Texas › Hockley › Tree of Life RTC

Tree of Life RTC

Child care center · 19402 BAUER RD, Hockley, TX 77447-4241 · License 1723466

0Compliance score
Poor

Capacity 8. 8-17

Violation history (500)

Severity	Date	Standard / narrative	Corrected
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 The child's service plan was not updated. The last service plan made available was dated 8/9/2021.	—
3	—	748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures A staff member did not follow the operations policy to check for a body part to ensure the child's presence in the facility	—
2	—	748.1331(b)(5) - Preliminary Service Plan-For child receiving treatment services, designate who will be responsible for meeting each of the child's needs Five of five plans reviewed did not have a designated person for each child.	—
4	—	748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards During the inspection, it was observed that over five windows do not have screens to protect against insects/bugs.	—
5	—	748.911(a) - Each caregiver must have a current certificate of training with an expiration or renewal date in pediatric first aid with rescue breathing and choking The employee file reviewed at inspection CPR/First Aid certification was expired.	—
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 It was determined that the caregiver did not use appropriate disciplinary measures.	—
4	—	748.2101(6) - Medication storage & destruction-remove discontinued medication immediately & destroy it in a way that ensures children do not have access to it Expired medication was observed stored in the medication cart and not properly discarded. It was also noted the cart was full and expired medication were falling out.	—
4	—	748.3061(2) - Gas Inspection-Operation inspected at least once every 24 months from date of last inspection for gas leaks The operation does not have current gas inspection for the facility.	—
3	—	748.363(4) - Personnel records-Include evidence of valid professional licensures, certifications, or registrations required for the position After reviewing the personnel records one of the staff did not have their high school diploma or transcripts in their file.	—
1	—	748.1217(b)(14) - Admission Assessment-At admission, must include parent's expectations for placement, duration of placement, & family involvement One of two records reviewed was missing the duration of placement, family involvement, and social history.	—
3	—	748.4653(a)(1) - Pre-Service Training- All caregivers must receive 8 hours of general pre-service training before being only caregiver responsible for a child in care There is no documentation regarding pre-service training for one of two employee records reviewed.	—
4	—	748.685(b)(5) - Caregiver responsibility - when deciding how close to supervise, takes into account the child's physical, mental, emotional, and social needs Staff failed to appropriately supervise a child in care. The child has been involved in several accounts of physical and verbal aggression incidents. Staff have not taken into account the child's mental, emotional and social history and have not been able to prevent the incidents involving this child.	—
3	—	748.681(2) - Caregiver qualifications- HS diploma or GED from program recognized by TEA, TPSAC, other state or documentaion of equivalency from home schooling One of two employee records reviewed does not contain the correct proof of HS diploma or GED.	—
3	—	748.311(1) - Serious Incident Documentation-Includes name of the operation, physical address, and telephone number A serious incident report was missing the operations physical address, telephone number and the child's gender.	—
1	—	748.1217(c)(6) - Admission Assessment-Prior to initial service plan, add child's school history Five of five assessments reviewed did not have the complete school history of each child. They also didn't include the reason child was removed or placed at previous homes or RTCs.	—
2	—	748.1209(a) - Child Orientation-Provided to child who is 5 years old or older within 7 days of admission and geared to child's intellectual level The orientation was missing from the child's record.	—
4	—	748.981(b)(1) - First-aid-CPR training-At all times, at least one caregiver counted in child/caregiver ratio must have current certification in CPR It was observed that two children in care was left with a caregiver/case manager that has an expired CPR certificate.	—
3	—	748.309 - Reporting Serious Incident - All serious incident reports to Licensing must be made to the Texas Abuse & Neglect Hotline It was determined that the operation did not report three different incidents with a particular child.	—
5	—	748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being A staff at the operation did not provide adequate overnight supervision checks which resulted in the child's subsequent AWOL, involvement in criminal activity, and injury.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records During the review of one staff file, multiple dates of hire was observed. The date of hire for the staff in staff list is different from the date of hire on the staff file binder cover.	—
