| Severity | Date | Standard / narrative | Corrected |
|---|
| 5 | — |
745.621(a)(3) - AP Initial background checks submitted - At the time you contract with someone who requires a background check
Three foster parents do not have active background checks completed. |
— |
| 3 | — |
749.1951(b)(1) - Disciplinary Measures-Must be consistent with agency policies & procedures
Both foster parents confirmed the use of discipline techniques that are against the agency's policy and procedures. |
— |
| 3 | — |
745.651(1) - Background Check Validation - You must inactivate a subject who is no longer associated with your operation within 7 days of leaving
Staff member who has not been employed with the agency since 10/6/2023 was not inactivated until 3/27/2024. |
— |
| 4 | — |
749.153(a)(3)(B) - Notfication - New controlling person
A new controlling person was not added to the controlling person list within the required timeframe. |
— |
| 2 | — |
749.153(a)(2)(B) - Notfication - At least 15 days in advance - Changes to policies and procedures required by 749.103(b)
Licensing was not notified about personal restraint changes in operation's behavior intervention policy. |
— |
| 5 | — |
749.1463(b)(5) - Administration of Medication-Ensure the child has taken the medication as prescribed
The foster parent doesn't ensure the children in care take their medication as prescribed by admitting she does not always observe the children take their medication. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on April 8, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan; and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plan for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with the heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on February 7, 2025, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the administrator?s failure to ensure compliance include the following: Your operation received a medium -high weighted citation in a pattern/trend category on 2/7/25. Specifically, the operation was cited for 749.503(a)(2)(A): Serious Incident Reporting- The foster parents did not report the child in care critical illness to the agency within 24 hours, it is pending. - Operation failed to satisfy the conditions of the plan. - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring; and - Operation was unable to meet compliance with Medium-High weighted licensing citations. Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plan. An administrative penalty will be assessed as a result of this citation, in accordance with Texas Human Resources Code Sec. 42.078. The maximum daily penalty for your operation is $500. |
— |
| 4 | — |
749.2063(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
Both foster parents confirmed the use of an emergency behavior intervention as a means to get the child in care to comply on multiple occasions. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on April 3, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 3 | — |
749.1281(a)(3) - Subsequent Placement-If move is not an emergency, child placement management staff must comply with the pre-placement requirements in 749.1251
When requesting for documentation on subsequent pre-placement visits there was none available. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on October 2, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 4 | — |
749.930(c)(4) - Annual Training- Caregiver's who administer psychotropic medication must complete psychotropic medication training annually.
It was confirmed by both the caregiver and the case manager that a caregiver who administered psychotropic medication did not have the required annual training. |
— |
| 3 | — |
749.503(e)(3)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness if an adult contracts a reportable communicable disease
One communicable disease was not reported within timeframes. The positive result was received on 8/1 and it was reported on 8/3 to Licensing. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on September 30, 2022, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation is now unable to successfully move to post-plan monitoring. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 5 | — |
749.1521(1) - Medication Storage-Store medication in a locked container
During the inspection, medication was observed inside a weekly organizer, which was placed in an unlocked drawer. |
— |
| 2 | — |
749.3023(c)(3) - Bedrooms-foster children or any other household members may not use a room that does not have doors for privacy as a bedroom
The foster parent confirmed that she had the bedroom door removed on multiple occasions due to the child's behavior. |
— |
| 5 | — |
745.641 - AP Background check results - Must receive notification prior to allowing subject to be present at your operation
Foster parent's son and niece both visit every Thursday. They both meet the criteria definition of what a frequent visitor is, and both did not have a background check completed prior to their visits. |
— |
| 3 | — |
749.503(a)(10)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
Failure to report a serious incident. |
— |
| 3 | — |
749.121(7) - Rights & responsibilities of CPA and foster parents - Type and amount of services available to foster parents
when reviewing documentation day care was not provided in a timely manner as stated in the agencies policy. |
— |
| 5 | — |
745.621(a)(5) - AP Initial background checks submitted - At the time a non-client resident 14 or older moves into your home or operation
The background role was ran as a frequent visitor when it should have been run as a household member when the change occurred. |
— |
| 4 | — |
749.1021(1) - Children's Rights prohibited techniques-Prohibited from using chemical restraints, mechanical restraints, and seclusion on a child
The foster parent used a seclusion restraint by leaving the child alone in a room and preventing her from leaving by holding the door shut. |
— |
| 4 | — |
749.939(d) - Training Criteria-A health-care professional or a pharmacist must lead the training in administering psychotropic medication.
