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Dream Residential Treatment Center, Inc.

Child care center · 4506 S RIDGEWALK DR, Houston, TX 77053-5300 · License 1706226

0Compliance score
Poor

Capacity 18. 10-17

Violation history (386)

Severity	Date	Standard / narrative	Corrected
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records The medication record for one child was for March but he arrived at the facility in April.	—
5	—	748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work. Staff members use corporal punishment by punching a child and pushing another.	—
4	—	748.3061(2) - Gas Inspection-Operation inspected at least once every 24 months from date of last inspection for gas leaks The operation Gas inspection expired in Jan 2024.	—
4	—	748.1101(b)(4)(A)(vii) - Children's rights- Free from demeaning behavior to embarrass/control/harm/intimidate/isolate the child Three out of three youth interviewed stated staff will get in their personal space as a means of intimidating or getting them to comply.	—
5	—	748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity Children reported that 2 children were smoking vape pens in the game room and a child in care was able to offer drugs to other children in care in their bedroom.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model During the medication review, it was found that the Medication log for one of the 5 children shows that he should have a remaining 7 pills and the count reflects a remaining 6.	—
3	—	748.363(7) - Personnel records-Include notarized Licensing Affidavit for Applicants for Employment form as specified in Human Resources Code, 42.059 Staff file is missing an Affidavit for Employment.	—
5	—	748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being Three residents left the facility without staff knowledge while under supervision.	—
3	—	748.3443(b)(1) - Food Preparation-Must have a thermometer in refrigerators & store refrigerated food at 40 degrees Fahrenheit or below The thermometer in the refrigerator reads that 46.	—
5	—	748.3301(a)(1) - Physical Site- Buildings must be structurally sound and not pose a risk to the health and safety of children. There is a whole in the upstairs bathroom	—
5	—	748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation Staff put residents at risk for substantial physical injury when she failed to remove both from an unsafe environment. Staff continued to put resident at risk by allowing another resident to restrain and hit the resident numerous times without removing either from the situation, resulting in the resident receiving a black eye due to the other resident striking him in the face with no intervention from Staff. Staff continued to put resident at risk by allowing him to remain present after resident broke the glass. Due to the severity of the situation, resident was transported to the hospital because he had major cuts on his arm and lost a lot of blood.	—
4	—	748.457(a) - Unauthorized Absence?Triggered Review of child?s unauth absences must occur ASAP, but no later than 30 days after third absence within 60-days Two children have more than three documented Unauthorized Absences, with no documented Triggered Review.	—
5	—	748.3(a) - The permit holder must ensure compliance with applicable minimum standards rules The permit holder allowed a contractor access to the facility with children in care without a background check.	—
3	—	748.363(8) - Personnel records - Include signed dated statement by the employee that he must immediately report suspected child abuse, neglect, or exploitation. Both staff files reviewed were missing a signed statement for reporting and suspected incident of child abuse, neglect or exploitation.	—
4	—	748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders Over five medication records reviewed determined that the operation did not administer the meds as the doctor prescribed for certain days.	—
3	—	748.303(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. The facility became aware of the missing children at 10:00AM, but the incident was not reported to licensing, law-enforcement, and CPS until 6:30PM.	—
5	—	748.2461(b)(1) - Short Personal Restraint-Caregiver may not use a prone or supine restraint Two of five children interviewed stated that when they are restrained, they are in a supine position. Two of five children interviewed stated that other residents are restrained in a supine position. One of five children interviewed stated that during restraints, residents are in a supine position or prone position.	—
5	—	748.2605(a)(5) - Personal Restraints Prohibited-Restraints that twist or place the child's limb(s) behind the child's back Two out of three youth interviewed stated multiple staff have twisted their arms behind their back and held them in this position as a restraint.	—
3	—	748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures An overnight shift staff member did not follow the RTC's policy when they prefilled out the bed check log form, notating all children were asleep the entire night until 6am.	—