4	—	748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards The window in the back bedroom does not have locks.	—
2	—	748.4003(1)(B) - General requirements-When transporting a child the operation must ensure each driver is covered by automobile insurance During inspection, it was noted that there was no copy of the car insurance of the operation's vehicle.	—
4	—	748.3301(i) - Physical Site-Equipment and furniture must be safe for children and must be kept clean and in good repair During the walk-through, it was observed that a bathroom door was split open, one hole in the wall, one door has been kicked at the bottom, wooden rods in closet can be easily removed, electrical plug is not connected to wall, and one dresser was missing the drawer.	—
3	—	748.4653(a)(1) - Pre-Service Training- All caregivers must receive 8 hours of general pre-service training before being only caregiver responsible for a child in care There is no documentation regarding pre-service training for one of two employee records reviewed.	—
3	—	748.2151(c)(2) - Medication record - must include prescribing health-care professional's name After reviewing the medication log space I observed that the log was missing the prescribing health care professional.	—
3	—	748.505(b)(4) - Minimum qualifications for employees-Complete notarized Licensing Affidavit for Applicants for Employment form One of two employee records reviewed is missing an affidavit.	—
2	—	748.1437(4) - Discharge/Transfer Documentation-Must include copies of child's service plans while in operation's care for the past 12 months The discharge paperwork was missing the child's service plans for the last 12 months and the child's list of medications.	—
3	—	748.363(7) - Personnel records - Include statement signed and dated by the employee that he has read a copy of the operational policies It was determined that four employee records did not consist the operational policies.	—
5	—	748.151(1) - Operational responsibilities - Designate a qualified full-time child-care administrator The operation failed to employ a full-time administrator for the operation at the expiration of the 60 days given to them in technical assistance issued by assessment on 11-17-25. As a result, the operation was cited on 1-16-26 and given another 60 days to employ a new administrator.	—
2	—	748.1335 - Initial Service Plan-Complete the initial service plan within 45 days after admission During inspection, it was noted that 2 out of 2 children's files reviewed did not contain an initial/updated service plan.	—
2	—	748.1217(c)(7) - Admission Assessment-Prior to initial service plan, add child's history of other placements (admission and discharge dates, reasons for placement) One of the two records reviewed did not include the history of other placements, neonatal history, criminal history, school history, or skills/special interest	—
2	—	748.867(d) - Pre-Service Training Exemption-Document the applicable exemption factors in the appropriate personnel record One of three staff records reviewed indicated that he was exempt from pre-service training due to receiving it at previous employment. There is no documentation of these trainings being completed.	—
2	—	748.1217(b)(16) - Admission Assessment-At admission, must include determination of whether operation can meet immediate needs of child. Three of three records reviewed does not have a clear determination of how they will meet the needs of the children in care.	—
3	—	748.105(2) - Personnel Policies - Develop written job descriptions including minimum qualifications and job responsibilities for each position One of two records reviewed did not contain a job description.	—
5	—	748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation Caregivers failed to adhere to the child's rights to be free of abuse, neglect, and exploitation as defined in Texas Family Code Section 261.001.	—
2	—	748.915(b)(5) - Pediatric CPR training documentation must include the expiration date of the certification determined by the organization providing the certification During inspection, it was noted that a CPR Certificate of a staff did not contain an expiration and/or renewal date as determined by the organization providing the certificate.	—
3	—	748.681(2) - Caregiver qualifications- HS diploma or GED from program recognized by TEA, TPSAC, other state or documentaion of equivalency from home schooling Two of three staff records reviewed did not contain proof of graduating high school or college.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records A review of records revealed that a child's service plan was incomplete and unsigned by the administrator.	—
2	—	748.1217(c)(7) - Admission Assessment-Prior to initial service plan, add child's history of other placements (admission and discharge dates, reasons for placement) The admission assessment did not contain the reason for previous placements.	—
4	—	748.4653(a)(2) - Pre-Service Training- All caregivers must receive 16 hours of EBI training, if operation prohibits EBI then 8 hours only. It was determined that the caregiver was not properly trained in EBI.	—
