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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315002837
Report Date: 05/15/2026
Date Signed: 05/15/2026 03:25:07 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/02/2026 and conducted by Evaluator Graham Gunby
COMPLAINT CONTROL NUMBER: 59-AS-20260202100741
FACILITY NAME:CROWN POINT VILLAFACILITY NUMBER:
315002837
ADMINISTRATOR:NABUGO, EDITHFACILITY TYPE:
740
ADDRESS:1001 TAMARACK COURTTELEPHONE:
(301) 541-4028
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY:6CENSUS: DATE:
05/15/2026
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Licensee - Violet MubeeziTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff are not following universal precautions to prevent the spread of scabies
INVESTIGATION FINDINGS:
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On 05/15/2026, Licensing Program Analyst (LPA) Graham Gunby arrived at the facility unannounced to deliver complaint findings into the allegation listed above and met with Licensee, Violet Mubeezi.


*Report will continue on LIC9099-C*
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Graham Gunby
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 59-AS-20260202100741
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CROWN POINT VILLA
FACILITY NUMBER: 315002837
VISIT DATE: 05/15/2026
NARRATIVE
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Based on observation, record review, and interviews, the facility was following infection control requirements. Public Health was contacted and they stated since it was only one client, they were not going to get involved. The administrator provided documentation regarding doctors’ appointments for R1 on 01/23/2026 and 02/05/2026. The administrator did submit an incident report to the department and provided an updated Infectious Disease Control Plan. As a precaution, during the first sign of a rash, facility provided PPE for staff and residents in care, notified staff of the potential of scabies, and an in-service training for staff on proper hand washing and universal precautions. Facility encouraged residents to stay in their room during the episode.

It was observed facility had required PPE available at the facility; therefore, the allegation is UNFOUNDED. A finding of unfounded means that the allegation is false, could not have happened and/or is without a reasonable basis.

Exit interview conducted. Report left with facility.

SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Graham Gunby
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2