1	—	748.1339(c) - Initial Service Plan-Child & parent must be invited to meeting to develop service plan & discuss participation in childhood activities Two children record reviewed indicated child, caregiver, and CPS worker did not participate or reviewed the child's service plan.	—
3	—	748.3239(b) - Evacuation-Must practice severe weather drill at least once every 6 months from date of last severe weather drill The operation has not conducted a weather drill.	—
3	—	748.935(a)(2) - Annual Training Timeline-Each person must complete the required annual training during each subsequent 12-month period Records reviewed show multiple staff members did not renew annual trainings timely.	—
2	—	748.1381(2) - Service Plan Review-If child receiving treatment services for ED, ASD, or PMN, review at least 90 days from date of last service plan In review of two child service plans, it was found that service plans are being reviewed after 90 days from the last service plan.	—
5	—	748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation The owner of the operation was negligent in their duty by allowing a contracted person to continue being present at the facility, despite admitting knowledge that the contracted person was not allowed to be on the property, and in doing so exposed the children placed at the facility at immediate risk of harm.	—
4	—	748.3301(i) - Physical Site-Equipment and furniture must be safe for children and must be kept clean and in good repair The couch in the game room was observed to have a hole in the material.	—
4	—	748.303(a)(2)(A) - AP Serious Incdt-Report to Licensing no later than 24 hours after injury/illness that warrants treatment by a medical professional or hospitalization The operation failed to report a serious incident in time.	—
4	—	748.461(1) - Unauthorized Absence-Triggered Review must include review of child?s records abt previous unauth absences, including previous debriefings Trigger review has not been conducted for a child who has run away more than 3 times within a 60 day period.	—
4	—	748.3237(c) - Safety Practices-Children must be able to open emergency exit doors easily from inside, unless written approval on file from fire inspector Both the front and rear exit doors from the facility required a code/key to leave building.	—
3	—	748.2151(c)(2) - Medication record - must include prescribing health-care professional's name Two out of the four medication records reviewed were missing the health professionals name or had the wrong health care professional's name on the form and did not reflect the medication.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records The medication log does not have an accurate count of remaining medication.	—
1	—	748.1337(b)(1)(N) - Initial Service Plan-Include signatures of service planning team members that were involved in development of service plan The children's service plans are missing the signatures of persons who participated in the completion of the service plan.	—
3	—	748.2151(c)(3) - Medication record - must include reason medication was prescribed, for prescription medication Medication logs reviewed listed "N/A" as reason for medication.	—
3	—	748.1103(d) - Informing child of rights-Person being informed must sign statement indicating he read and understands the rights-signed copy filed in child's record A child right form has not been by the child.	—
3	—	748.1103(d) - Informing child of rights-Person being informed must sign statement indicating he read and understands the rights-signed copy filed in child's record One of the two child files reviewed is missing a signed statement for the child's rights.	—
3	—	748.303(a)(9)(A) - Serious Incident-Report to Licensing no later than 6 hours after determining unauthorized absence of a child 13 yrs old or older Staff did not report to Licensing that a child ran away within the 6 hour timeframe.	—
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 A child in care in missing documentation of the TB exam.	—
4	—	748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards During walk through, it was observed that the far left window, on the back of the home, was missing a screen.	—
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 two child files reviewed were missing documentation of a TB screening.	—
4	—	748.2203(c)(5) - Medication Error-Document the health-care professional's medical recommendations There is no medication error report completed for a medication log that shows a change in medication dosage prescribed vs. the dosage of medication administered.	—
2	—	748.1351 - Initial Service Plan-Implement & follow plan as soon as all team members have reviewed/signed it, but no later than 15 days after date of meeting According to interviews with residents and staff, residents ride the bus to and from school daily and walk to and from the bus stop on their own. The children's service plan specifies that they are to be transported to and from school by shelter staff due to their history of running and/or leaving school or assigned areas without permission.	—