4	—	748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards During a walkthrough of the operation I observed a window on the outside of the back porch has a screen that appeared to be torn and coming open.	—
4	—	748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks It was determined that a caregiver placed a child in a chokehold and slammed him against the wall, hitting the child's head. The child was not provided with medical care and has a history of a traumatic brain injury.	—
2	—	748.681(1)(B) - Caregiver qualifications-Must be at least 21 yrs old if all children in group are 13 yrs old or older It was determined that a caregiver was 20 years old working with children 13 years old and older.	—
5	—	748.2461(b)(3) - Short Personal Restraint-Caregiver may not use restraint that obstructs child's airways or impairs child's breathing It was determined that a caregiver placed a child in a chokehold.	—
4	—	748.885(3) - General pre-service training curriculum-Includes techniques and methods of administering medications if caregiver administers psychotropic meds There was no documentation of a training for the administering of medication.	—
5	—	748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being Staff failed to provide adequate supervision which caused a child in care to sustain injuries.	—
3	—	748.1333 - Preliminary Service Plan-Treatment director or PLSP must develop, sign, and date the plan for children receiving treatment services The plan was not signed or dated by the Treatment Director.	—
4	—	748.885(3) - General pre-service training curriculum-Includes techniques and methods of administering medications if caregiver administers psychotropic meds One of two records did not contain documentation of training for the administering of medication.	—
5	—	748.151(1) - Operational responsibilities - Designate a qualified full-time child-care administrator It was determined that the operation does not currently have an administrator.	—
4	—	748.1209(c)(1) - Child Orientation - Include information on how to make complaints to outside agencies It was determined that the orientation provided did not include how to make complaints.	—
4	—	748.601 - Treatment Director-Facility providing treatment services to 25 or more children or to more than 30% of children in care must have treatment director The treatment director is only present once a week at the operation. The treatment director needs to work at least 30 hours a week at the operation to meet the full-time status.	—
4	—	748.753(a)(2) - Pre-Employment Screening-You must contact each of the two references to verify that the applicant is suitable to work with or around children. Reference checks were not completed for the personnel file that was reviewed.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records The policies and procedures contained conflicting information regarding whether the operation will allow staff to take children away from the operation on overnight visits. The preservice training policy (page 29) includes the name of another operation.	—
4	—	748.861(b) - Pre-Service Training-If facility provides certain amount of tx svcs, caregiver must have 40 hours experience in operation that provides same tx svcs A caregiver employed by the operation did not have previous treatment services childcare experience, the personnel record did not show 40 hours of documented observation, prior to being on shift as a sole caregiver and the caregiver was not exempt from the observation.	—
4	—	748.303(a)(3)(A) - Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child Caregivers failed to notify licensing of a child in care of an incident involving the child sustaining an injury.	—
4	—	748.1217(b)(3) - Admission Assessment-At admission, must include description of child's behavior, appropriate & maladaptive, behavior posing risk to self/others Five of five assessments reviewed does not have a description of the actual behaviors.	—
4	—	748.885(3) - General pre-service training curriculum- Must include techniques and methods of administering medications. Staff did not have training for administering medication and no training for psychotropic medication.	—
4	—	748.1217(b)(3) - Admission Assessment-At admission, must include description of child's behavior, appropriate & maladaptive, behavior posing risk to self/others The admission assessment does not contain the child's behavior, why he is in placement, the address/phone numbers for child's caseworker and foster parents. The admission assessment also did not contain the child's behavioral levels while at school.	—
4	—	748.3441(a) - Food Preparation-Food & drinks must be of safe quality, stored, prepared, distributed, & served under sanitary & safe conditions During a walkthrough inspection of the operation, milk, hot dog and hamburger buns, wheat bread, and tortillas were found past the sell or use by date. The operation disposed of the expired items while inspector was present.	Yes
