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Texas › Hope for Tomorrow DBA Bridge to Hope

Hope for Tomorrow DBA Bridge to Hope

Child care center · , TX · License 1720357

0Compliance score
Poor

Capacity 17. 0-17

Violation history (256)

SeverityDateStandard / narrativeCorrected
3 748.705(b)(7) - Reasonable & prudent parent standard-must consider the surrounding circumstances, hazards, and risks of the activity
A child in care brought inside and cleaned up another child's wounds with minimal staff intervention.
3 748.2551(d)(1) - EBI Implementation-Caregiver must make every effort to protect the child's privacy, including shielding the child from onlookers
Several children in care stated they saw the situation occur.
4 748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
Five children stated they cheeked medication and were able to crush and snort the medication.
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
The service plan of a child in care with high-risk behaviors does not have a plan to address the behavior and minimize risk.
3 748.2301(c) - Disciplinary Measures-goal must be to teach a child acceptable behavior and self-control; caregiver must explain reason for discipline when imposed
5 of the 7 children interviewed described negative interactions with staff such as being called demeaning names, being treated unfairly, and staff assuming children are misbehaving.
5 748.2605(a)(5) - Personal Restraints Prohibited-Restraints that twist or place the child's limb(s) behind the child's back
An employee pulled two children's arms behind their back, pretending to arrest them.
4 748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
It was found that a child in care was given double the amount of their medication due to an oversight in checking the medication log.
4 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
A child in care was pulled out of the shower and restrained, which was not an emergency situation.
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 was administered a 20mg and 30mg medication, equaling 50mg, instead of the prescribed 30mg, as noted in the medication reviewed from the prescribing physician. This is stopped on the day the operation was made aware of the error and the operation met with the physician to see how to continue.
5 748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Several children mentioned supervision concerns during the investigation. Children were able to obtain, crush, and snort medications with no staff being aware. A child was able to go outside, cut their arms, be found by another child, and brought inside and cleaned up with minimal staff intervention.
3 748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures
6 children interviewed stated a night staff does not complete night checks, and 3 of those children stated they have seen the night staff asleep. Per the operation's policies and procedures, staff should be awake, provide 24 hour supervision, and conduct checks every 15-20 minutes.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
4 children in care were made uncomfortable by an employee pulling at their clothing and pulling them by the arms.
4 748.685(c)(5) - Caregiver responsibility - ensure continuity of care by sharing information concerning each child with incoming caregivers
A child was given the wrong dosage of medication for a month, after a change in medication from a medication review. No staff administering medication caught the error. It does not seem the medication change was communicated to staff appropriately.
5 748.4041 - Driver & passengers must follow all laws when driving, including laws on use of child passenger safety seat systems, seat belts & liability insurance
Multiple children reported staff driving recklessly- speeding, going off the road, and almost hitting a barrier.
2 748.3273(6) - First Aid Kits-Each one must contain scissors
Two first aid kits reviewed did not have all the required supplies needed.
5 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
During the DFPS ANE investigation, this standard was found to be deficient. A child in care was pulled out of the shower and restrained in a non-emergency situation.
2 748.401 - Archived child record-kept safe from damage and available for Licensing review within 48 hours.
Documentation had to requested on multiple occasions from the operation. Documentation was initially requested in person on 10.27.22 during the inspection. It was requested again to be sent via email on 11.3.22 by 5PM. Part of the documentation was received on 11.4.22. The remainder of the documentation was requested by EOBD via email on 11.8.22. Another email had to be sent on 11.10.22 for the remainder of the documentation to be obtained. All requested documentation was received on 11.10.22.
4 748.2203(c) - Medication Error-Operation must meet documentation requirements within 24 hrs
It was found no medication error documentation was completed/provided for four children's medication errors.
5 748.2101(1) - Medication Storage-Store medication in a locked container
This standard was found deficient as part of a DFPS Investigation.
4 748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
It was determined that children's medications were being crushed when administered.
4 748.3115(3) - Fire Extinguisher-Must ensure fire extinguishers are serviced as required by manufacturer's instructions, or as required by fire inspector
Fire extinguishers in the home were recently out of date and need to be serviced.
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 was left without staff supervision at a store for about 45 minutes. Although the staff and children stated that staff did count the children, the child was still left, and the others were able to go to another store until noticing.
3 748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures
Medication polices regarding administering medications in the staff office and locking medications/storage were not being followed.
2 748.4083(b) - Vehicle and maintenance-Each vehicle used must be registered and have a current inspection sticker for the state in which it is registered