3	—	748.393(b)(3) - Active child record - Ensure record is kept accurate and current During the review of documents obtained, the victim child's service plan was not signed by any of the participating parties.	—
4	—	748.2151(c)(5) - Medication record - must include date (day/month/year) & time each medication was administered Mulitple medication logs did not include the date and time.	—
4	—	748.2151(c)(5) - Medication record - must include date (day/month/year) & time each medication was administered One med record reviewed did not contain a time of administration.	Yes
5	—	745.621(a)(3) - AP Initial background checks submitted - At the time you contract with someone who requires a background check A background check for a maintenance person was submitted on 12/01/2021 as a Contracted Service Provider. It was cancelled by the operation on 12/16/2020 but the person was still allowed to be at the operation performing work for the operation.	—
3	—	748.453(a)(1) - Unauthorized Absence ? Annual summary log must include name, age, gender, date of admission Unauthorized Absence Log is missing pertinent information required by standards: (1) gender, DOA, (2) time the unauthorized absence was discovered, (4) the name of the caregiver responsible for the child at the time the child?s absence was discovered, (5) the intake report number,if a report was made to Licensing or the DFPS, and (6) whether law enforcement was contacted, including the name of any law enforcement agency that was contacted and the number of the police report, if applicable.	—
1	—	748.1349(b)(2) - Initial Service Plan- When given to child then child must sign or operation document child's refusal to sign Records reviewed show service plans not signed by all required parties as a form of acknowledgment or a child's refusal to sign is not noted.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Multiple records did not include the daily amount given each day.	—
5	—	748.1337(b)(1)(H)(i) - Initial Service Plan-For child who exhibits high risk behaviors, include plans to minimize risk of harm to self or others Records reviewed did not documented how identified high-risks behaviors will be mitigated.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Four medication records were reviewed and all of them contained medication count errors.	—
3	—	748.3443(b)(1) - Food Preparation-Must have a thermometer in refrigerators & store refrigerated food at 40 degrees Fahrenheit or below The thermometer in the refrigerator reads that 46.	—
4	—	748.3301(i) - Physical Site-Equipment and furniture must be safe for children and must be kept clean and in good repair The couch in the game room was observed to have a hole in the material.	—
4	—	748.2151(c)(5) - Medication record - must include date (day/month/year) & time each medication was administered One med record reviewed did not contain a time of administration.	Yes
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records The medication record for one child was for March but he arrived at the facility in April.	—
5	—	748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation Staff put residents at risk for substantial physical injury when she failed to remove both from an unsafe environment. Staff continued to put resident at risk by allowing another resident to restrain and hit the resident numerous times without removing either from the situation, resulting in the resident receiving a black eye due to the other resident striking him in the face with no intervention from Staff. Staff continued to put resident at risk by allowing him to remain present after resident broke the glass. Due to the severity of the situation, resident was transported to the hospital because he had major cuts on his arm and lost a lot of blood.	—
4	—	748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders Over five medication records reviewed determined that the operation did not administer the meds as the doctor prescribed for certain days.	—
3	—	748.363(8) - Personnel records - Include signed dated statement by the employee that he must immediately report suspected child abuse, neglect, or exploitation. Both staff files reviewed were missing a signed statement for reporting and suspected incident of child abuse, neglect or exploitation.	—
3	—	748.1103(d) - Informing child of rights-Person being informed must sign statement indicating he read and understands the rights-signed copy filed in child's record One of the two child files reviewed is missing a signed statement for the child's rights.	—
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 two child files reviewed were missing documentation of a TB screening.	—
3	—	748.363(7) - Personnel records-Include notarized Licensing Affidavit for Applicants for Employment form as specified in Human Resources Code, 42.059 Staff file is missing an Affidavit for Employment.	—
