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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334804325
Report Date: 12/03/2025
Date Signed: 12/03/2025 02:29:12 PM

Document Has Been Signed on 12/03/2025 02:29 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334804325
ADMINISTRATOR/
DIRECTOR:		MARGARITA D. GUILLERMOFACILITY TYPE:
830
ADDRESS:23301 OLIVEWOOD PLAZA DRIVETELEPHONE:
(951) 924-1956
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 40TOTAL ENROLLED CHILDREN: 27CENSUS: 16DATE:
12/03/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:25 PM
MET WITH:Director Margarita "Jessika" GuillermoTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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On 12/03/2025, Licensing Program Analyst (LPA) Brian Morris conducted an unannounced Case Management inspection to follow-up on an Unusual Incident Report (UIR) submitted to Community Care Licensing on 10/02/2025. LPA met with Director Margarita “Jessika” Guillermo and toured the facility and gathered census. During this visit, LPA interviewed Director, staff members who witnessed the incident and had direct knowledge of what occurred.

Per incident report, on October 02, 2025, at approximately 4:50 PM, C1 was playing on the 3-year-old playground area and teacher Ms. Amanda reported seeing C1 place an unknown object into their mouth before staff could intervene. Ms. Amanda asked C1 to spit out the unknown object, and upon approach, Ms. Amanda recognized the unknown object to be a pill. Ms. Amanda reported, there was a piece of the pill missing, believed to be about %25 of the pill was ingested by C1. Ms. Amanda notified Mr. Guillermo, who was also in the playground area during the incident. Mr. Guillermo asked C1 not to swallow the pill and went inside the facility to the restroom area to rinse C1s mouth out. Mr. Guillermo took C1 to Director Guillermo's office to notify C1’s parents of the incident. Director Guillermo contacted C1’s father Jacoby to notify him of the incident and Jacoby was already in route to KinderCare. Director Guillermo reports, we now have security to come and secure our location over nights and weekends, we believe the homeless population are using our facilities while they are closed and the paraphernalia left behind is dangerous for children. Director Guillermo reports, we are also having our landscape crew, look over our grass area for unknown objects and we also asked them to cut our grass lower so staff can walk the area prior to children arriving to ensure safety. Director Guillermo reports, C1 returned to our facility, they missed one day and stayed home with their family and returned on 10/04/2025 without any restrictions and no doctors note, staff report no change in behaviors and C1 is doing well in our program.
NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Morris
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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 CENTER
FACILITY NUMBER: 334804325
VISIT DATE: 12/03/2025
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Director Guillermo reports, parents contacted our facility and reported, C1 was cleared to return on 10/03/2025, but stayed home with parents and returned 10/04/2025. Additionally, LPA observed the playground and area of incident and found no Title 22 violations that would have contributed to C1's incident.
No deficiencies issues.

An exit interview was held with Director Guillermo. A copy of this report was issued, along with a Notice of Site visit. This report shall be public record for three years.
NAME OF LICENSING PROGRAM MANAGER: Carlos Martinez
NAME OF LICENSING PROGRAM ANALYST: Brian Morris
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
LIC809 (FAS) - (06/04)
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