Psychotropic medication training is not being instructor led by a healthcare professional. |
— |
| 4 | — |
749.939(d) - Training Criteria-A health-care professional or a pharmacist must lead the training in administering psychotropic medication.
A healthcare professional has not been found to teach the instructor led portion of the psychotropic medication training. |
— |
| 4 | — |
749.503(a)(3)(A) - Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child
Operation did not call in to report when they became aware of an allegation made by child in care being hit by the foster parent. |
— |
| 5 | — |
749.1521(2) - Medication Storage-Keep medication inaccessible other than to caregivers responsible for stored medication
Unsecured medications (approximately 5 bottles) to include old prescription medications were observed in the foster parent's bedroom bathroom medication cabinet. |
— |
| 3 | — |
749.2305(a) - EBI Documentation-Caregiver must document EBI in child's record as soon as possible, but no later than 24 hours after initiation of the intervention
According to the agency, no emergency behavior intervention documentation has been completed for any of the interventions used in the foster home. |
— |
| 4 | — |
749.2153(2)(C) - EBI Release-Child released from personal restraint as soon as child not a danger to self or others
The foster parent confirmed that he used a restraint by holding the child in care on the arm of a chair for 20 minutes preventing her from leaving the hold. |
— |
| 5 | — |
749.2593(a)(3) - Supervision-The caregiver is responsible for ensuring each child's safety and well being, including auditory and/or visual awareness of the child
A foster child ran away from (and returned to) the foster home on a Friday night and then again two days later. The foster parent indicated the operation did not implement any type of extra supervision nor notify the foster parent that the operation would discharge the foster child the next day. |
— |
| 5 | — |
749.1003(b)(1)(B) - Children's rights-Safety & care including right to be free from abuse, neglect and exploitation
A child in care was not supervised appropriately several times in the foster home. |
— |
| 3 | — |
749.503(a)(10)(A) - Serious Incident-Report to Licensing no later than 6 hours after determining unauthorized absence of a child 13 yrs old or older.
Child in care ran away from the home on 12/01/2022 at 11pm, this was not reported to Licensing until 12/02/2022 at 9:14am. The child in care is 15 years old and the runaway was reported 10 hours later, exceeding the 6-hour timeframe to report. |
— |
| 3 | — |
749.503(a)(10)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
A report to Licensing of a child contracting a communicable disease is required no later than 24 hours after becoming aware of the communicable disease. Child Odis R. tested positive for COVID on 7.24.21 at 8 AM; Licensing was not notified until the afternoon of 7.26.21. |
— |
| 5 | — |
749.1521(2) - Medication Storage-Keep medication inaccessible other than to caregivers responsible for stored medication
Over the counter medication was left out in unlocked left kitchen cabinet. |
— |
| 3 | — |
749.2307(a) - No later than 72 hours after the initiation of the intervention, you must provide written notice to the parent.
