Child care center ·
650 SCARBOUROUGH, Canyon Lake, TX 78133-4529 ·
License 503875
Capacity 60. 11-17
| Severity | Date | Standard / narrative | Corrected |
|---|
| 4 | — |
748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication
One prescription medication was not documented as administered within the two hour timeframe. |
Yes |
| 4 | — |
748.535(2) - AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.
During a review conducted on August 8, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 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, due to your recent citations issued on August 3, 2023, 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 failure of your operation?s administrator to ensure compliance include the following: The operation received a high weighted citation in a pattern/trend category on August 3,2023. Specifically, the operation was cited for 748.685(a)(4) Caregiver responsibility - being able to intervene when necessary to ensure child's safety. The operation has until August 16, 2023, to meet compliance on. - 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 - Operation was unable to meet compliance with High weighted licensing citations Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 4 | — |
748.685(c)(5) - Caregiver responsibility - ensure continuity of care by sharing information concerning each child with incoming caregivers
Caregivers and Medical staff were unaware of child's self-harming incident reported on 5/3/23 per interviews. Medical information was not shared from shift to shift according to interviews with nursing staff and caregivers. This information was also not documented in shift communication or progress notes observed. |
— |
| 4 | — |
748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child
Staff member used profanity and yelled at children in care. |
— |
| 3 | — |
748.935(a)(1) - Annual Training Timeline-Each person must complete the required annual training within 12 months from the date of hire
During the review of employee records, it was discovered that two direct care staff had not completed their required annual trainings. |
— |
| 4 | — |
748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
A child was restrained by plugging of the nose by one staff while the nurse held the child in place in an attempt to have the child swallow their medication. |
— |
| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Video footage showed that staff allowed resident to walk past them while at the same time a dispute between residents in their room was happening and another staff was trying to handle the situation behind them. Staff in the hallway didn't attempt to prevent the resident from running into the other resident's dorm which led to punching the victim. |
— |
| 3 | — |
748.2003(b)(4) - Administration of prescription medication-Administer each child's medication within one hour of preparation
Medication was prepared four hours before time of administration. |
— |
| 5 | — |
748.2001(a) - Administration of Medication-Must obtain a general written consent to administer routine, preventive, & emergency medications
Medical consenter was not notified child in care received prescription medication until after the medication was given. |
— |
| 4 | — |
748.125(d)(3) - Suicide Screening- Document that any person conducting a suicide screening meets the conditions and training requirements.
The operation provided an intake suicide screening tool used at admission on a child in care with no documentation of the personnel who administered the tool having the training to do so. |
— |
| 4 | — |
748.2151(c)(5) - Medication record - must include date (day/month/year) & time each medication was administered
Medication administration was observed between 8:40 am and 8:51 am. The medication record was not updated from the scheduled medication administration time of 8 am. The time was not documented with the correct time of administration. |
— |
| 5 | — |
748.3301(a) - Physical Site-Buildings must be structurally sound, clean, and in good repair. Paints must be lead-free
A light fixture wires were hanging down where residents could reach and pull down and a light bulb was broken. |
— |
| 4 | — |
748.535(2) - AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.