3	—	748.453(a)(1) - Unauthorized Absence ? Annual summary log must include name, age, gender, date of admission Unauthorized Absence Log is missing pertinent information required by standards: (1) gender, DOA, (2) time the unauthorized absence was discovered, (4) the name of the caregiver responsible for the child at the time the child?s absence was discovered, (5) the intake report number,if a report was made to Licensing or the DFPS, and (6) whether law enforcement was contacted, including the name of any law enforcement agency that was contacted and the number of the police report, if applicable.	—
5	—	748.1337(b)(1)(H)(i) - Initial Service Plan-For child who exhibits high risk behaviors, include plans to minimize risk of harm to self or others Records reviewed did not documented how identified high-risks behaviors will be mitigated.	—
1	—	748.1337(b)(1)(N) - Initial Service Plan-Include signatures of service planning team members that were involved in development of service plan The children's service plans are missing the signatures of persons who participated in the completion of the service plan.	—
3	—	748.2151(c)(2) - Medication record - must include prescribing health-care professional's name Two out of the four medication records reviewed were missing the health professionals name or had the wrong health care professional's name on the form and did not reflect the medication.	—
4	—	748.303(a)(2)(A) - AP Serious Incdt-Report to Licensing no later than 24 hours after injury/illness that warrants treatment by a medical professional or hospitalization The operation failed to report a serious incident in time.	—
4	—	748.2151(c)(5) - Medication record - must include date (day/month/year) & time each medication was administered Mulitple medication logs did not include the date and time.	—
3	—	748.2151(c)(3) - Medication record - must include reason medication was prescribed, for prescription medication Medication logs reviewed listed "N/A" as reason for medication.	—
4	—	748.3061(2) - Gas Inspection-Operation inspected at least once every 24 months from date of last inspection for gas leaks The operation Gas inspection expired in Jan 2024.	—
5	—	748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being Three residents left the facility without staff knowledge while under supervision.	—
4	—	748.461(1) - Unauthorized Absence-Triggered Review must include review of child?s records abt previous unauth absences, including previous debriefings Trigger review has not been conducted for a child who has run away more than 3 times within a 60 day period.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Multiple records did not include the daily amount given each day.	—
4	—	748.1101(b)(4)(A)(vii) - Children's rights- Free from demeaning behavior to embarrass/control/harm/intimidate/isolate the child Three out of three youth interviewed stated staff will get in their personal space as a means of intimidating or getting them to comply.	—
1	—	748.1339(c) - Initial Service Plan-Child & parent must be invited to meeting to develop service plan & discuss participation in childhood activities Two children record reviewed indicated child, caregiver, and CPS worker did not participate or reviewed the child's service plan.	—
3	—	748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures An overnight shift staff member did not follow the RTC's policy when they prefilled out the bed check log form, notating all children were asleep the entire night until 6am.	—
3	—	748.303(a)(9)(A) - Serious Incident-Report to Licensing no later than 6 hours after determining unauthorized absence of a child 13 yrs old or older Staff did not report to Licensing that a child ran away within the 6 hour timeframe.	—
4	—	748.457(a) - Unauthorized Absence?Triggered Review of child?s unauth absences must occur ASAP, but no later than 30 days after third absence within 60-days Two children have more than three documented Unauthorized Absences, with no documented Triggered Review.	—
3	—	748.935(a)(2) - Annual Training Timeline-Each person must complete the required annual training during each subsequent 12-month period Records reviewed show multiple staff members did not renew annual trainings timely.	—
4	—	748.2203(c)(5) - Medication Error-Document the health-care professional's medical recommendations There is no medication error report completed for a medication log that shows a change in medication dosage prescribed vs. the dosage of medication administered.	—
2	—	748.1351 - Initial Service Plan-Implement & follow plan as soon as all team members have reviewed/signed it, but no later than 15 days after date of meeting According to interviews with residents and staff, residents ride the bus to and from school daily and walk to and from the bus stop on their own. The children's service plan specifies that they are to be transported to and from school by shelter staff due to their history of running and/or leaving school or assigned areas without permission.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records The medication log does not have an accurate count of remaining medication.	—
