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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601433
Report Date: 05/18/2023
Date Signed: 05/18/2023 11:05:10 AM

Document Has Been Signed on 05/18/2023 11:05 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
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:WISE ADULT DAY SERVICE CENTERFACILITY NUMBER:
198601433
ADMINISTRATOR:CATHERINE JONASFACILITY TYPE:
775
ADDRESS:1527 4TH STREETTELEPHONE:
(310) 394-9871
CITY:SANTA MONICASTATE: CAZIP CODE:
90401
CAPACITY: 60CENSUS: 25DATE:
05/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Allamary Moore-DirectorTIME COMPLETED:
03:30 PM
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 On 5/17/2023 & 5/18/2023, LPA Alfonso Iniguez visited the facility unannounced. The purpose of today's visit was to conduct an unannounced annual inspection of the facility. On today's visit, LPA met with facility staff Allamary Moore-Director. The facility profile shows that the facility is licensed for a capacity of (60) clients, of which (10) may be non-Ambulatory. The director stated that the facility has (25) clients enrolled in the program. The total number of non-ambulatory clients attending the program is (0). The staff-to-client ratio is (1) staff to (2) clients. Director stated that the facility has (0) clients with a Restricted Health Care condition. Currently, there are (0) clients using protective devices. The facility conducted a fire drill on 3/27/2023, and a Disaster Plan was on file. The last inspection held by the fire department was on 11/1/2022. The program does not provide transportation.

As a part of today's inspection, LPA reviewed 5 client records, 5 staff records, and medications and inspected the entire facility inside and out. LPA and Director toured the entire facility. The facility is a three-story building of which the day program occupies the second floor. Facility grounds consists of two (2) activities rooms, storage rooms, copy room, conference room, activities supervisor room, quiet room, director’s office, staff room, staff break room, kitchen with a pantry (not accessible to clients), dining room, and three (3) bathrooms of which one is used by staff, and the other are used by clients. Common areas were observed to be clean, operational, and properly furnished. There is also a shaded outdoor patio area for clients to utilize with tables and chairs.

Evaluation Report continues LIC 809-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: WISE ADULT DAY SERVICE CENTER
FACILITY NUMBER: 198601433
VISIT DATE: 05/18/2023
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Inside areas are free of hazards and obstructions. (2) restrooms have working toilets and wash basins. They will accommodate non-ambulatory clients in a wheelchair. Emergency Phone Numbers are Posted & readily available for review in the activity area. Fire Extinguishers are up to fire code. The facilities telephone system is working correctly.
Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured in bathroom #1 was 118.5° F. In the bathroom, #2 was 105.7° F. A comfortable temperature is maintained in the facility. Smoke detectors and carbon monoxide alarm system is build-in and checked by the fire department every year. The facility is equipped with central air and heat. Toxins were stored and inaccessible to clients in kitchen area.
A first aid kit has been inspected, with at least the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze, and current first aid manual, which are stored in locked steel drawers, available for staff use but inaccessible to clients.
The facility does not handle the cash resources of clients.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA did not observe deficiencies therefore no citations were issued at this time.

An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Director Allamary Moore.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC809 (FAS) - (06/04)
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