Angel Touch Memory Care Llc.

LPA Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with the Administrator, Christina Andreasyan. Also present was staff, Nina Aivazyan. LPA observed (3) residents in the common area and (2) resident resting in their rooms during the inspection. LPA was advised (1) resident was currently on an outing with their family member. The facility is licensed for (6) residents and has an approved hospice waiver for (4) residents. Currently, there are (2) residents under hospice care. LPA and the administrator toured the interior/exterior of the facility including the common areas, (3) shared resident bedrooms, (2.5) resident bathrooms, staff room, kitchen, laundry and garage. LPA observed the facility to be clean, in good repair and odor free. Carpet is scheduled to be cleaned on 1/24/2026. The bathrooms have the necessary grab bars, skid-resistant flooring, soap, and paper towels. There is 2+ day perishable, including fresh produce, and 7+ day non-perishable food. The freezer/refrigerator temperatures displayed as 0/36*F, within regulation. Fire extinguishers were last serviced on 11/14/2025, and the smoke/monoxide alarms are functioning. Sharps and medications are locked in the kitchen, and toxins are secured in the laundry room. Hot water measured 114*F in the kitchen and the facility temperature displayed as 73*F. There are no blockages to any exit doors and all doors have audio alerts. Staff are aware of the utility shut off valves are located. There are sufficient linens/towels/blankets/PPE on site. Activities/Games are on site. All required posting are visible in the common area. There is one unlocked exit gate in the backyard. There is patio seating and a covered table with chairs. There are no pools. LPA reviewed (3) resident and (2) staff files. Files were organized and contained required paperwork. Medications/orders were reviewed for (1) resident. No discrepancies noted. Staff has completed their required initial/annual training-documentation on file. There is current RCFE Administrator certificate #6072690740-exp 10/27/2026. Administrator to provide a current copy of liability insurance. LPA printed an updated copy of the license. There were no deficiencies observed and no citations issued in this report. Exit interview. Copy of report provided.

LPA Sabrina Calzada arrived unannounced to conduct a Post- Licensing inspection and met with staff, Svitlana Petryk, who contacted Administrator, Christina Andreasyan. The Administrator and Hasmik Khachatryan, Administrator Designee arrived around 3:15 pm. LPA observed (2) residents in the common area and (4) residents resting in their rooms. The facility is licensed for (6) residents and has an approved hospice waiver for (2) residents. Currently, there are (2) residents under hospice care. LPA and the care staff toured the interior/exterior of the facility including the common areas, (2) private resident bedrooms, (2) shared resident bedroom, (2.5) resident bathrooms, staff room, kitchen, laundry and garage. LPA observed the facility to be clean, in good repair and odor free. The bathrooms have the necessary grab bars, non-skid flooring, soap, paper towels. There is 2+ day perishable and 7+ day non-perishable food. Fire extinguishers were last serviced on 11/22/24. Sharps are locked in the kitchen and toxins are secured in the laundry room. All required posting are visible in the common area. There is one exit gate in the backyard. There is patio seating and a covered table with chairs. LPA observed both staff and resident files to be organized and contain required paperwork. Administrator to provide a current copy of liability insurance. Discussed process to increase the hospice waiver. LPA to provide information on the Department's Guardian. There were no deficiencies observed. Exit interview. Copy of report provided.

Licensing Program Analyst (LPA) Sabrina Calzada arrived announced for a scheduled pre-licensing inspection and met with Christina Andreasyan, Administrator. There is a pending RCFE license for (6) residents- (1) resident may be bedridden, and (5) may be non-ambulatory. There are currently no residents present as this location is not currently licensed. LPA and Administrator toured the interior and exterior of the facility including the common areas, (2) private resident bedrooms, (2) shared resident bedroom, (2.5) resident bathrooms, staff room, kitchen, laundry and garage. LPA observed the facility to be clean, in good repair and to have sufficient furniture and lighting throughout. The bathrooms have the necessary grab bars, non-skid flooring, soap, paper towels. Administrator to post a 20-second hand-washing poster at each sink. LPA observed 7+ day non-perishable food, and sufficient dishes, flatware and cooking pans in the kitchen. Sharps will be locked in the kitchen. There is a medications cabinet with a lock in the kitchen. All toxins will be locked in the laundry room. Hot water measured 115*F in the kitchen and the inside temperature measured 71*F. Fire extinguishers were last serviced on 11/22/24, and the smoke/monoxide alarms are in working order. There is a complete First Aid kit, paper supplies, and sufficient linens/towels/blankets. There are flashlights and night lights on hand. All resident rooms are completely furnished. There are various required postings posted, including the Theft & Loss Policy. There is one exit gate in the backyard, and a table/chairs will be delivered tomorrow. LPA observed folders to be used for staff and resident files to contain the required forms. During today's inspection, the following items were ordered and will be delivered as early as tomorrow, or by Friday, 1/17/25. Exit door alarms for all exit doors and magnetic lock for the kitchen sharps. PPE supplies, additional games/activities and resident call button necklaces were ordered. Thermometer for the First Aid Kit, phone land lines/internet scheduled to be installed cont on 809C-1.. 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 809C-1... Administrator to add a visitor sign-in area. Component III was reviewed during today’s inspection. Pre-Licensing is incomplete with deficiencies to be resolved by 1/17/25. Administrator to send photos of the door alarms and kitchen drawer lock once they are installed. LPA will inform Centralized Applications Bureau as soon as deficiencies are resolved. Exit interview. Copy of report left at facility.

Facility Type: RCFE Application Type: Initial Capacity: 6 Method: Telephone call with CAB COMP II Participants: Andreasyan, Christina On 12/23/24, the applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. 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. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readiness