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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000303
Report Date: 09/23/2026
Date Signed: 09/23/2026 01:03:33 PM

Document Has Been Signed on 09/23/2026 01:03 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: 50CENSUS: 46DATE:
09/23/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:21 AM
MET WITH:Jamie Falkenhainer and Dale Kleisley TIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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On September 23, 2026, Licensing Program Analysts (LPAs) Leong and Tso arrived at the facility to conduct an unannounced annual inspection. LPAs met with Assistant Director Jamie Falkenhainer, and Director Dale Kleisley, and explained the purpose of the visit.

The facility was staffed by the director, assistant director, and 12 staff members, with 46 children in care (39 pre-k and 7 toddlers). The facility was operating within the licensed capacity and staff-to-child ratio requirements. All present staff members on site have criminal record clearance on file.

The toddler room is named Gan Mayim

The preschool rooms are named Gan Keshet, Gan Adamah, Gan Shemesh, and Gan Orr.

The facility operates in five rooms: four pre-K and one toddler room, which 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. All poisons, cleaning solutions, and hazardous materials were stored in areas inaccessible to children. The bathrooms were clean and equipped with sufficient toileting supplies. Storage cubbies were observed available for the children. Two diaper changing stations were observed within arm’s reach of a sink.

Prescribed medications were observed on site and found to be current, in original packaging, and with the prescription label.

The facility was equipped with fire extinguishers, fully stocked first-aid kits, a centralized fire alarm, and a centralized carbon monoxide system.

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Garfield Leung
Hanson Leong
DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2026
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
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: 09/23/2026
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Parents are required to provide lunch and snacks for their children. Children use their own water bottles and refill them at the designated water dispenser at the front of the facility.

LPAs observed that the facility uses cots and mats for children’s naps. The parents provide the sheets, which are laundered weekly. Children’s names were marked on each child’s cot and mat.

The outdoor play area was equipped with age-appropriate toys and equipment. Resilient and artificial grass were installed beneath one of the outdoor play areas. Water barrels were present on the outdoor plaza, and each cover was secured. All toys and equipment appeared to be in good condition. No pools, spas, or other bodies of water were observed on the premises.

Required licensing documents were posted and available for review. Emergency disaster drills are conducted and documented, with the most recent drill completed on June 15, 2026. All children present at the facility were confirmed as signed in using an electronic app called Bright Wheel.

LPA Tso reviewed ten children's records and found that all ten children had the required licensing forms and immunization records.

LPA Leong reviewed the records of five staff members and found that four hold valid Pediatric CPR/First Aid certifications. The facility is only required to have at least one staff member on site certified in Pediatric CPR/First Aid. Five staff members also held current Mandated Reporter Training certifications. LPA reviewed transcripts for five staff members and confirmed that all five met the educational requirements for an infant/toddler or preschool teacher.

Six children’s sleep logs were reviewed, including the child’s name, date, time, sleeping position, side of distress, and staff initial. All were found to be complete.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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

DATE: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
LIC809 (FAS) - (06/04)
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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
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: 09/23/2026
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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test as specified in Health and Safety Code section 1597.16.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

CCC COMPLETED SAMPLING BUT THE TEST RESULTS ARE NOT YET AVAILABLE.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for and removing any recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

There were no deficiencies cited at this time.

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: 09/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026
LIC809 (FAS) - (06/04)
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