Two of the operation's vans did not have current inspection stickers.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff member took a child to a road and behind the vehicle, out of sight from other staff and children, while the child was elevated.
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 child went to the emergency room on 10/31/24, and the incident was reported to licensing on 11/6/24.
5 748.2551(c)(1) - EBI Implementation-Caregiver must minimize risk of physical discomfort, harm, or pain to the child
A child was pulled out of the shower and restrained. The child was restrained again on the porch. Staff had their weight on the child and a few collaterals stated it was done incorrectly. The child in care said she was hurt and had to spit after the restraint.
5 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
A child was dropped off at an appointment without staff ensuring there was someone there, resulting in the child waiting outside unsupervised for about 45 minutes.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff caregiver put their hands on a child's forehead and pushed their head back. A staff caregiver engaged in banter with a child during this incident.
3 748.685(c)(6) - Implement and follow the children's service plans.
An employee was alone with a child when the child's high risk behaviors in their service plan cautions against being alone with the child. The administrator and staff of the operation stated this individual was not to be alone with residents at the operation.
5 748.1101(b)(7) - Child's rights-Make complaints/calls/reports w/o interference,coercion,punishment,retaliation,threats.Right to make them anonymously
Multiple children and staff stated a former employee told children in care to lie about reporting and threatened retaliation.
4 748.303(a)(12)(A) - Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child
A staff member did not report a child's suicide attempt to the appropriate operation supervisors or to the Hotline.
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 was administered a 20mg and 30mg medication, equaling 50mg, instead of the prescribed 30mg, as noted in the medication reviewed from the prescribing physician. This is stopped on the day the operation was made aware of the error and the operation met with the physician to see how to continue.
4 748.685(c)(5) - Caregiver responsibility - ensure continuity of care by sharing information concerning each child with incoming caregivers
A child was given the wrong dosage of medication for a month, after a change in medication from a medication review. No staff administering medication caught the error. It does not seem the medication change was communicated to staff appropriately.
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
The service plan of a child in care with high-risk behaviors does not have a plan to address the behavior and minimize risk.
2 748.3273(6) - First Aid Kits-Each one must contain scissors
Two first aid kits reviewed did not have all the required supplies needed.
5 748.1101(b)(7) - Child's rights-Make complaints/calls/reports w/o interference,coercion,punishment,retaliation,threats.Right to make them anonymously
Multiple children and staff stated a former employee told children in care to lie about reporting and threatened retaliation.
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 was left without staff supervision at a store for about 45 minutes. Although the staff and children stated that staff did count the children, the child was still left, and the others were able to go to another store until noticing.
2 748.4083(b) - Vehicle and maintenance-Each vehicle used must be registered and have a current inspection sticker for the state in which it is registered
Two of the operation's vans did not have current inspection stickers.
5 748.2605(a)(5) - Personal Restraints Prohibited-Restraints that twist or place the child's limb(s) behind the child's back
An employee pulled two children's arms behind their back, pretending to arrest them.
5 748.2551(c)(1) - EBI Implementation-Caregiver must minimize risk of physical discomfort, harm, or pain to the child
A child was pulled out of the shower and restrained. The child was restrained again on the porch. Staff had their weight on the child and a few collaterals stated it was done incorrectly. The child in care said she was hurt and had to spit after the restraint.
4 748.3115(3) - Fire Extinguisher-Must ensure fire extinguishers are serviced as required by manufacturer's instructions, or as required by fire inspector
Fire extinguishers in the home were recently out of date and need to be serviced.
3 748.2551(d)(1) - EBI Implementation-Caregiver must make every effort to protect the child's privacy, including shielding the child from onlookers
Several children in care stated they saw the situation occur.
4 748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
It was determined that children's medications were being crushed when administered.
5 748.2101(1) - Medication Storage-Store medication in a locked container
This standard was found deficient as part of a DFPS Investigation.
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 child went to the emergency room on 10/31/24, and the incident was reported to licensing on 11/6/24.
2 748.401 - Archived child record-kept safe from damage and available for Licensing review within 48 hours.
Documentation had to requested on multiple occasions from the operation. Documentation was initially requested in person on 10.27.22 during the inspection. It was requested again to be sent via email on 11.3.22 by 5PM. Part of the documentation was received on 11.4.22. The remainder of the documentation was requested by EOBD via email on 11.8.22. Another email had to be sent on 11.10.22 for the remainder of the documentation to be obtained. All requested documentation was received on 11.10.22.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff caregiver put their hands on a child's forehead and pushed their head back. A staff caregiver engaged in banter with a child during this incident.
3 748.705(b)(7) - Reasonable & prudent parent standard-must consider the surrounding circumstances, hazards, and risks of the activity
