Child care center ·
1313 W WASHINGTON ST, Levelland, TX 79336-3921 ·
License 1716949
Capacity 15. 6-17
| Severity | Date | Standard / narrative | Corrected |
|---|
| 4 | — |
748.2151(c)(5) - Medication record - must include date (day/month/year) & time each medication was administered
The time medication was administered was not documeted for at least two children in care and for several of there medications. |
— |
| 3 | — |
748.303(a)(6)(A) - Serious Incident-Report to Licensing no later than 24 hours after becoming aware that child is indicted, charged, or arrested or when police respond.
A child in care was taken into police custody following a motor vehicle accident on October 22, 2022. The operation did not report the incident until October 24, 2022. |
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| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
There were two missed medications. One on 1/8/2022 and one on 1/9/2022. |
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| 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
A child in care was injured at the operation and had to be transported to the hospital via ambulance and Licensing was not notified of the child's injury. |
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| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A caregiver permitted a child in care to view information that was intended to be accessible only to staff members. |
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| 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. |
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| 5 | — |
748.2551(c)(1) - EBI Implementation-Caregiver must minimize risk of physical discomfort, harm, or pain to the child
A child in care was placed in a short personal restraint in a bedroom, between two wooden beds. During the restraint, the child complained of not being able to breathe. After the restraint, the was observed with scratches on her face and bruising on her wrist and was later taken to the doctor for complaints of pain in her chest and arms. |
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| 4 | — |
748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child
A caregiver yells and uses profanity in the presence of children in care. |
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| 5 | — |
748.1101(b)(7) - Child's rights-Make complaints/calls/reports w/o interference,coercion,punishment,retaliation,threats.Right to make them anonymously
Children in care reported that they only have access to phones to communicate with their CASA or Case Manger during their call day and are not allowed to contact their workers on the weekend. Several staff stated that they must get approval from the Caseworker for children in make calls. Caseworker stated he tries to get phone calls completed during the week due to not having floater staff on the weekends which would enable a staff to take the child to make calls. |
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| 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 citation issued on May 18, 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-high weighted citation in a pattern/trend category on May 18, 2022. Specifically, the operation was cited for 748.2307(8) Other prohibited Punishments. The operation met compliance on June 2, 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. |
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| 3 | — |
748.2151(c)(3) - Medication record - must include reason medication was prescribed, for prescription medication
Two medication logs did not have documentation what the medication was prescribed for. |
— |
| 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) the Administrator failed to ensure compliance with the current HM Plan; and (2) 12 months had elapsed since the effective date of the plan. The heightened monitoring plan for this operation included a specific ?planned end date? at the 12-month mark by which the operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with the heightened monitoring plan, this operation is now unable to successfully move to post-plan monitoring. Furthermore, the operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended. Further details of the administrator?s failure to ensure compliance include the following: - Operation failed to satisfy the conditions of the plan - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring; and - Operation was unable to meet compliance with Medium-High or High weighted licensing citations. |
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| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
A child in care was given another child in care's medication. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
An employee did not read the child's documentation that showed the child had a religious exemption to not get vaccinated. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Two caregivers showed inappropriate videos/photos on their cell phones to children in care. Two caregivers failed to maintain personal boundaries with one another around children in care. |
— |
| 4 | — |
748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
Staff failed to implement an EBI restraint when a child in care was engaging in self-harm. Additionally, staff failed to de-escalate the behaviors and provoked escalation when an intervention could have prevented the injuries. |
— |
| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
A child in care was given a full tablet instead of a half tablet as prescribed by the doctor |
— |
| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
This standard is being tasked as a follow up to inspection 3854778. There have been 12 different medications given in inproper dosages to children in care according to the instructions on the label. These medications were either not given to children at all or were given in a higher dosage than prescribed. |
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| 4 | — |
748.2203(c)(2) - Medication Error-Document the medication error
There were four children in care with medication errors that did not have a full explenation of what the errors were. |
— |
| 4 | — |
748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
A caregiver implemented an emergency behavior intervention on a child in care through a short personal restraint in a non-emergency situation. |
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| 5 | — |
748.1661(a) - Tobacco Products and E-Cigarettes -Children may not use or possess tobacco products, e-cigarettes or any type of vaporizers
Three children in care accessed and used an e-cigarette lost by an employee in the facility. |
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| 4 | — |
748.1101(b)(3)(C) - Children's rights-Adhere to the child's rights to have religious needs met
A child in care's religious needs were not bet by having a child get vaccinated even though there was a documented exemption due to religious reasons. |
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| 5 | — |
748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
