Capacity 64. 12-17
| Severity | Date | Standard / narrative | Corrected |
|---|
| 4 | — |
748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
1 tablet of a child's Cetrizine 10mg AM was left on the counter top in the medication room. This was noticied during the walkthrough after 3PM. |
Yes |
| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
Children mentioned staff use profane language at them. 1 staff member admitted to using profane language toward a child. |
— |
| 4 | — |
748.303(a)(12)(A) - Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child
A child in care had a mark on their neck from wrapping a string around their neck. The child answered yes to all questions on a suicide screening, indicating this was a suicide attempt. This was not self-reported to Licensing. |
— |
| 4 | — |
748.1661(b) - Tobacco Products-Adult may not smoke tobacco products, e-cigarettes, or vaporizers in children's living areas/inside any building on premises w/ kids
There is sufficient evidence to show a staff member is vaping inside the home the children live in. |
— |
| 4 | — |
748.3563(c) - Protective Surfacing-If loose-fill surfacing materials are used, the operation must install 9 inches or more of uncompressed loose-fill material
During the walkthrough of the operaiton the fill surface for the swings were observed having about 4 to 5 inches of loose wood material. |
— |
| 4 | — |
748.2151(c)(5) - Medication record - must include date (day/month/year) & time each medication was administered
The time the medication was administered was not documented on the medication log. |
— |
| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
It was observed in video footage that child in care was able to assault another child in care with multiple staff present. Some employees are observed to not having a reaction to try to stop the altercation. |
— |
| 4 | — |
748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
A child in care sustained injuries after being improperly restrained in a non-emergency situation. |
— |
| 4 | — |
748.2203(c) - Medication Error-Operation must meet documentation requirements within 24 hrs
When reviewing documentation, it was observed that the operation did not complete medication error documentation timely. |
— |
| 4 | — |
748.1101(b)(4)(A)(v) - Children's rights- To be free from being subjected to remarks that belittle or ridicule the child or the child's family
Based on information gathered it was determined that a caregiver belittled the children in care when they made profane remarks about their families. |
— |
| 4 | — |
748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
During the course of an investigation, it was found that a caregiver used force to get a child to comply. |
— |
| 5 | — |
748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
A staff member attempted to kick a child in the head while the child was in handcuffs laying on the ground. |
— |
| 3 | — |
748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
A child was admitted on 12.7.23, however, documentation within their record was dated with the admission date of both 12.7.23 and 12.4.23. |
— |
| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
It was noted that on several occasions staff appear to have used curse words at children based off of interviews completed. |
— |
| 3 | — |
748.3365(b)(2) - Bedding-must provide each child with a mattress cover or protector unless mattress is waterproof
There were more than 10 beds observed currently being used by children in care that did not contain a mattress protector or cover. |
— |
| 3 | — |
748.125(d)(4)(C) - Suicide Screening- Must be administered every 30 days after admission for children 10 years of age or older in a residential treatment center.
Two suicide screenings were completed late. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Staff members were using vulgar language around a child speaking of another staff member. The language was later directed at a child for the incident the child had placed themselves in. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff member was speaking to a child's parent via phone call with the child present. It was determined the staff was belittling the child during the conversation and being unprofessional with the parent. |
— |
| 3 | — |
748.3443(a)(6) - Food Preparation-Food items must be covered when stored in the refrigerator
During the unannounced walk through of the operation food was observed uncovered and not secured appropriately in the refrigerator. |
Yes |
| 5 | — |
748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity
The staff member responsible for the child who eloped was inside the unit while that child and 2 others children were outside the unit. During this time, the two children helped the third child over the operation fence which led to the child eloping the operation. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
During the investigation it was found two staff physically abused two children when completing two separate inappropriate restraints. |
— |
| 4 | — |
748.1101(b)(4)(A)(vii) - Children's rights- Free from demeaning behavior to embarrass/control/harm/intimidate/isolate the child
A child in care was pushed by a caregiver. |
— |
| 3 | — |
748.125(b) - All employees and caregivers must be aware of and follow your operation's policies and procedures
During the course of the investigation, one staff admitted to sleeping during their night shifts, one staff admitted to dozing off during their shifts, and another staff admitted to falling asleep one time during an unexpected double shift. |
— |
| 4 | — |
748.303(a)(5)(A) - Serious Incident-Report to Licensing soon as aware of an incident of sexual abuse of a child against another child
The operation did not report the serious incident. The child made allegations to a staff member of inappropriate physical contact with another child. |
— |
| 3 | — |
748.705(b)(9) - Reasonable & prudent parent standard-must consider the supervision instructions in the child's service plan
During the course of the investigation, it was determined that a child in care required supervision with close proximity. However, staff did not verify the child's location, which resulted in the child being able to elope during an outing. |
— |
| 5 | — |
748.2461(b)(6) - Short Personal Restraint-Caregiver may not use restraint that twists or places the child's limb(s) behind the child's back
During the investigation it was found a staff member restrained a child placing the child?s arms bent behind their back. |
— |
| 4 | — |
748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
While reviewing the investigation multiple people stated that the child was moved due to refusing to go to their room. It was seen in the video that the child was grabbed by the shoulders and moved to the room after refusing. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
Based on sufficient evidence gathered in an investigation conducted by DFPS, a child in care was abused. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff member was observed yelling and using profane language outside to another staff member outside in the presence of children in care. |
— |
| 5 | — |
748.1101(b)(4)(A) - Children's rights-The right to be free from any harsh, cruel, unusual, unnecessary, demeaning, or humiliating treatment or punishment.