A child in care brought inside and cleaned up another child's wounds with minimal staff intervention.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff member took a child to a road and behind the vehicle, out of sight from other staff and children, while the child was elevated.
4 748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
It was found that a child in care was given double the amount of their medication due to an oversight in checking the medication log.
3 748.2301(c) - Disciplinary Measures-goal must be to teach a child acceptable behavior and self-control; caregiver must explain reason for discipline when imposed
5 of the 7 children interviewed described negative interactions with staff such as being called demeaning names, being treated unfairly, and staff assuming children are misbehaving.
4 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
A child in care was pulled out of the shower and restrained, which was not an emergency situation.
3 748.685(c)(6) - Implement and follow the children's service plans.
An employee was alone with a child when the child's high risk behaviors in their service plan cautions against being alone with the child. The administrator and staff of the operation stated this individual was not to be alone with residents at the operation.
3 748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures
Medication polices regarding administering medications in the staff office and locking medications/storage were not being followed.
5 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
A child was dropped off at an appointment without staff ensuring there was someone there, resulting in the child waiting outside unsupervised for about 45 minutes.
5 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
During the DFPS ANE investigation, this standard was found to be deficient. A child in care was pulled out of the shower and restrained in a non-emergency situation.
3 748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures
6 children interviewed stated a night staff does not complete night checks, and 3 of those children stated they have seen the night staff asleep. Per the operation's policies and procedures, staff should be awake, provide 24 hour supervision, and conduct checks every 15-20 minutes.
4 748.2203(c) - Medication Error-Operation must meet documentation requirements within 24 hrs
It was found no medication error documentation was completed/provided for four children's medication errors.
4 748.303(a)(12)(A) - Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child
A staff member did not report a child's suicide attempt to the appropriate operation supervisors or to the Hotline.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
4 children in care were made uncomfortable by an employee pulling at their clothing and pulling them by the arms.
5 748.4041 - Driver & passengers must follow all laws when driving, including laws on use of child passenger safety seat systems, seat belts & liability insurance
Multiple children reported staff driving recklessly- speeding, going off the road, and almost hitting a barrier.
5 748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Several children mentioned supervision concerns during the investigation. Children were able to obtain, crush, and snort medications with no staff being aware. A child was able to go outside, cut their arms, be found by another child, and brought inside and cleaned up with minimal staff intervention.
4 748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
Five children stated they cheeked medication and were able to crush and snort the medication.
4 748.2203(c) - Medication Error-Operation must meet documentation requirements within 24 hrs
It was found no medication error documentation was completed/provided for four children's medication errors.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
4 children in care were made uncomfortable by an employee pulling at their clothing and pulling them by the arms.
2 748.401 - Archived child record-kept safe from damage and available for Licensing review within 48 hours.
Documentation had to requested on multiple occasions from the operation. Documentation was initially requested in person on 10.27.22 during the inspection. It was requested again to be sent via email on 11.3.22 by 5PM. Part of the documentation was received on 11.4.22. The remainder of the documentation was requested by EOBD via email on 11.8.22. Another email had to be sent on 11.10.22 for the remainder of the documentation to be obtained. All requested documentation was received on 11.10.22.
3 748.2551(d)(1) - EBI Implementation-Caregiver must make every effort to protect the child's privacy, including shielding the child from onlookers
Several children in care stated they saw the situation occur.
4 748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
It was determined that children's medications were being crushed when administered.
4 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
A child in care was pulled out of the shower and restrained, which was not an emergency situation.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff member took a child to a road and behind the vehicle, out of sight from other staff and children, while the child was elevated.
5 748.2101(1) - Medication Storage-Store medication in a locked container
This standard was found deficient as part of a DFPS Investigation.
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
The service plan of a child in care with high-risk behaviors does not have a plan to address the behavior and minimize risk.
5 748.2605(a)(5) - Personal Restraints Prohibited-Restraints that twist or place the child's limb(s) behind the child's back
An employee pulled two children's arms behind their back, pretending to arrest them.
4 748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
Five children stated they cheeked medication and were able to crush and snort the medication.
3 748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures
Medication polices regarding administering medications in the staff office and locking medications/storage were not being followed.
3 748.2301(c) - Disciplinary Measures-goal must be to teach a child acceptable behavior and self-control; caregiver must explain reason for discipline when imposed