During a review conducted on February 8, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 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, due to your recent citations issued on February 1, 2024, 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 failure of your operation?s administrator to ensure compliance include the following: The operation received a medium weighted citation in a pattern/trend category on February 1, 2024. Specifically, the operation was cited for 748.2151(c)(6): Medication record - must include name & signature of person who administered each medication. The purpose of the signature is to be able to identify the person who administered a specific medication to a child if a concern arises later about that medication. Compliance of deficiency remains 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 Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
In video footage reviewed, the caregiver exhibits a lack of urgency and fails to protect the child from harm. Body positioning was not positioned to protect the child from injury. The aggressive child was not restrained, and the targeted child was not removed. |
— |
| 4 | — |
748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
1 out of 3 child s medication record reviewed it was discovered that a psychotropic medication count was documented incorrectly on the medication log. |
— |
| 3 | — |
748.2151(c)(6) - Medication record - must include name & signature of person who administered each medication
The name/sigature of the staff who administered medications to a child in care was missing from the medication log. |
— |
| 4 | — |
748.3233(b)(4)(B) - Evacuation-Emergency evacuation & relocation diagram includes at least 2 exit routes that are not blocked in any way
During the walk through a wooden picnic table was seen blocking the side door. |
Yes |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
A child in care, with identified high risk behaviors, was not provided 15-minute wellness checks and was left alone in the residence by a staff member. |
— |
| 3 | — |
748.3115 - Fire Extinguisher-Must inspect fire extinguisher(s) monthly
Fire extinguisher are NOT being inspected monthly. |
— |
| 5 | — |
748.1693(a)(1) - Nutrition-Provide food of adequate variety, quality, and in sufficient quantity to supply the nutrients needed for proper growth and development
During face to face interviews of the victim and collateral children, all five children in care stated they do not receive a sufficient quantity of food at meal times and are not allowed seconds even if they state they are hungry. All five also stated alternatives are not provided. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
The child was not supervised in the staff only area allowing access to a craft knife which was later used for self-harming. |
— |
| 5 | — |
748.2307(1) - Other Prohibited Punishments-any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline/punishment
From witness interviews and video footage, a staff states, "it works on dogs to hold their nose closed." after plugging a child's nose. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A child was escorted by police to a psychiatric hospital. Operation staff did not accompany the child. At the hospital, the child filled out the admission's paperwork and listed an unauthorized parent. The individual was able to gain knowledge of the incident and child?s whereabouts. |
— |
| 4 | — |
748.3351(1) - Interior Space-Provide living space, appropriate furnishings, & bathroom facilities that are safe, clean and maintained in good repair
During a walkthrough of the cottage, hair and other debris was found on the bathroom sink counter and the floor. |
— |
| 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
Licensing observed and photographed the surfacing material under the swings to be worn to down to the earth and the surrounding surfacing material to be compacted. |
— |
| 4 | — |
748.2553(2)(C) - EBI Release-Child released from personal restraint as soon as child is not a danger to self or others
During the second restraint the child was observed being quiet and still for several minutes. Staff did not provide an opportunity for the child to be released. |
— |
| 5 | — |
748.2307(1) - Other Prohibited Punishments-any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline/punishment
On video, a staff member was seen shoving a child to prevent them from going into the room of a peer. |
— |
| 5 | — |
748.1101(b)(4)(A)(ii) - Children's rights-The right to be free from being subjected to or threatened with corporal punishment, including spanking or hitting
In observing video footage, the staff slaps the child's hand. |
— |
| 3 | — |
748.1583(a) - TB exam-Persons over 1 yr old who live, work, volunteer at facility have exam w/in 30 days, unless person had previous exam that meets requirements
One of the three child records reviewed did not have an up to date TB test. |
— |
| 2 | — |
748.1583(b) - TB exam-Documentation of baseline test or chest xray results in person's record w/in 40 days of beginning to live, work, volunteer at facility
Two of the three child records reviewed did not have the child s TB test results located in the child s records. However the operation was able to request one child's TB test results and placed it in the child's file. |
Yes |
| 4 | — |
748.535(2) - AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.
During a review conducted on February 20, 2026, 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 again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring, including having an open investigation(s). Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 3 | — |
748.685(c)(6) - Implement and follow the children's service plans.
A child's service plan was not followed when the child self-harmed and a safety plan was not put in place. The child's service plan states due to the child's high risk of self-harming behaviors a safety plan should be implemented following this type of incident. |
— |
| 4 | — |
748.3233(b)(2) - Evacuation-Emergency evacuation & relocation diagram must include designated location outside operation where all caregivers & children meet
Emergency evacuation signs did not notate a designated relocation area outside the operation. |
— |
| 5 | — |
748.2461(b)(3) - Short Personal Restraint-Caregiver may not use restraint that obstructs child's airways or impairs child's breathing
A child's nose was plugged by staff which restricted the child's breathing. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
One staff member fell asleep while counted in ratio. Video footage shows the staff's alarm sounding and children waking her. The incident was confirmed in child interviews. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
After reviewing video footage, EBI curriculum, and staff statements, Emergency Behavioral Intervention training was not utilized on the aggressive child as required by the extent of possible physical injury. The child's hair was pulled twice, and she was kicked four times prior to the caregiver pulling out phone to call for assistance. The decision was made not to restrain the aggressive child without assistance despite the behaviors needing further management. |
— |
| 4 | — |
748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
During the review of a child's medication record it was discovered that a psychotropic medication count was documented incorrectly on the medication log. |
Yes |
| 4 | — |
748.125(d)(4)(E) - Suicide Screening- Must be administered immediately if the child exhibits warning signs that necessitate a suicide screening be conducted.