There is sufficient evidence to show staff have been demeaning children who self harm telling them they are attention seeking, not normal and minimizing the issue. There is also evidence the staff have been yelling and cussing at the children. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
This standard was found deficient as part of a DFPS investigation. |
— |
| 4 | — |
748.2101(6) - Medication storage & destruction-remove discontinued medication immediately & destroy it in a way that ensures children do not have access to it
During a walkthrough of the operation, it was noted in a staff office there was a significant amount of medication that was described as discontinued when seen. Staff identified it had been there approximately 5-6 months. |
— |
| 5 | — |
748.2461(b)(3) - Short Personal Restraint-Caregiver may not use restraint that obstructs child's airways or impairs child's breathing
Based on interviews with children and staff and video footage, a staff placed a child in a chokehold when trying to break up a physical altercation between children in care. |
— |
| 4 | — |
748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
Multiple children's medication logs and count logs were reviewed and found to be incorrect in multiple spots and missing required information. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Children mentioned staff make fun of a child in care for their physical disability. |
— |
| 5 | — |
748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
Video was observed of a child being lifted off their feet and thrown to the ground during a restraint. |
— |
| 3 | — |
748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
There is sufficient evidence to show that staff failed to document the events occurring during the search of a child. |
— |
| 4 | — |
748.303(a)(3)(A) - Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child
During the course of a review of serious incident reports it was discovered that 1 incident report of abuse/neglect was not reported as soon as the operation became aware as required by minimum standards. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
During a power struggle to retrieve a phone back from a child who was attempting to make an unapproved call, a staff member placed their hands on the child's wrist on 2 occasions. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
This standard was found deficient as part of a DFPS investigation. |
— |
| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
A caregiver was observed on their cell phone and then working on paperwork when a child in care, who was on eyesight supervision, attempted to commit suicide in the bathroom. |
— |
| 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
During the review of the operations background checks three persons where not inactivated within 7 days of leaving the operation. |
Yes |
| 4 | — |
748.1661(b) - Tobacco Products-Adult may not smoke tobacco products, e-cigarettes, or vaporizers in children's living areas/inside any building on premises w/ kids
Two staff members admitted to using their vaporizers in the staff room of the children's houses and multiple children stated that staff vape around them. |
— |
| 5 | — |
748.1531(a)(2) - Medical care-A child in care must receive medical care as needed for injury, illness, and pain
A child in care was not seen by a medical professional after an attempted suicide. |
— |
| 1 | — |
748.1349(b)(2) - Initial Service Plan- When given to child then child must sign or operation document child's refusal to sign
While reviewing service plans on 3 children's files, the signatures of the children did not match other documents signed by the children. |
— |
| 4 | — |
748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
A child in care was escorted into the house for refusing to comply. |
— |
| 4 | — |
748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
During a walkthrough of the facility it was observed bathroom tubs in each home had mildew in the corners and along the edges of the tubs. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
It was found during the investigation a child sustained injuries as the result of an improper restraint. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
This standard was found deficient as part of a DFPS investigation. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff member was observed yelling and using profane language outside to another staff member outside in the presence of children in care. |
— |
| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
A caregiver was observed on their cell phone and then working on paperwork when a child in care, who was on eyesight supervision, attempted to commit suicide in the bathroom. |
— |
| 3 | — |
748.125(d)(4)(C) - Suicide Screening- Must be administered every 30 days after admission for children 10 years of age or older in a residential treatment center.