The guardian of the child in care stated that she did not know interventions have been used on the child in care. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on March 31, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 5 | — |
749.1463(b)(3) - AP Administration of Medication-Administer medications according to label instructions or a prescribing health-care professional's subsequent orders
Two PM medications were not administered to child in care for 1 day. |
— |
| 5 | — |
749.2151(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
The foster parent confirmed pulling the child in care by her wrists upstairs while the child in care complained of pain. |
— |
| 4 | — |
749.1115(b) - Information to provide caregivers-By child's admission, inform caregivers of any special needs, such as medical, dietary, supervision needs/condition
When conducting an inspection of the home and requesting documentation of the child the foster parent had no documentation provided from the facility. |
— |
| 4 | — |
749.3663(b) - Adoptive Home Care/Safety-Pets vaccinated and treated as recommended by vet
One of the 5 dogs did not have a current rabies vaccination. |
— |
| 5 | — |
745.641 - AP Background check results - Must receive notification prior to allowing subject to be present at your operation
Foster parent's son and niece both visit every Thursday. They both meet the criteria definition of what a frequent visitor is, and both did not have a background check completed prior to their visits. |
— |
| 3 | — |
749.1951(b)(1) - Disciplinary Measures-Must be consistent with agency policies & procedures
Both foster parents confirmed the use of discipline techniques that are against the agency's policy and procedures. |
— |
| 5 | — |
749.1003(b)(1)(B) - Children's rights-Safety & care including right to be free from abuse, neglect and exploitation
A child in care was not supervised appropriately several times in the foster home. |
— |
| 3 | — |
749.121(7) - Rights & responsibilities of CPA and foster parents - Type and amount of services available to foster parents
when reviewing documentation day care was not provided in a timely manner as stated in the agencies policy. |
— |
| 4 | — |
749.2063(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
Both foster parents confirmed the use of an emergency behavior intervention as a means to get the child in care to comply on multiple occasions. |
— |
| 3 | — |
749.503(a)(10)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
Failure to report a serious incident. |
— |
| 2 | — |
749.3023(c)(3) - Bedrooms-foster children or any other household members may not use a room that does not have doors for privacy as a bedroom
The foster parent confirmed that she had the bedroom door removed on multiple occasions due to the child's behavior. |
— |
| 3 | — |
745.651(1) - Background Check Validation - You must inactivate a subject who is no longer associated with your operation within 7 days of leaving
Staff member who has not been employed with the agency since 10/6/2023 was not inactivated until 3/27/2024. |
— |
| 5 | — |
749.2593(a)(3) - Supervision-The caregiver is responsible for ensuring each child's safety and well being, including auditory and/or visual awareness of the child
A foster child ran away from (and returned to) the foster home on a Friday night and then again two days later. The foster parent indicated the operation did not implement any type of extra supervision nor notify the foster parent that the operation would discharge the foster child the next day. |
— |
| 3 | — |
749.503(a)(10)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
A report to Licensing of a child contracting a communicable disease is required no later than 24 hours after becoming aware of the communicable disease. Child Odis R. tested positive for COVID on 7.24.21 at 8 AM; Licensing was not notified until the afternoon of 7.26.21. |
— |
| 4 | — |
749.1115(b) - Information to provide caregivers-By child's admission, inform caregivers of any special needs, such as medical, dietary, supervision needs/condition
When conducting an inspection of the home and requesting documentation of the child the foster parent had no documentation provided from the facility. |
— |
| 5 | — |
749.1521(2) - Medication Storage-Keep medication inaccessible other than to caregivers responsible for stored medication
Unsecured medications (approximately 5 bottles) to include old prescription medications were observed in the foster parent's bedroom bathroom medication cabinet. |
— |
| 3 | — |
749.503(a)(10)(A) - Serious Incident-Report to Licensing no later than 6 hours after determining unauthorized absence of a child 13 yrs old or older.
Child in care ran away from the home on 12/01/2022 at 11pm, this was not reported to Licensing until 12/02/2022 at 9:14am. The child in care is 15 years old and the runaway was reported 10 hours later, exceeding the 6-hour timeframe to report. |
— |
| 5 | — |
749.1521(2) - Medication Storage-Keep medication inaccessible other than to caregivers responsible for stored medication
Over the counter medication was left out in unlocked left kitchen cabinet. |
— |
| 2 | — |
749.153(a)(2)(B) - Notfication - At least 15 days in advance - Changes to policies and procedures required by 749.103(b)
Licensing was not notified about personal restraint changes in operation's behavior intervention policy. |
— |
| 3 | — |
749.2305(a) - EBI Documentation-Caregiver must document EBI in child's record as soon as possible, but no later than 24 hours after initiation of the intervention
According to the agency, no emergency behavior intervention documentation has been completed for any of the interventions used in the foster home. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on April 3, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on September 30, 2022, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation is now unable to successfully move to post-plan monitoring. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 5 | — |
749.1521(1) - Medication Storage-Store medication in a locked container
During the inspection, medication was observed inside a weekly organizer, which was placed in an unlocked drawer. |
— |
| 4 | — |
749.939(d) - Training Criteria-A health-care professional or a pharmacist must lead the training in administering psychotropic medication.
A healthcare professional has not been found to teach the instructor led portion of the psychotropic medication training. |
— |
| 3 | — |
749.2307(a) - No later than 72 hours after the initiation of the intervention, you must provide written notice to the parent.