A caregiver shoved a child in care on the shoulder during an argument. |
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| 4 | — |
748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child
A caregiver engaged in a verbal altercation with a child in care, yelling at and shaming the child. |
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| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
A caregiver permitted a child in care to assault another child in care and video recorded children play fighting which would sometimes turn into real altercations. |
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| 4 | — |
748.1531(d) - Medical care-Obtain follow-up medical treatment as recommended by the health-care professional
A child in care injured her knee at the operation and was transported to the hospital via ambulance the attending physician provided orders that the child receive a follow up within two days with the child's primary care physician. The operation did not take the child for a follow up appointment. |
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| 1 | — |
748.1337(b)(1)(A)(vii) - Initial Service Plan-Include therapeutic needs, including plans for evals, follow-up treatment, testing and use of psychotropic medications
One out of three service plans reviewed did not have psychological recommendations documented in the service plan. |
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| 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
Multiple staff were using vapes inside with children on the premises. |
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| 4 | — |
748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
A caregiver performed a short personal restraint on a child in care as a means to get a child to comply in a non-emergency situation. The caregiver grabbed the child's arm so that the caregiver could remove photographs from the child's hand. |
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| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
A child in care has not been given two doses of her Clonidine medication. |
— |
| 4 | — |
748.2003(b)(2) - Administration of Medication-Store medication in the original container unless there is an additional container with the same label & instructions
Two bottles of melatonin contained pills of different sizes and colors. |
— |
| 4 | — |
748.2003(b)(10) - Administration of prescription medication-must not borrow or administer prescription medication to a child that is prescribed to another person
A child in care was administered prescription medications which were prescribed to another child in care. |
— |
| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
A child in care was not given one medication for 3 days in a row and was also not given a lunch dose of another medication. |
— |
| 5 | — |
748.1101(b)(7) - Child's rights-Make complaints/calls/reports w/o interference,coercion,punishment,retaliation,threats.Right to make them anonymously
A child in care was intimidated by staff regarding allegations of a previous investigation. Children in care were offered incentives to provide information to staff regarding activity on the unit. |
— |
| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
A child in care was given another child in care's medication. |
— |
| 3 | — |
748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures
Two staff failed to follow the operations policies and procedures. One staff brought into the operation their personal prescribed medication. The second staff failed to follow policy by allowing children into the kitchen. |
— |
| 3 | — |
748.685(c)(6) - Implement and follow the children's service plans.
Direct Care Staff and Administrative staff failed to follow the directives included in a child's service plan which calls for contact with the child's caseworker outside of normal business hours when the child is escalated. |
— |
| 3 | — |
748.2855(a) - EBI Documentation-Caregiver must document EBI in child's record as soon as possible, but no later than 24 hours after initiation of the intervention
Emergency behavior Intervention for a child in care documentation was not fully completed within 24 hours. Missing information includes any injuries the child sustained during the intervention and the action the caregiver took to help the child return to normal activity. |
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| 5 | — |
748.2307(1) - Other Prohibited Punishments-any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline/punishment
A caregiver pushed a child in care. |
— |
| 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 7, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan; and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plan for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with the heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on January 4, 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 a high weighted citation in a pattern/trend category on January 4, 2024. Specifically, the operation was cited for 748.685(a)(4) Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being. The operation met compliance on January 10, 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; and - 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 plan. |
— |
| 4 | — |
748.2455(a)(1) - Emergency Behavior Intervention-Before using EBI, the caregiver must attempt less restrictive interventions that prove to be ineffective
A child in care was subject to a short personal restraint for throwing a water bottle and hitting staff. The staff member failed to utilize any form of de-escalation prior to implementing the restraint. Other staff present noted that de-escalation strategies should have been attempted prior to the restraint. |
— |
| 4 | — |
748.2855(b) - EBI Documentation-Supervisors of caregivers involved in EBI must document review of the intervention within 72 hours of the incident
An emergency behavior incident report did not include a documented review by the supervisor of the incident within 72 hours. |
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| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Five children stated they saw a staff sleeping. |
— |
| 4 | — |
748.685(b)(4) - Caregiver responsibility - when deciding how close to supervise take into account the surrounding circumstances, hazards, and risks
During an outing, staff allowed two children with histories of elopements, to be out of visual range supervision. Staff were also unaware the children had taken keys to the operation's vehicle. |
— |
| 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 10, 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 the heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on January 15, 2025, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the administrator?s failure to ensure compliance include the following: Your operation received a medium high weighted citation in a pattern/trend category on January 15, 2025. Specifically, the operation was cited for 748.1101(b)(3)(C) Children's Rights-Adhere to the child's rights to have religious needs met. The operation met compliance on January 23, 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; and - Operation was unable to meet compliance with medium high and/or high weighted licensing citations. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plan. |
