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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000303
Report Date: 07/10/2026
Date Signed: 07/10/2026 05:16:46 PM

Document Has Been Signed on 07/10/2026 05:16 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:JEWISH FAMILY PRESCHOOL-CONGREGATION BETH SHOLOMFACILITY NUMBER:
384000303
ADMINISTRATOR/
DIRECTOR:		DALE KLEISLEYFACILITY TYPE:
850
ADDRESS:301 14TH AVETELEPHONE:
(415) 221-8736
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY: 76TOTAL ENROLLED CHILDREN: 45CENSUS: 41DATE:
07/10/2026
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:25 PM
MET WITH:Dale KleisleyTIME VISIT/
INSPECTION COMPLETED:
05:30 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 July 10, 2026, Licensing Program Analyst (LPA) Leong arrived at the facility to conduct a scheduled case management visit. LPA met with Director Dale Kleisley and explained the purpose of the visit.

There were 41 children and 11 staff members present during today’s visit. The 11 staff members have criminal record clearance on file.

The facility submitted an application requesting approval to temporarily relocate the program to another part of the property. The initial application requested a capacity of 76 children. The director reported that the original licensed child care areas will be under construction, with an anticipated completion date of August 2027.

The local fire authority issued a clearance on Form STD 850, specifying that the facility is approved to use Rooms 102, 103, 105, 110, 126, Chapel, Plaza, and Koret Hall.

Preschool Indoor measurements are:

Five rooms, the Chapel, and Koret Hall will be used by the preschool children. One room, the Chapel, and Koret Hall will also be used by the toddlers (ages 18 months to 36 months). The indoor area measures 6,909.91 square feet and accommodates the requested capacity of 76 preschool children.

The eight indoor areas were observed to be clean, well-ventilated, and maintained at a comfortable temperature. Age-appropriate toys, materials, and furniture were available and in good condition. Storage cubbies were observed to be available for the children.

The facility was equipped with fire extinguishers, fully stocked first-aid kits, and a carbon monoxide and smoke detector attached to the HVAC system.

See Page 2

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Hanson Leong
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2026
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 3
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)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: JEWISH FAMILY PRESCHOOL-CONGREGATION BETH SHOLOM
FACILITY NUMBER: 384000303
VISIT DATE: 07/10/2026
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
26
27
28
29
30
31
32
Page 2
Preschool Outdoor measurements are:

The two outdoor areas measure 9,516.49 square feet and accommodates the requested capacity of 76 preschool children.

The two outdoor play areas were fully fenced and equipped with age-appropriate toys and equipment. Artificial turf was observed beneath the outdoor play surfaces for both play areas. All toys and equipment appeared to be in good condition. Two sandboxes were observed in the outdoor play area. According to the director, the sandbox will be inspected daily. No pools, spas, or other bodies of water were observed on the premises.

Preschool sinks and toilets:

There are 6 sinks, and 7 toilets that are available for the children to use. The toilet-to-sink ratio is sufficient to accommodate the requested capacity of 76 preschool children.

LPA observed that the children's bathroom was in working condition. The bathroom was found clean and equipped with sufficient toileting supplies

LPA observed that floor mats and cots were available for children’s naps. According to the director, blankets are provided by the parents and will be sent home weekly for laundering

Licensing documents are posted in the facility and available for review. Children will be signed in and out of the program with an electronic app.

The application to use Rooms 102, 103, 105, 110, 126, Chapel, Plaza, and Koret Hall for 76 children is now approved and effective as of July 10, 2026. The facility must adhere to a capacity of 71 preschool-aged children and 5 toddlers (ages 18 months to 36 months).

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Dale Kleisley

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Hanson Leong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026
LIC809 (FAS) - (06/04)
Page: 3 of 3