Two suicide screenings were completed late. |
— |
| 4 | — |
748.303(a)(12)(A) - Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child
A child in care had a mark on their neck from wrapping a string around their neck. The child answered yes to all questions on a suicide screening, indicating this was a suicide attempt. This was not self-reported to Licensing. |
— |
| 4 | — |
748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
A child in care sustained injuries after being improperly restrained in a non-emergency situation. |
— |
| 1 | — |
748.1349(b)(2) - Initial Service Plan- When given to child then child must sign or operation document child's refusal to sign
While reviewing service plans on 3 children's files, the signatures of the children did not match other documents signed by the children. |
— |
| 5 | — |
748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity
The staff member responsible for the child who eloped was inside the unit while that child and 2 others children were outside the unit. During this time, the two children helped the third child over the operation fence which led to the child eloping the operation. |
— |
| 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
During the review of the operations background checks three persons where not inactivated within 7 days of leaving the operation. |
Yes |
| 4 | — |
748.3563(c) - Protective Surfacing-If loose-fill surfacing materials are used, the operation must install 9 inches or more of uncompressed loose-fill material
During the walkthrough of the operaiton the fill surface for the swings were observed having about 4 to 5 inches of loose wood material. |
— |
| 4 | — |
748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
1 tablet of a child's Cetrizine 10mg AM was left on the counter top in the medication room. This was noticied during the walkthrough after 3PM. |
Yes |
| 3 | — |
748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
A child was admitted on 12.7.23, however, documentation within their record was dated with the admission date of both 12.7.23 and 12.4.23. |
— |
| 5 | — |
748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
Video was observed of a child being lifted off their feet and thrown to the ground during a restraint. |
— |
| 5 | — |
748.2461(b)(3) - Short Personal Restraint-Caregiver may not use restraint that obstructs child's airways or impairs child's breathing
Based on interviews with children and staff and video footage, a staff placed a child in a chokehold when trying to break up a physical altercation between children in care. |
— |
| 4 | — |
748.2151(c)(5) - Medication record - must include date (day/month/year) & time each medication was administered
The time the medication was administered was not documented on the medication log. |
— |
| 4 | — |
748.1661(b) - Tobacco Products-Adult may not smoke tobacco products, e-cigarettes, or vaporizers in children's living areas/inside any building on premises w/ kids
There is sufficient evidence to show a staff member is vaping inside the home the children live in. |
— |
| 4 | — |
748.2203(c) - Medication Error-Operation must meet documentation requirements within 24 hrs
When reviewing documentation, it was observed that the operation did not complete medication error documentation timely. |
— |
| 4 | — |
748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
During the course of an investigation, it was found that a caregiver used force to get a child to comply. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
During the investigation it was found two staff physically abused two children when completing two separate inappropriate restraints. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Staff members were using vulgar language around a child speaking of another staff member. The language was later directed at a child for the incident the child had placed themselves in. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff member was speaking to a child's parent via phone call with the child present. It was determined the staff was belittling the child during the conversation and being unprofessional with the parent. |
— |
| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
Children mentioned staff use profane language at them. 1 staff member admitted to using profane language toward a child. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
This standard was found deficient as part of a DFPS investigation. |
— |
| 4 | — |
748.303(a)(5)(A) - Serious Incident-Report to Licensing soon as aware of an incident of sexual abuse of a child against another child
The operation did not report the serious incident. The child made allegations to a staff member of inappropriate physical contact with another child. |
— |
| 4 | — |
748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
A child in care was escorted into the house for refusing to comply. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Children mentioned staff make fun of a child in care for their physical disability. |
— |
| 5 | — |
748.2461(b)(6) - Short Personal Restraint-Caregiver may not use restraint that twists or places the child's limb(s) behind the child's back
During the investigation it was found a staff member restrained a child placing the child?s arms bent behind their back. |
— |
| 3 | — |
748.3365(b)(2) - Bedding-must provide each child with a mattress cover or protector unless mattress is waterproof
There were more than 10 beds observed currently being used by children in care that did not contain a mattress protector or cover. |
— |
| 3 | — |
748.3443(a)(6) - Food Preparation-Food items must be covered when stored in the refrigerator
During the unannounced walk through of the operation food was observed uncovered and not secured appropriately in the refrigerator. |
Yes |
| 4 | — |
748.1661(b) - Tobacco Products-Adult may not smoke tobacco products, e-cigarettes, or vaporizers in children's living areas/inside any building on premises w/ kids