5 of the 7 children interviewed described negative interactions with staff such as being called demeaning names, being treated unfairly, and staff assuming children are misbehaving.
5 748.1101(b)(7) - Child's rights-Make complaints/calls/reports w/o interference,coercion,punishment,retaliation,threats.Right to make them anonymously
Multiple children and staff stated a former employee told children in care to lie about reporting and threatened retaliation.
4 748.685(c)(5) - Caregiver responsibility - ensure continuity of care by sharing information concerning each child with incoming caregivers
A child was given the wrong dosage of medication for a month, after a change in medication from a medication review. No staff administering medication caught the error. It does not seem the medication change was communicated to staff appropriately.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff caregiver put their hands on a child's forehead and pushed their head back. A staff caregiver engaged in banter with a child during this incident.
3 748.685(c)(6) - Implement and follow the children's service plans.
An employee was alone with a child when the child's high risk behaviors in their service plan cautions against being alone with the child. The administrator and staff of the operation stated this individual was not to be alone with residents at the operation.
2 748.4083(b) - Vehicle and maintenance-Each vehicle used must be registered and have a current inspection sticker for the state in which it is registered
Two of the operation's vans did not have current inspection stickers.
5 748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Several children mentioned supervision concerns during the investigation. Children were able to obtain, crush, and snort medications with no staff being aware. A child was able to go outside, cut their arms, be found by another child, and brought inside and cleaned up with minimal staff intervention.
3 748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures
6 children interviewed stated a night staff does not complete night checks, and 3 of those children stated they have seen the night staff asleep. Per the operation's policies and procedures, staff should be awake, provide 24 hour supervision, and conduct checks every 15-20 minutes.
5 748.4041 - Driver & passengers must follow all laws when driving, including laws on use of child passenger safety seat systems, seat belts & liability insurance
Multiple children reported staff driving recklessly- speeding, going off the road, and almost hitting a barrier.
2 748.3273(6) - First Aid Kits-Each one must contain scissors
Two first aid kits reviewed did not have all the required supplies needed.
4 748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
It was found that a child in care was given double the amount of their medication due to an oversight in checking the medication log.
5 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
During the DFPS ANE investigation, this standard was found to be deficient. A child in care was pulled out of the shower and restrained in a non-emergency situation.
3 748.705(b)(7) - Reasonable & prudent parent standard-must consider the surrounding circumstances, hazards, and risks of the activity
A child in care brought inside and cleaned up another child's wounds with minimal staff intervention.
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 was left without staff supervision at a store for about 45 minutes. Although the staff and children stated that staff did count the children, the child was still left, and the others were able to go to another store until noticing.
4 748.3115(3) - Fire Extinguisher-Must ensure fire extinguishers are serviced as required by manufacturer's instructions, or as required by fire inspector
Fire extinguishers in the home were recently out of date and need to be serviced.
4 748.303(a)(12)(A) - Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child
A staff member did not report a child's suicide attempt to the appropriate operation supervisors or to the Hotline.
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 was administered a 20mg and 30mg medication, equaling 50mg, instead of the prescribed 30mg, as noted in the medication reviewed from the prescribing physician. This is stopped on the day the operation was made aware of the error and the operation met with the physician to see how to continue.
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 child went to the emergency room on 10/31/24, and the incident was reported to licensing on 11/6/24.
5 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
A child was dropped off at an appointment without staff ensuring there was someone there, resulting in the child waiting outside unsupervised for about 45 minutes.
5 748.2551(c)(1) - EBI Implementation-Caregiver must minimize risk of physical discomfort, harm, or pain to the child
A child was pulled out of the shower and restrained. The child was restrained again on the porch. Staff had their weight on the child and a few collaterals stated it was done incorrectly. The child in care said she was hurt and had to spit after the restraint.
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 was left without staff supervision at a store for about 45 minutes. Although the staff and children stated that staff did count the children, the child was still left, and the others were able to go to another store until noticing.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff member took a child to a road and behind the vehicle, out of sight from other staff and children, while the child was elevated.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff caregiver put their hands on a child's forehead and pushed their head back. A staff caregiver engaged in banter with a child during this incident.
5 748.1101(b)(7) - Child's rights-Make complaints/calls/reports w/o interference,coercion,punishment,retaliation,threats.Right to make them anonymously
Multiple children and staff stated a former employee told children in care to lie about reporting and threatened retaliation.

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

Inspections (168)

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

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