Suicide screening was not completed immediately after child in care was found with a t-shirt around their neck. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Two direct care staff admitted to using profane language in the presence of children in care. |
— |
| 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
According to an incident report reviewed, a child disclosed of past sexual abuse. A report was not made to licensing until three days after a staff member and therapist became aware. |
— |
| 3 | — |
748.2857(a) - No later than 72 hours after the initiation of the intervention, you must provide written notice to the parent.
A child in care was restrained and caseworker was not notified in a timely manner. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Five children in care were left unattended on unit for ten minutes. During this time, one child pushes two children. |
— |
| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Two children in care were involved in a physical altercation. When staff separated the children, this left other residents unsupervised leading to another child in care being assaulted. |
— |
| 4 | — |
748.537(a) - On Call Staff-A person designated to handle emergencies must be on call and accessible to caregivers
Two children were in a physical altercation and the staff supervising was unable to intervene successfully to prevent harm to a child. Support staff was not available to respond immediately to the incident. The child involved had a history of physical altercations requiring safety precautions. |
— |
| 4 | — |
748.535(2) - AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.
During a review conducted on February 13, 2025, 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 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 December 16th, 2024, 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 high weighted citation in a pattern/trend category on December 16, 2024. Specifically, the operation was cited for 748.685(a)(3): Caregiver responsibility - Child in care was left unsupervised inside the dorm. The purpose of this standard is to protect the health, safety, and well-being of children by ensuring adequate supervision. Supervision is a basic element to the prevention of harm. The operation met compliance on 1/01/2025. - 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. - Operation was unable to meet compliance with high weighted licensing citation. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plan. |
— |
| 4 | — |
748.1101(b)(1)(C) - Children's rights-Adhere to the child's right to receive fair treatment
It was confirmed that a staff member gave gifts to a child and showed them preferential treatment. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Caregivers and children provided corroborating information that a staff member behaved inappropriately with children in care. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Direct care staff admitted a child in care was left behind in a residential area for 30 minutes. The child in care was not supposed to be alone for more than 15 minutes as per the child in care's service plan. Video footage also confirms this. |
— |
| 4 | — |
748.1101(b)(4)(A)(vii) - Children's rights- Free from demeaning behavior to embarrass/control/harm/intimidate/isolate the child
The operation staff discouraged children in care from writing grievances. |
— |
| 3 | — |
748.303(a)(11)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
The operation did not report a diagnosed communicable disease 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 did not receive medical treatment for a fracture until two days after their injury. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
During DFPS investigation staff reported having earphones on and admitted to having their eyes closed while working the overnight shift. |
— |
| 4 | — |
748.535(2) - AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.
During a review conducted on August 12, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 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, due to your recent citations issued on June 03, 2024, 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 failure of your operation?s administrator to ensure compliance include the following: The operation received a medium high weighted citation in a pattern/trend category on June 03, 2024. Specifically, the operation was cited for 748.125(d)3: Suicide Screening - Document that any person conducting a suicide screening meets the conditions and training requirements. Compliance of deficiency was met on July 02, 2024. - 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 - Operation was unable to meet compliance with medium high weighted licensing citation. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
There was only one caregiver for 9 children for 30 minutes during the morning shift. The other staff memeber that was supposed to be on the unit had called in, and a replacement for the staff was not sent to the unit. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
A resident was on a safety plan and staff did not check on resident while showering. Resident got ahold of her hygiene and ingested her bottle of shampoo. |
— |
| 5 | — |
748.151(1) - Operational responsibilities - Designate a qualified full-time child-care administrator
The Administrator's position has been vacant for more than 60 days. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
Resident was standing on a table and staff moved the table causing resident to fall onto the ground, resulting in a fractured shoulder. |
— |
| 5 | — |
748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity
Child in care was left unsupervised inside the dorm. |
— |
| 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
Multiple staff became aware of indications of neglectful supervision on the day it occurred. An incident report was not written at this time. The incident was called into the hotline 3 days after awareness. |
— |
| 4 | — |
748.535(2) - AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.