Two staff members admitted to using their vaporizers in the staff room of the children's houses and multiple children stated that staff vape around them. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
Based on sufficient evidence gathered in an investigation conducted by DFPS, a child in care was abused. |
— |
| 4 | — |
748.1101(b)(4)(A)(vii) - Children's rights- Free from demeaning behavior to embarrass/control/harm/intimidate/isolate the child
A child in care was pushed by a caregiver. |
— |
| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
It was noted that on several occasions staff appear to have used curse words at children based off of interviews completed. |
— |
| 5 | — |
748.1531(a)(2) - Medical care-A child in care must receive medical care as needed for injury, illness, and pain
A child in care was not seen by a medical professional after an attempted suicide. |
— |
| 4 | — |
748.303(a)(3)(A) - Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child
During the course of a review of serious incident reports it was discovered that 1 incident report of abuse/neglect was not reported as soon as the operation became aware as required by minimum standards. |
— |
| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
It was observed in video footage that child in care was able to assault another child in care with multiple staff present. Some employees are observed to not having a reaction to try to stop the altercation. |
— |
| 4 | — |
748.1101(b)(4)(A)(v) - Children's rights- To be free from being subjected to remarks that belittle or ridicule the child or the child's family
Based on information gathered it was determined that a caregiver belittled the children in care when they made profane remarks about their families. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
It was found during the investigation a child sustained injuries as the result of an improper restraint. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
During a power struggle to retrieve a phone back from a child who was attempting to make an unapproved call, a staff member placed their hands on the child's wrist on 2 occasions. |
— |
| 3 | — |
748.125(b) - All employees and caregivers must be aware of and follow your operation's policies and procedures
During the course of the investigation, one staff admitted to sleeping during their night shifts, one staff admitted to dozing off during their shifts, and another staff admitted to falling asleep one time during an unexpected double shift. |
— |
| 3 | — |
748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
There is sufficient evidence to show that staff failed to document the events occurring during the search of a child. |
— |
| 3 | — |
748.705(b)(9) - Reasonable & prudent parent standard-must consider the supervision instructions in the child's service plan
During the course of the investigation, it was determined that a child in care required supervision with close proximity. However, staff did not verify the child's location, which resulted in the child being able to elope during an outing. |
— |
| 4 | — |
748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
During a walkthrough of the facility it was observed bathroom tubs in each home had mildew in the corners and along the edges of the tubs. |
— |
| 5 | — |
748.1101(b)(4)(A) - Children's rights-The right to be free from any harsh, cruel, unusual, unnecessary, demeaning, or humiliating treatment or punishment.
There is sufficient evidence to show staff have been demeaning children who self harm telling them they are attention seeking, not normal and minimizing the issue. There is also evidence the staff have been yelling and cussing at the children. |
— |
| 4 | — |
748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
Multiple children's medication logs and count logs were reviewed and found to be incorrect in multiple spots and missing required information. |
— |
| 5 | — |
748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
A staff member attempted to kick a child in the head while the child was in handcuffs laying on the ground. |
— |
| 4 | — |
748.2101(6) - Medication storage & destruction-remove discontinued medication immediately & destroy it in a way that ensures children do not have access to it
During a walkthrough of the operation, it was noted in a staff office there was a significant amount of medication that was described as discontinued when seen. Staff identified it had been there approximately 5-6 months. |
— |
| 4 | — |
748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
While reviewing the investigation multiple people stated that the child was moved due to refusing to go to their room. It was seen in the video that the child was grabbed by the shoulders and moved to the room after refusing. |
— |
| 4 | — |
748.303(a)(12)(A) - Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child
A child in care had a mark on their neck from wrapping a string around their neck. The child answered yes to all questions on a suicide screening, indicating this was a suicide attempt. This was not self-reported to Licensing. |
— |
| 5 | — |
748.1531(a)(2) - Medical care-A child in care must receive medical care as needed for injury, illness, and pain
A child in care was not seen by a medical professional after an attempted suicide. |
— |
| 4 | — |
748.2203(c) - Medication Error-Operation must meet documentation requirements within 24 hrs
When reviewing documentation, it was observed that the operation did not complete medication error documentation timely. |
— |
| 4 | — |
748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
While reviewing the investigation multiple people stated that the child was moved due to refusing to go to their room. It was seen in the video that the child was grabbed by the shoulders and moved to the room after refusing. |
— |
304 inspection record(s) on file from TX-HHSC.