A.M.D Angel Garden

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Sandra Urena conducted a Pre-licensing visit and met with the Applicants Margarita Sahakyan and Meline Petrosian. This is a Change of Ownership (CHOW) application for a Residential Facility for the Elderly (RCFE) for six (6) non-ambulatory residents; one (1) of which may be a bedridden resident(s). Fire Clearance was approved on 02/27/2026. Bedridden resident approved to be in bedroom # 4 Only. The LPA, and the Applicant toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility will be following Title 22 Regulations. COMMON AREAS: The living room area is equipped with a television, and activities for residents in care. There is a dedicated area for the posting of required documents at the entrance of the facility and in the living room area. Smoke and carbon monoxide alarms were tested and functional at the time of the visit. Medications will be stored in a locked cabinet in the living room area. The residents’ and staff files will be stored in a locked cabinet located in the living room area. The first aid supplies were complete, including a thermometer and a current version of a first aid manual. Applicant will ensure all window seals are free of dust and walls are cleaned. LAUNDRY ROOM: There is a laundry area equipped with washer and dryer. The washer and dryer are located adjacent to the kitchen. At the time of the visit the detergents and cleaning supplies are locked in a cabinet located inside the washer and dryer room. . Continues on LIC 809C... KITCHEN: Kitchen knives are stored locked and inaccessible in a locked kitchen drawer. A seven-day supply of non-perishable food was available. The supply of dishes is adequate. Appliances in the kitchen were clean, and all appeared functional. Kitchen cleaning supplies are currently stored and locked under the kitchen sink. Hot water temperature was recorded at 113.8 degrees Fahrenheit. Trash cans have a tight-fitting lid. There were no pesticides or toxins stored near food, or preparation area. There is one fire extinguisher located next to the dining room. The fire extinguisher was purchased on 04/27/2026. BEDROOMS: There are four (4) bedrooms for residents in care. Rooms #1 and #4 are shared bedrooms. Room #4 is approved for one (1) bedridden resident only and one non-ambulatory resident. Rooms # 2 and Room #3 are private bedrooms approved for single occupancy only. All bedrooms were supplied with all required bedding and linens. There is sufficient lighting as well as closet and drawer space available. The Applicant will add a divider inside the closet of bedroom #1 and will clear out and relocate all incontinent care items to the garage. BATHROOMS: There are three (3) full bathrooms, with showers. The entrance hallway bathroom is used for staff and visitors. The hallway bathroom near Room #2 is used by residents. The shower area needs a bottom guard to ensure the area is safe for residents, even though this shower is not used for showers. The third bathroom is located inside room #4 short hallway leading to the inside of the bedroom and is used for showers for all residents. Bathrooms are equipped with toilets and shower grab bars, and non-skid mats. There are sufficient supplies of towels, paper goods and personal hygiene supplies. Hot water delivered was between 113.8 and 118.6 degrees Fahrenheit. SURROUNDING GROUNDS/OUTDOOR AREA: The exterior passageways were clean. The patio is furnished with outdoor furniture for residents’ use, and shade is available. The building has a central entrance for residents and visitors. Left passageway is cleared and has a self-latching gate. The applicant completed Component III orientation. This report will be sent to the Centralized Application Bureau (CAB). You will be notified by the CAB Analyst when your license has been approved. Failure to comply could affect approval of your license. Exit interview was conducted and reviewed with the applicant. A copy of the report was issued.the state’s words, verbatim · CDSS document, Jun 12, 2026

Type of visit: Office

COMP II by CAB successfully completed Method: Phone Call at CAB Applicant/administrator participated in COMP II at CAB telephone call with analyst at CAB. Identification of the applicant and administrator was verified by presenting photo ID via phone. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Staff qualifications and responsibilities 3. Applicant and Administrator qualifications 4. Program policy: Abuse, admission agreement, medication management, reporting incidents to CCL, restricted & prohibited conditions 5. Grievances, Complaints, Community resources 6. Physical plant, food service 7. Application document review and technical assistance: Criminal record clearance, Health screening, Fire clearance, First Aid/CPR certificate, Administrator certificate, Financial verification, Pre-licensing inspection, Compliance history, Control of propertythe state’s words, verbatim · CDSS document, May 13, 2026