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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334804323
Report Date: 01/18/2024
Date Signed: 01/18/2024 11:01:34 AM

Document Has Been Signed on 01/18/2024 11:01 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334804323
ADMINISTRATOR:MARGARITA D. GUILLERMOFACILITY TYPE:
850
ADDRESS:23301 OLIVEWOOD PLAZA DRIVETELEPHONE:
(951) 924-1956
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: 21DATE:
01/18/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:08 AM
MET WITH:Jesika GuillermoTIME COMPLETED:
11:10 AM
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On Thursday, January 18, 2024 Licensing Program Analyst (LPA) Amber Shaw conducted an unannounced Case Management inspection to follow-up on an Unusual Incident Report (UIR) submitted to Community Care Licensing CCL on January 16, 2024. LPA met with Jesika Guillermo (Director). LPA interviewed the director and two staff members during this inspection.

On January 16, 2024, CCL received information via UIR that one child was running in the classroom and fell and injured her foot. This resulted in the child having a possible pulled ligament. Confidential interviews revealed to LPA that proper and timely aid was provided to the injured child. In addition, the incident was reported to CCL and documentation observed in the injured child’s file and parents were notified. Records review also confirmed that the CCC was operating within proper staff to child ratios.

Based on information gathered, the CCC acted appropriately and no violations of Title 22 have been identified.

An exit interview was held with Jesika Guillermo. A copy of this report was issued, along with a Notice of Site visit. This report shall be public record for three years.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Amber Shaw
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2024
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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