— |
| 3 | — |
748.1101(b)(2) - Children's rights-Family contacts: maintaining regular contact with parents and siblings, unless restrictions needed because of child's best interest
Multiple children in care were denied the right to contact their caseworker. |
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| 5 | — |
745.4151(c)(4)(A) - Mandatory drug testing-all applicants intended to be hired are subject to pre-employment testing, must have results prior to child access
A caregiver did not complete a pre-employment drug screening prior to having contact with children in care. |
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| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Child received medical attention for an injury to the knee three days prior to child reporting they had slipped and fell in the shower. The incident, of the child falling in the shower was not documented and medical attention was not provided. Staff failed to use prudent judgement when decided to not document the incident or offer medical attention knowing that the child had received an injury three days prior to reporting the fall. |
— |
| 3 | — |
748.125(b) - All employees and caregivers must be aware of and follow your operation's policies and procedures
A caregiver failed to comply with the operation's tobacco and e-cigarette policy by vaping in an operation owned vehicle when children were not in the vehicle. |
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| 3 | — |
748.683(1) - Caregiver Supervision-Provide oversight of caregivers to protect children's health, safety and well-being
Caregivers created an unsafe environment for an escalated child by verbally provoking the child until law enforcement was called to intervene by arrest. |
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| 4 | — |
748.1337(b)(1)(H)(ii) - Initial Service Plan-child w/ high risk behaviors, include specific safety contract developed btwn child & staff to ensure safety
Children in care with histories of elopement disassembled a lock and eloped from the facility while unsupervised by caregivers. |
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| 4 | — |
748.303(a)(2)(B) - AP Serious Incdt- Report to parents any injury/illness that warrants treatment from a medical prof. directly after ensuring the safety of the child.
A child in care was injured at the operation and had to be transported to the hospital via ambulance and the managing conservator was not notified of the child's injury. |
— |
| 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 2/6/2023, 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 citation issued on January 20, 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 January 20, 2023. Specifically, the operation was cited for 748.685(a)(3) Caregiver responsibility - being aware of and accountable for each child's on-going activity. The operation met compliance on January 30, 2023. - 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. |
— |
| 5 | — |
748.1661(a) - Tobacco Products and E-Cigarettes -Children may not use or possess tobacco products, e-cigarettes or any type of vaporizers
Children in care were found to be using vapes |
— |
| 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 9, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan; and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plan for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with the heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on July 8, 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 a high weighted citation in a pattern/trend category on July 8, 2024. Specifically, the operation was cited for 748.2003(b)(2) Administration of Medication-Store medication in the original container unless there is an additional container with the same label & instructions. The operation met compliance on July 22, 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; and - 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 plan. An administrative penalty will be assessed as a result of this citation, in accordance with Texas Human Resources Code Sec. 42.078. The maximum daily penalty for your operation is $100. |
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| 3 | — |
748.125(b) - All employees and caregivers must be aware of and follow your operation's policies and procedures
A caregiver failed to follow the operation's policies and procedures by bringing tobacco products onto the campus and into the facility. |
— |
| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
A child in care was given another child in care's medication. |
— |
| 4 | — |
748.1101(b)(3)(C) - Children's rights-Adhere to the child's rights to have religious needs met
A child in care's religious needs were not bet by having a child get vaccinated even though there was a documented exemption due to religious reasons. |
— |
| 4 | — |
748.2003(b)(10) - Administration of prescription medication-must not borrow or administer prescription medication to a child that is prescribed to another person
A child in care was administered prescription medications which were prescribed to another child in care. |
— |
| 5 | — |
748.1661(a) - Tobacco Products and E-Cigarettes -Children may not use or possess tobacco products, e-cigarettes or any type of vaporizers
Three children in care accessed and used an e-cigarette lost by an employee in the facility. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Child received medical attention for an injury to the knee three days prior to child reporting they had slipped and fell in the shower. The incident, of the child falling in the shower was not documented and medical attention was not provided. Staff failed to use prudent judgement when decided to not document the incident or offer medical attention knowing that the child had received an injury three days prior to reporting the fall. |
— |
| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
A child in care was given a full tablet instead of a half tablet as prescribed by the doctor |
— |
| 4 | — |
748.2203(c)(2) - Medication Error-Document the medication error
There were four children in care with medication errors that did not have a full explenation of what the errors were. |
— |
| 4 | — |
748.685(b)(4) - Caregiver responsibility - when deciding how close to supervise take into account the surrounding circumstances, hazards, and risks
During an outing, staff allowed two children with histories of elopements, to be out of visual range supervision. Staff were also unaware the children had taken keys to the operation's vehicle. |
— |
| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
There were two missed medications. One on 1/8/2022 and one on 1/9/2022. |
— |
| 3 | — |
748.303(a)(6)(A) - Serious Incident-Report to Licensing no later than 24 hours after becoming aware that child is indicted, charged, or arrested or when police respond.