The guardian of the child in care stated that she did not know interventions have been used on the child in care. |
— |
| 5 | — |
749.2151(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
The foster parent confirmed pulling the child in care by her wrists upstairs while the child in care complained of pain. |
— |
| 4 | — |
749.939(d) - Training Criteria-A health-care professional or a pharmacist must lead the training in administering psychotropic medication.
Psychotropic medication training is not being instructor led by a healthcare professional. |
— |
| 5 | — |
745.621(a)(3) - AP Initial background checks submitted - At the time you contract with someone who requires a background check
Three foster parents do not have active background checks completed. |
— |
| 4 | — |
749.930(c)(4) - Annual Training- Caregiver's who administer psychotropic medication must complete psychotropic medication training annually.
It was confirmed by both the caregiver and the case manager that a caregiver who administered psychotropic medication did not have the required annual training. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on October 2, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 4 | — |
749.153(a)(3)(B) - Notfication - New controlling person
A new controlling person was not added to the controlling person list within the required timeframe. |
— |
| 4 | — |
749.2153(2)(C) - EBI Release-Child released from personal restraint as soon as child not a danger to self or others
The foster parent confirmed that he used a restraint by holding the child in care on the arm of a chair for 20 minutes preventing her from leaving the hold. |
— |
| 4 | — |
749.3663(b) - Adoptive Home Care/Safety-Pets vaccinated and treated as recommended by vet
One of the 5 dogs did not have a current rabies vaccination. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on March 31, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 3 | — |
749.1281(a)(3) - Subsequent Placement-If move is not an emergency, child placement management staff must comply with the pre-placement requirements in 749.1251
When requesting for documentation on subsequent pre-placement visits there was none available. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on April 8, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan; and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plan for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with the heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on February 7, 2025, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the administrator?s failure to ensure compliance include the following: Your operation received a medium -high weighted citation in a pattern/trend category on 2/7/25. Specifically, the operation was cited for 749.503(a)(2)(A): Serious Incident Reporting- The foster parents did not report the child in care critical illness to the agency within 24 hours, it is pending. - Operation failed to satisfy the conditions of the plan. - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring; and - Operation was unable to meet compliance with Medium-High weighted licensing citations. Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plan. An administrative penalty will be assessed as a result of this citation, in accordance with Texas Human Resources Code Sec. 42.078. The maximum daily penalty for your operation is $500. |
— |
| 4 | — |
749.1021(1) - Children's Rights prohibited techniques-Prohibited from using chemical restraints, mechanical restraints, and seclusion on a child
The foster parent used a seclusion restraint by leaving the child alone in a room and preventing her from leaving by holding the door shut. |
— |
| 3 | — |
749.503(e)(3)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness if an adult contracts a reportable communicable disease
One communicable disease was not reported within timeframes. The positive result was received on 8/1 and it was reported on 8/3 to Licensing. |
— |
| 5 | — |
749.1463(b)(5) - Administration of Medication-Ensure the child has taken the medication as prescribed
The foster parent doesn't ensure the children in care take their medication as prescribed by admitting she does not always observe the children take their medication. |
— |
| 4 | — |
749.503(a)(3)(A) - Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child
Operation did not call in to report when they became aware of an allegation made by child in care being hit by the foster parent. |
— |
| 5 | — |
749.1463(b)(3) - AP Administration of Medication-Administer medications according to label instructions or a prescribing health-care professional's subsequent orders
Two PM medications were not administered to child in care for 1 day. |
— |
| 5 | — |
745.621(a)(5) - AP Initial background checks submitted - At the time a non-client resident 14 or older moves into your home or operation
The background role was ran as a frequent visitor when it should have been run as a household member when the change occurred. |
— |
| 4 | — |
749.3663(b) - Adoptive Home Care/Safety-Pets vaccinated and treated as recommended by vet
One of the 5 dogs did not have a current rabies vaccination. |
— |
| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on April 8, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan; and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plan for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with the heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on February 7, 2025, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the administrator?s failure to ensure compliance include the following: Your operation received a medium -high weighted citation in a pattern/trend category on 2/7/25. Specifically, the operation was cited for 749.503(a)(2)(A): Serious Incident Reporting- The foster parents did not report the child in care critical illness to the agency within 24 hours, it is pending. - Operation failed to satisfy the conditions of the plan. - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring; and - Operation was unable to meet compliance with Medium-High weighted licensing citations. Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plan. An administrative penalty will be assessed as a result of this citation, in accordance with Texas Human Resources Code Sec. 42.078. The maximum daily penalty for your operation is $500. |
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749.1281(a)(3) - Subsequent Placement-If move is not an emergency, child placement management staff must comply with the pre-placement requirements in 749.1251
When requesting for documentation on subsequent pre-placement visits there was none available. |
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749.939(d) - Training Criteria-A health-care professional or a pharmacist must lead the training in administering psychotropic medication.
