198601433-6-30-2026-11-AS-RCLD-DV5SEM-20260617134858

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198601433
Report Date: 06/17/2026
Date Signed: 06/30/2026 09:11:39 AM

Document Has Been Signed on 06/30/2026 09:11 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 ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME:	WISE ADULT DAY SERVICE CENTER		FACILITY NUMBER:	198601433
ADMINISTRATOR/ DIRECTOR:	RACHEL SANGESTANIAN		FACILITY TYPE:	775
ADDRESS:	1527 4TH STREET		TELEPHONE:	(310) 394-9871
CITY:	SANTA MONICA	STATE: CA	ZIP CODE:	90401
CAPACITY: 60		CENSUS: 28	DATE:	06/17/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:11 AM
MET WITH:	Rachel Sangestanian		TIME VISIT/ INSPECTION COMPLETED:	02:05 PM

NARRATIVE

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On 06/17/26, Licensing Program Analyst (LPA) Regina Cloyd and Investigator Chet Johnson conducted an unannounced Required – 1 Year Inspection to the above-named facility and met with Program Director Rachel Sangestanian. LPA explained the purpose of the visit and was accompanied by the Program Director inside and outside of the facility during this inspection. The Day Program is licensed to serve sixty (60) older adults ages 60 and above. Ten (10) clients may be non-ambulatory. Facility fees are current.

WISE & Healthy Aging occupies all three floors of this building but the day program clients will only occupy the second floor. The following was observed: administrative offices, kitchen with a pantry off the kitchen, laundry room within the kitchen, a staff break room, four restrooms, client activity rooms, three storage rooms, a rest area for clients, and an outdoor patio. There are two offices located near the client activity room with a window in each office so staff may monitor clients. One of the restrooms has a shower and states clients may utilize the shower upon request. There are cubbies in the middle storage room where clients’ belongings will be kept.

Day Program walls and floors were in good condition, adequate lighting, fire extinguishers were properly charged. Continue to LIC809-C.

NAME OF LICENSING PROGRAM MANAGER: Ulysses Coronel
NAME OF LICENSING PROGRAM ANALYST: Regina Cloyd
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/17/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2026

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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Document Has Been Signed on 06/30/2026 09:11 AM - It Cannot Be Edited

Created By: Regina Cloyd On 06/17/2026 at 01:11 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WISE ADULT DAY SERVICE CENTER	FACILITY NUMBER: 198601433
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/17/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

82019(e)(3)

(e) Prior to working, residing or volunteering in a licensed day program, all individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall do the following: (3) Request the licensee or applicant for a license to request a transfer of a criminal record clearance as specified in Section 82019(f); or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above for one out of six staff members which poses an immediate safety rights risk to clients in care. Record review revealed Staff #1 (S1) was not associated with the facility. Personnel Report revealed S1 was employed on 07/06/15.
	POC Due Date: 06/18/2026
	Plan of Correction
1 2 3 4	The Director has submitted a criminal transfer request for S1. The Director will ensure all future employees are associated with the facility prior to working.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Ulysses Coronel
NAME OF LICENSING PROGRAM MANAGER:

	Regina Cloyd
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/17/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2026

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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WISE ADULT DAY SERVICE CENTER	FACILITY NUMBER: 198601433
	VISIT DATE: 06/17/2026

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Plenty of storage space for clients’ belongings and activity supplies. Sharps and toxins were properly locked. Water temperature measured at 119-degree Fahrenheit. The men's and women's restrooms were clean and within Title 22 regulations. Water dispenser is available for clients’ use. The kitchen was clean and food is provided by a third-party vendor. First aid kits with booklet were available. Medications are kept locked. Walkways throughout the day program were clear of hazards and all exits were clear of debris. There are no bodies of water on the premises. LPA observed the day program to be sanitary and appropriately supplied at the time of visit.

Six staff records were reviewed, five out of six staff records had required criminal record clearances or criminal record exemptions and associations.

Six client records were reviewed, six out of six client records had Admission Agreements, Medical Assessments, Pre-appraisals (or Reappraisals) and/or Needs & Services Plans.

Deficiencies are being cited according to California Code of Regulation, see LIC809-D.

During record review, Staff #1 (S1) was not associated with the facility. Personnel Report revealed S1 was employed on 07/06/15. The Program Director immediately submitted a criminal record transfer request to the Department.

An exit interview was conducted, technical assistance provided, plans of correction developed and a copy of this report with appeal rights were discussed and left with the Program Director Rachel Sangestanian.

NAME OF LICENSING PROGRAM MANAGER: Ulysses Coronel
NAME OF LICENSING PROGRAM ANALYST: Regina Cloyd
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/17/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2026

LIC809 (FAS) - (06/04)

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