A child in care was taken into police custody following a motor vehicle accident on October 22, 2022. The operation did not report the incident until October 24, 2022. |
— |
| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
A child in care was not given one medication for 3 days in a row and was also not given a lunch dose of another medication. |
— |
| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
A child in care has not been given two doses of her Clonidine medication. |
— |
| 3 | — |
748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures
Two staff failed to follow the operations policies and procedures. One staff brought into the operation their personal prescribed medication. The second staff failed to follow policy by allowing children into the kitchen. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Two caregivers showed inappropriate videos/photos on their cell phones to children in care. Two caregivers failed to maintain personal boundaries with one another around children in care. |
— |
| 4 | — |
748.1531(d) - Medical care-Obtain follow-up medical treatment as recommended by the health-care professional
A child in care injured her knee at the operation and was transported to the hospital via ambulance the attending physician provided orders that the child receive a follow up within two days with the child's primary care physician. The operation did not take the child for a follow up appointment. |
— |
| 4 | — |
748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
Staff failed to implement an EBI restraint when a child in care was engaging in self-harm. Additionally, staff failed to de-escalate the behaviors and provoked escalation when an intervention could have prevented the injuries. |
— |
| 4 | — |
748.2003(b)(2) - Administration of Medication-Store medication in the original container unless there is an additional container with the same label & instructions
Two bottles of melatonin contained pills of different sizes and colors. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
An employee did not read the child's documentation that showed the child had a religious exemption to not get vaccinated. |
— |
| 3 | — |
748.125(b) - All employees and caregivers must be aware of and follow your operation's policies and procedures
A caregiver failed to follow the operation's policies and procedures by bringing tobacco products onto the campus and into the facility. |
— |
| 4 | — |
748.1337(b)(1)(H)(ii) - Initial Service Plan-child w/ high risk behaviors, include specific safety contract developed btwn child & staff to ensure safety
Children in care with histories of elopement disassembled a lock and eloped from the facility while unsupervised by caregivers. |
— |
| 3 | — |
748.2151(c)(3) - Medication record - must include reason medication was prescribed, for prescription medication
Two medication logs did not have documentation what the medication was prescribed for. |
— |
| 4 | — |
748.2151(c)(5) - Medication record - must include date (day/month/year) & time each medication was administered
The time medication was administered was not documeted for at least two children in care and for several of there medications. |
— |
| 5 | — |
748.1661(a) - Tobacco Products and E-Cigarettes -Children may not use or possess tobacco products, e-cigarettes or any type of vaporizers
Children in care were found to be using vapes |
— |
| 3 | — |
748.685(c)(6) - Implement and follow the children's service plans.
Direct Care Staff and Administrative staff failed to follow the directives included in a child's service plan which calls for contact with the child's caseworker outside of normal business hours when the child is escalated. |
— |
| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A caregiver permitted a child in care to view information that was intended to be accessible only to staff members. |
— |
| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
This standard is being tasked as a follow up to inspection 3854778. There have been 12 different medications given in inproper dosages to children in care according to the instructions on the label. These medications were either not given to children at all or were given in a higher dosage than prescribed. |
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748.303(a)(2)(B) - AP Serious Incdt- Report to parents any injury/illness that warrants treatment from a medical prof. directly after ensuring the safety of the child.
