn by Princess Leia in Return of the Jedi. When the foster children are taken away from them, the girls try to use their chains to strangle Steve in a similar manner to how Leia killed Jabba the Hutt in the same movie.
Francine wears the Bride's yellow jumpsuit from Kill Bill in the motorcycle chase which, in turn, was a homage to the Bruce Lee film Game of Death.
The delivery boy tells Hayley that Costco now has doctors in store and later, Hayley gets a phone call from Dr. Kirkland at Costco. Kirkland Signature is Costco's store brand.
The title of the episode is a word play of the song "The Tears of a Clown" by Smokey Robinson and the Miracles.
The scene where Francine stalks Stan in the dark while she is wearing night vision goggles is from the film "The Silence of the Lambs".
One of the vineyard scenes refers to Cool Hand Luke as the foster children work in a line with pick-axes in a very similar fashion to a chain-gang with Roger watching over them dressed in attire like the "Man With No Eyes" in Cool Hand Luke. One of the children says to him "Water break boss?". "boss" was the term used by the inmates to refer to the men in charge over them.