During a review conducted on August 19, 2025, 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 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 June 6, 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 high weighted citation in a pattern/trend category on June 6, 2025. Specifically, the operation was cited for 748.685(a)(4): Caregiver responsibility - During DFPS investigation staff reported having earphones on and admitted to having their eyes closed while working the overnight shift. The purpose of this standard is to protect the health, safety, and well-being of children by ensuring adequate supervision. Supervision is a basic element to the prevention of harm. The operation met compliance on 7/10/2025. - 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. - Operation was unable to meet compliance with high weighted licensing citation. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plan. |
— |
| 4 | — |
748.535(2) - Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.
During a review conducted on August 5, 2022, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 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, due to your recent citations issued on July 20, 2022, 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 failure of your operation?s administrator to ensure compliance include the following: The operation received a medium and medium-high weighted citation in a pattern/trend category on July 20, 2022. Specifically, the operation was cited for 748.2151(c)(6) and 748.2151(d) related to medication documentation. The operation met compliance on July 25, 2022. - 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 or High weighted licensing citations. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans. |
— |
| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
Two staff interviewed made statements that the staff to child ratio exceeded 1:5 during the incident. One staff said there were eight children. Another said there were at least six children. Interviews confirm two staff were present, however, one staff was in observations and not counted into ratio on the day of the incident. Management confirms the staff was not counted into ratio during their interview. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
A youth in care was left alone in the unit unsupervised. |
— |
| 3 | — |
748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
Suicide screening that was provided was denied to have been completed by staff and child in care. |
— |
| 3 | — |
748.2151(c)(6) - Medication record - must include name & signature of person who administered each medication
During the review of three child medication records if was noticed that two staff who administered medication to a child in care had not written their name and/or signature in the section provided on the bottom of the medication log to identify their initials. |
— |
| 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
The incident was witnessed by two staff members and not reported by either. One staff interviewed states a supervisor and manager were also made aware of the incident on the day it occurred. An incident report was not completed at the time of the incident. |
— |
| 4 | — |
748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
The medication count was documented incorrectly on the med log for a child s prescribed medication. |
— |
| 4 | — |
748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
Shower was dirty and coming apart from wall. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Caregivers and children provided corroborating information that a staff member behaved inappropriately with children in care. |
— |
| 3 | — |
748.2003(b)(4) - Administration of prescription medication-Administer each child's medication within one hour of preparation
Medication was prepared four hours before time of administration. |
— |
| 3 | — |
748.3115 - Fire Extinguisher-Must inspect fire extinguisher(s) monthly
Fire extinguisher are NOT being inspected monthly. |
— |
| 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
The incident was witnessed by two staff members and not reported by either. One staff interviewed states a supervisor and manager were also made aware of the incident on the day it occurred. An incident report was not completed at the time of the incident. |
— |
| 4 | — |
748.537(a) - On Call Staff-A person designated to handle emergencies must be on call and accessible to caregivers
Two children were in a physical altercation and the staff supervising was unable to intervene successfully to prevent harm to a child. Support staff was not available to respond immediately to the incident. The child involved had a history of physical altercations requiring safety precautions. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
After reviewing video footage, EBI curriculum, and staff statements, Emergency Behavioral Intervention training was not utilized on the aggressive child as required by the extent of possible physical injury. The child's hair was pulled twice, and she was kicked four times prior to the caregiver pulling out phone to call for assistance. The decision was made not to restrain the aggressive child without assistance despite the behaviors needing further management. |
— |
| 3 | — |
748.1583(a) - TB exam-Persons over 1 yr old who live, work, volunteer at facility have exam w/in 30 days, unless person had previous exam that meets requirements
One of the three child records reviewed did not have an up to date TB test. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
A youth in care was left alone in the unit unsupervised. |
— |
| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Two children in care were involved in a physical altercation. When staff separated the children, this left other residents unsupervised leading to another child in care being assaulted. |
— |
| 3 | — |
748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
Suicide screening that was provided was denied to have been completed by staff and child in care. |
— |
| 5 | — |
748.2461(b)(3) - Short Personal Restraint-Caregiver may not use restraint that obstructs child's airways or impairs child's breathing