A healthcare professional has not been found to teach the instructor led portion of the psychotropic medication training. |
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749.2593(a)(3) - Supervision-The caregiver is responsible for ensuring each child's safety and well being, including auditory and/or visual awareness of the child
A foster child ran away from (and returned to) the foster home on a Friday night and then again two days later. The foster parent indicated the operation did not implement any type of extra supervision nor notify the foster parent that the operation would discharge the foster child the next day. |
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749.930(c)(4) - Annual Training- Caregiver's who administer psychotropic medication must complete psychotropic medication training annually.
It was confirmed by both the caregiver and the case manager that a caregiver who administered psychotropic medication did not have the required annual training. |
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749.153(a)(3)(B) - Notfication - New controlling person
A new controlling person was not added to the controlling person list within the required timeframe. |
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| 5 | — |
749.1521(1) - Medication Storage-Store medication in a locked container
During the inspection, medication was observed inside a weekly organizer, which was placed in an unlocked drawer. |
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| 3 | — |
749.503(a)(10)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
A report to Licensing of a child contracting a communicable disease is required no later than 24 hours after becoming aware of the communicable disease. Child Odis R. tested positive for COVID on 7.24.21 at 8 AM; Licensing was not notified until the afternoon of 7.26.21. |
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749.503(e)(3)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness if an adult contracts a reportable communicable disease
One communicable disease was not reported within timeframes. The positive result was received on 8/1 and it was reported on 8/3 to Licensing. |
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| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on March 31, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
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749.1521(2) - Medication Storage-Keep medication inaccessible other than to caregivers responsible for stored medication
Unsecured medications (approximately 5 bottles) to include old prescription medications were observed in the foster parent's bedroom bathroom medication cabinet. |
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| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on April 3, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
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749.1463(b)(5) - Administration of Medication-Ensure the child has taken the medication as prescribed
The foster parent doesn't ensure the children in care take their medication as prescribed by admitting she does not always observe the children take their medication. |
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| 3 | — |
749.2305(a) - EBI Documentation-Caregiver must document EBI in child's record as soon as possible, but no later than 24 hours after initiation of the intervention
According to the agency, no emergency behavior intervention documentation has been completed for any of the interventions used in the foster home. |
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| 3 | — |
749.1951(b)(1) - Disciplinary Measures-Must be consistent with agency policies & procedures
Both foster parents confirmed the use of discipline techniques that are against the agency's policy and procedures. |
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| 5 | — |
745.621(a)(5) - AP Initial background checks submitted - At the time a non-client resident 14 or older moves into your home or operation
The background role was ran as a frequent visitor when it should have been run as a household member when the change occurred. |
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| 4 | — |
749.2063(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
Both foster parents confirmed the use of an emergency behavior intervention as a means to get the child in care to comply on multiple occasions. |
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| 4 | — |
749.2153(2)(C) - EBI Release-Child released from personal restraint as soon as child not a danger to self or others
The foster parent confirmed that he used a restraint by holding the child in care on the arm of a chair for 20 minutes preventing her from leaving the hold. |
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| 4 | — |
749.635(2) - AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
During a review conducted on October 2, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
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749.1115(b) - Information to provide caregivers-By child's admission, inform caregivers of any special needs, such as medical, dietary, supervision needs/condition
When conducting an inspection of the home and requesting documentation of the child the foster parent had no documentation provided from the facility. |
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749.1463(b)(3) - AP Administration of Medication-Administer medications according to label instructions or a prescribing health-care professional's subsequent orders
Two PM medications were not administered to child in care for 1 day. |
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| 3 | — |
745.651(1) - Background Check Validation - You must inactivate a subject who is no longer associated with your operation within 7 days of leaving
Staff member who has not been employed with the agency since 10/6/2023 was not inactivated until 3/27/2024. |
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| 3 | — |
749.503(a)(10)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
Failure to report a serious incident. |
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217 inspection record(s) on file from TX-HHSC.