A child in care was injured at the operation and had to be transported to the hospital via ambulance and the managing conservator was not notified of the child's injury. |
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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
Multiple staff were using vapes inside with children on the premises. |
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748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Five children stated they saw a staff sleeping. |
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748.1101(b)(7) - Child's rights-Make complaints/calls/reports w/o interference,coercion,punishment,retaliation,threats.Right to make them anonymously
A child in care was intimidated by staff regarding allegations of a previous investigation. Children in care were offered incentives to provide information to staff regarding activity on the unit. |
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748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
A caregiver permitted a child in care to assault another child in care and video recorded children play fighting which would sometimes turn into real altercations. |
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748.1101(b)(7) - Child's rights-Make complaints/calls/reports w/o interference,coercion,punishment,retaliation,threats.Right to make them anonymously
Children in care reported that they only have access to phones to communicate with their CASA or Case Manger during their call day and are not allowed to contact their workers on the weekend. Several staff stated that they must get approval from the Caseworker for children in make calls. Caseworker stated he tries to get phone calls completed during the week due to not having floater staff on the weekends which would enable a staff to take the child to make calls. |
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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 9, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan; and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plan for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with the heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on July 8, 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 a high weighted citation in a pattern/trend category on July 8, 2024. Specifically, the operation was cited for 748.2003(b)(2) Administration of Medication-Store medication in the original container unless there is an additional container with the same label & instructions. The operation met compliance on July 22, 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; and - 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 plan. An administrative penalty will be assessed as a result of this citation, in accordance with Texas Human Resources Code Sec. 42.078. The maximum daily penalty for your operation is $100. |
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745.4151(c)(4)(A) - Mandatory drug testing-all applicants intended to be hired are subject to pre-employment testing, must have results prior to child access
A caregiver did not complete a pre-employment drug screening prior to having contact with children in care. |
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748.2551(c)(1) - EBI Implementation-Caregiver must minimize risk of physical discomfort, harm, or pain to the child
A child in care was placed in a short personal restraint in a bedroom, between two wooden beds. During the restraint, the child complained of not being able to breathe. After the restraint, the was observed with scratches on her face and bruising on her wrist and was later taken to the doctor for complaints of pain in her chest and arms. |
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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 10, 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 the heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on January 15, 2025, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the administrator?s failure to ensure compliance include the following: Your operation received a medium high weighted citation in a pattern/trend category on January 15, 2025. Specifically, the operation was cited for 748.1101(b)(3)(C) Children's Rights-Adhere to the child's rights to have religious needs met. The operation met compliance on January 23, 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; and - Operation was unable to meet compliance with medium high and/or high weighted licensing citations. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plan. |
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748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child
A caregiver engaged in a verbal altercation with a child in care, yelling at and shaming the child. |
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748.125(b) - All employees and caregivers must be aware of and follow your operation's policies and procedures
A caregiver failed to comply with the operation's tobacco and e-cigarette policy by vaping in an operation owned vehicle when children were not in the vehicle. |
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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 7, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan; and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plan for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with the heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on January 4, 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 a high weighted citation in a pattern/trend category on January 4, 2024. Specifically, the operation was cited for 748.685(a)(4) Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being. The operation met compliance on January 10, 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; and - 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 plan. |
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748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
A caregiver implemented an emergency behavior intervention on a child in care through a short personal restraint in a non-emergency situation. |
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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 citation issued on May 18, 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-high weighted citation in a pattern/trend category on May 18, 2022. Specifically, the operation was cited for 748.2307(8) Other prohibited Punishments. The operation met compliance on June 2, 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. |
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748.535(2) - AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.
During a review conducted on 2/6/2023, 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 citation issued on January 20, 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 January 20, 2023. Specifically, the operation was cited for 748.685(a)(3) Caregiver responsibility - being aware of and accountable for each child's on-going activity. The operation met compliance on January 30, 2023. - 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. |
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748.1101(b)(2) - Children's rights-Family contacts: maintaining regular contact with parents and siblings, unless restrictions needed because of child's best interest
Multiple children in care were denied the right to contact their caseworker. |
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748.2455(a)(1) - Emergency Behavior Intervention-Before using EBI, the caregiver must attempt less restrictive interventions that prove to be ineffective
A child in care was subject to a short personal restraint for throwing a water bottle and hitting staff. The staff member failed to utilize any form of de-escalation prior to implementing the restraint. Other staff present noted that de-escalation strategies should have been attempted prior to the restraint. |
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320 inspection record(s) on file from TX-HHSC.
Licensed facilities near this one, highest compliance score first.