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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010209547
Report Date: 03/11/2026
Date Signed: 03/13/2026 04:34:19 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/06/2026 and conducted by Evaluator Randy Miranda
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20260306114233
FACILITY NAME:BETH SHOLOM PRESCHOOLFACILITY NUMBER:
010209547
ADMINISTRATOR:CHASE, AMANDAFACILITY TYPE:
850
ADDRESS:642 DOLORES AVENUETELEPHONE:
(510) 357-8505
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY:49CENSUS: 34DATE:
03/11/2026
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Caroline Dorn and Beth ZygielbaumTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Ratio - Facility is operating out of ratio.
INVESTIGATION FINDINGS:
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On March 11, 2026, at 8:50am Licensing Program Analysts (LPA) Randy Miranda met with Interim Director Caroline Dorn and Executive Director Beth Zygielbaum to deliver the findings from a complaint investigation for the above allegation. Present during the inspection were the interim director, executive director, four (4) teachers, three (3) substitute teachers, and thirty four (34) preschool age children in care.
Based on information obtained through interviews and record reviews, the preponderance of evidence standard has been met. Facility operated briefly out of ratio due to a staff shortage related to the sudden passing of a staff member, main director’s medical leave of absence, and initial interim director’s leave of absence for travel. The allegation that the facility is operating out of ratio was SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1, Article 06. Continuing Requirements, Section 101216.3 (a) is cited on the attached LIC 9099D.
A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Exit interview
conducted and report was reviewed with Interim Director Caroline Dorn and Executive Director Beth Zygielbaum.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 52-CC-20260306114233
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: BETH SHOLOM PRESCHOOL
FACILITY NUMBER: 010209547
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/11/2026
Section Cited
CCR
101216.3(a)
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(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.
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Checking in with teachers with regularity to ensure breaks, attendance, and substitutes are provided. Ensuring staff that management is available for unexpected needs and coverage. Encourage communications.
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This requirement was not met as evidenced by: Staff briefly operating out of ratio due to a staff shortage related to the sudden passing of a staff member, main director’s medical leave of absence, and initial interim director's leave of absence for travel.
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Ensure adequate staffing by providing additional substitute teachers, hiring new teachers, and anticipating staffing shortages. Provide a guideline to LPA for the above mentioned.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2