A child's nose was plugged by staff which restricted the child's breathing. |
— |
| 3 | — |
748.303(a)(11)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
The operation did not report a diagnosed communicable disease to licensing. |
— |
| 4 | — |
748.685(c)(5) - Caregiver responsibility - ensure continuity of care by sharing information concerning each child with incoming caregivers
Caregivers and Medical staff were unaware of child's self-harming incident reported on 5/3/23 per interviews. Medical information was not shared from shift to shift according to interviews with nursing staff and caregivers. This information was also not documented in shift communication or progress notes observed. |
— |
| 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
According to an incident report reviewed, a child disclosed of past sexual abuse. A report was not made to licensing until three days after a staff member and therapist became aware. |
— |
| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
There was only one caregiver for 9 children for 30 minutes during the morning shift. The other staff memeber that was supposed to be on the unit had called in, and a replacement for the staff was not sent to the unit. |
— |
| 5 | — |
748.1693(a)(1) - Nutrition-Provide food of adequate variety, quality, and in sufficient quantity to supply the nutrients needed for proper growth and development
During face to face interviews of the victim and collateral children, all five children in care stated they do not receive a sufficient quantity of food at meal times and are not allowed seconds even if they state they are hungry. All five also stated alternatives are not provided. |
— |
| 4 | — |
748.3351(1) - Interior Space-Provide living space, appropriate furnishings, & bathroom facilities that are safe, clean and maintained in good repair
During a walkthrough of the cottage, hair and other debris was found on the bathroom sink counter and the floor. |
— |
| 2 | — |
748.1583(b) - TB exam-Documentation of baseline test or chest xray results in person's record w/in 40 days of beginning to live, work, volunteer at facility
Two of the three child records reviewed did not have the child s TB test results located in the child s records. However the operation was able to request one child's TB test results and placed it in the child's file. |
Yes |
| 3 | — |
748.935(a)(1) - Annual Training Timeline-Each person must complete the required annual training within 12 months from the date of hire
During the review of employee records, it was discovered that two direct care staff had not completed their required annual trainings. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A child was escorted by police to a psychiatric hospital. Operation staff did not accompany the child. At the hospital, the child filled out the admission's paperwork and listed an unauthorized parent. The individual was able to gain knowledge of the incident and child?s whereabouts. |
— |
| 5 | — |
748.2307(1) - Other Prohibited Punishments-any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline/punishment
On video, a staff member was seen shoving a child to prevent them from going into the room of a peer. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Five children in care were left unattended on unit for ten minutes. During this time, one child pushes two children. |
— |
| 4 | — |
748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
1 out of 3 child s medication record reviewed it was discovered that a psychotropic medication count was documented incorrectly on the medication log. |
— |
| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
Two staff interviewed made statements that the staff to child ratio exceeded 1:5 during the incident. One staff said there were eight children. Another said there were at least six children. Interviews confirm two staff were present, however, one staff was in observations and not counted into ratio on the day of the incident. Management confirms the staff was not counted into ratio during their interview. |
— |
| 4 | — |
748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
Shower was dirty and coming apart from wall. |
— |
| 4 | — |
748.2553(2)(C) - EBI Release-Child released from personal restraint as soon as child is not a danger to self or others
During the second restraint the child was observed being quiet and still for several minutes. Staff did not provide an opportunity for the child to be released. |
— |
| 5 | — |
748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity
Child in care was left unsupervised inside the dorm. |
— |
| 5 | — |
748.2001(a) - Administration of Medication-Must obtain a general written consent to administer routine, preventive, & emergency medications
Medical consenter was not notified child in care received prescription medication until after the medication was given. |
— |
| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Video footage showed that staff allowed resident to walk past them while at the same time a dispute between residents in their room was happening and another staff was trying to handle the situation behind them. Staff in the hallway didn't attempt to prevent the resident from running into the other resident's dorm which led to punching the victim. |
— |
| 4 | — |
748.1101(b)(1)(C) - Children's rights-Adhere to the child's right to receive fair treatment
It was confirmed that a staff member gave gifts to a child and showed them preferential treatment. |
— |
| 4 | — |
748.3233(b)(2) - Evacuation-Emergency evacuation & relocation diagram must include designated location outside operation where all caregivers & children meet
Emergency evacuation signs did not notate a designated relocation area outside the operation. |
— |
| 3 | — |
748.2151(c)(6) - Medication record - must include name & signature of person who administered each medication
During the review of three child medication records if was noticed that two staff who administered medication to a child in care had not written their name and/or signature in the section provided on the bottom of the medication log to identify their initials. |
— |
424 inspection record(s) on file from TX-HHSC.
Licensed facilities near this one, highest compliance score first.