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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198601433
Report Date: 03/28/2025
Date Signed: 03/28/2025 12:41:10 PM

Document Has Been Signed on 03/28/2025 12:41 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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:WISE ADULT DAY SERVICE CENTERFACILITY NUMBER:
198601433
ADMINISTRATOR/
DIRECTOR:		CATHERINE JONASFACILITY TYPE:
775
ADDRESS:1527 4TH STREETTELEPHONE:
(310) 394-9871
CITY:SANTA MONICASTATE: CAZIP CODE:
90401
CAPACITY: 60CENSUS: 8DATE:
03/28/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Rachel Sangestanian, Administrator TIME VISIT/
INSPECTION COMPLETED:
12:50 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
At 8:50 AM, Licensing Program Analyst (LPA) Bernadette Allen met with Molly Davies, President/CEO of Adult Day Center and explained the purpose of today’s visit. At 9:15 AM, Rachel Sangestanian, Administrator arrived and she was informed of the purpose of the visit.

The facility is licensed for a capacity of (60) clients, of which (10) may be non-Ambulatory.

Molly Davies, President/CEO stated there are seventy-seven (77) 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 (4) 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 2/28/2025 and a Disaster Plan was on file. Smoke detectors and carbon monoxide alarm system is build-in and checked by the fire department every year and the last inspection held on 7/24/2024.

The current census on today’s visit for the day program is eight (8) both the Molly Davis-CEO and Rachel Sagestanian-Administrator are aware they may not exceed the approved capacity of sixty (60).

At 10:16 AM, LPA reviewed four (4) clients files for admission agreements, updated physician reports, needs and services plans all of which were all current. LPA also reviewed four (4) staff files for First Aid/CPR certification, criminal record clearance, training's, and health screenings which were all current.

At 11:00 AM, LPA and Rachel Sagestanian- Administrator toured the entire facility. The facility is a three story building, with the day program located on the second floor.

NAME OF LICENSING PROGRAM MANAGER: Stephanie Cifuentes
NAME OF LICENSING PROGRAM ANALYST: Bernadette Allen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2025
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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: WISE ADULT DAY SERVICE CENTER
FACILITY NUMBER: 198601433
VISIT DATE: 03/28/2025
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
 The premises include two activity rooms, storage rooms, a copy room, a conference room, an activity room, a quiet room, a director's office, a staff room, a staff break room, a kitchen with a pantry (inaccessible to clients), a dining room, and three bathrooms—one designated for staff use and two for client use. All bathrooms are equipped with functioning toilets and washbasins. The common areas were observed to be clean, fully operational, and appropriately furnished.

The facility features a shaded outdoor patio area equipped with tables and chairs for client use. All indoor areas are free from hazards and obstructions. Two restrooms, fitted with working toilets and washbasins, are designed to accommodate non-ambulatory clients in wheelchairs. Emergency phone numbers are posted and readily accessible in the activity area. Fire extinguishers comply with fire code requirements, and the telephone system is functioning properly. The facility is equipped with central air and heating. Water temperatures throughout the facility range between 105–113°F, while the overall facility temperature remains between 72–75°F.

LPA observed that toxins are securely stored in the kitchen area, making them inaccessible to clients. Additionally, a first aid kit has been inspected and contains essential items, including a thermometer, tweezers, scissors, antiseptic, bandages, gauze, and a current first aid manual, all stored in the main activity room.

During today’s inspection LPA did not observe any deficiencies therefore no citations were issued at this time.

An exit interview was conducted, where this report was discussed and provided to Rachel Sagestanian- Administrator, at the conclusion of the visit.

NAME OF LICENSING PROGRAM MANAGER: Stephanie Cifuentes
NAME OF LICENSING PROGRAM ANALYST: Bernadette Allen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
LIC809 (FAS) - (06/04)
Page: 3 of 3