3	—	748.393(b)(3) - Active child record - Ensure record is kept accurate and current During the review of documents obtained, the victim child's service plan was not signed by any of the participating parties.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Four medication records were reviewed and all of them contained medication count errors.	—
1	—	748.1349(b)(2) - Initial Service Plan- When given to child then child must sign or operation document child's refusal to sign Records reviewed show service plans not signed by all required parties as a form of acknowledgment or a child's refusal to sign is not noted.	—
3	—	748.303(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. The facility became aware of the missing children at 10:00AM, but the incident was not reported to licensing, law-enforcement, and CPS until 6:30PM.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model During the medication review, it was found that the Medication log for one of the 5 children shows that he should have a remaining 7 pills and the count reflects a remaining 6.	—
5	—	748.2605(a)(5) - Personal Restraints Prohibited-Restraints that twist or place the child's limb(s) behind the child's back Two out of three youth interviewed stated multiple staff have twisted their arms behind their back and held them in this position as a restraint.	—
5	—	748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation The owner of the operation was negligent in their duty by allowing a contracted person to continue being present at the facility, despite admitting knowledge that the contracted person was not allowed to be on the property, and in doing so exposed the children placed at the facility at immediate risk of harm.	—
5	—	748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work. Staff members use corporal punishment by punching a child and pushing another.	—
5	—	748.2461(b)(1) - Short Personal Restraint-Caregiver may not use a prone or supine restraint Two of five children interviewed stated that when they are restrained, they are in a supine position. Two of five children interviewed stated that other residents are restrained in a supine position. One of five children interviewed stated that during restraints, residents are in a supine position or prone position.	—
3	—	748.1103(d) - Informing child of rights-Person being informed must sign statement indicating he read and understands the rights-signed copy filed in child's record A child right form has not been by the child.	—
5	—	748.3301(a)(1) - Physical Site- Buildings must be structurally sound and not pose a risk to the health and safety of children. There is a whole in the upstairs bathroom	—
5	—	748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity Children reported that 2 children were smoking vape pens in the game room and a child in care was able to offer drugs to other children in care in their bedroom.	—
5	—	745.621(a)(3) - AP Initial background checks submitted - At the time you contract with someone who requires a background check A background check for a maintenance person was submitted on 12/01/2021 as a Contracted Service Provider. It was cancelled by the operation on 12/16/2020 but the person was still allowed to be at the operation performing work for the operation.	—
4	—	748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards During walk through, it was observed that the far left window, on the back of the home, was missing a screen.	—
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 A child in care in missing documentation of the TB exam.	—
5	—	748.3(a) - The permit holder must ensure compliance with applicable minimum standards rules The permit holder allowed a contractor access to the facility with children in care without a background check.	—
3	—	748.3239(b) - Evacuation-Must practice severe weather drill at least once every 6 months from date of last severe weather drill The operation has not conducted a weather drill.	—
4	—	748.3237(c) - Safety Practices-Children must be able to open emergency exit doors easily from inside, unless written approval on file from fire inspector Both the front and rear exit doors from the facility required a code/key to leave building.	—
2	—	748.1381(2) - Service Plan Review-If child receiving treatment services for ED, ASD, or PMN, review at least 90 days from date of last service plan In review of two child service plans, it was found that service plans are being reviewed after 90 days from the last service plan.	—
3	—	748.363(7) - Personnel records-Include notarized Licensing Affidavit for Applicants for Employment form as specified in Human Resources Code, 42.059 Staff file is missing an Affidavit for Employment.	—
3	—	748.303(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. The facility became aware of the missing children at 10:00AM, but the incident was not reported to licensing, law-enforcement, and CPS until 6:30PM.	—

Severity 5 = most serious. Source: official state record.

Inspections (202)

202 inspection record(s) on file from TX-HHSC.

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