2	—	748.3351(5) - Interior Space-provide bedroom windows with curtains, blinds, shades, or other provisions for rest and privacy It was determined that one bedroom did not have blinds on the window,	—
4	—	748.3001(a)(2) - Sanitation Inspection-Sanitation official must conduct sanitation inspection at least once every 12 months from date of last inspection During inspection, it was noted that the Health and Sanitation permit for the operation has expired and needs to be renewed.	—
1	—	748.1217(b)(15) - Admission Assessment-At admission, must include child's understanding of the placement Five of five admission assessments reviewed did not provide a clear understanding of why the child was placed in your care.	—
2	—	748.1217(b)(11) - Admission Assessment-At admission, must include services the operation plans to provide to the child Two of two records reviewed did not contain the services the operation plans to provide for the child.	—
3	—	748.363(7) - Personnel records - Include statement signed and dated by the employee that he has read a copy of the operational policies One of two employee records still does not have a signed copy of the operational policies.	—
4	—	748.303(a)(3)(B) - Serious Incident-Report to parents allegations of abuse, neglect, or exploitation of a child directly after ensuring the child's safety. Caregivers failed to notify the parent of a child in care of an incident involving the child sustaining an injury.	—
3	—	748.505(b)(4) - Minimum qualifications for employees-Complete notarized Licensing Affidavit for Applicants for Employment form One of two records reviewed did not contain a notarized affidavit.	—
2	—	748.3239(d) - Evacuation-Must document fire and severe weather drills, including date, time, type of drill, and length of time for evacuation/relocation There was no documentation about the severe weather drills.	—
3	—	748.125(d)(4)(A) - Suicide Screening- A screening tool must be administered at admission for each child 10 years of age or older. Five of five records reviewed did not contain a suicide screening.	—
5	—	748.125(e)(1)(E) - You must adhere to recommendations of the MH professional and update the child?s safety/service plan's if child is at high risk for suicide. It was determined that the operation did not follow the safety plan in place to ensure the safety of a resident with known high-risk behaviors.	—
4	—	748.1337(b)(1)(D)(ii) - Initial Service Plan-Include instructions to caregivers about level of supervision required The service plan reviewed did not have specific level of supervision.	—
5	—	745.621(a)(2) - AP Initial background checks submitted - At the time you hire someone An active staff list was provided during the investigation inspection. A current employee that was hired on 11/21/2021 shows an inactive employment background check status since 08/25/2023.	—
5	—	745.8411(b)(2) - Responsibilities - Provides access to all areas of the operation During a walkthrough of the operation the door to the casemanagers office was locked and unable to be accessed.	—
4	—	748.3233(b)(3) - Evacuation-Emergency evacuation & relocation diagram must include designated location inside operation to take shelter from threatening weather The evacuation floor plans hung in the operation do not reflect an acurate depiction of the exit route or shelter in place location.	—
5	—	748.3301(a) - Physical Site-Buildings must be structurally sound, clean, and in good repair. Paints must be lead-free During a walk through of the facility I observed exposed wires near the shed in the back yard. The floor paneling from kitchen to bedroom is loose and lifts up. The dresser in one of the bedrooms was missing a door knob and appears to have unfinished paneling at the top. The hanging rods inside the closets are loose and can be removed. The upstairs bathroom has a hole on the side of the vanity where the toilet paper holder was located. The bathroom downstairs has a door for piping that does not shut well and is hanging.	—
4	—	748.3351(1) - Interior Space-Provide living space, appropriate furnishings, & bathroom facilities that are safe, clean and maintained in good repair During the inspection, it was observed that the home should be sanitized before accepting children.	—
3	—	748.363(7) - Personnel records - Include statement signed and dated by the employee that he has read a copy of the operational policies Three of three employee records did not contain a signed/dated statement of the operational policies.	—
5	—	748.3301(a)(1) - Physical Site- Buildings must be structurally sound and not pose a risk to the health and safety of children. During a follow-up walk through conducted at the operation, the sink in the bathroom remains leaking and the blind in the second bathroom downstairs is still broken.	—
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 Staff admitted they were not drug tested prior to starting position at the operation.	—
3	—	748.1103(a) - Informing child of rights-Review rights with child/parents within 7 days of child's admission; provide child/parents with written copy of rights One child record observed did not have a copy of their rights.	—
3	—	748.4009(c) - General requirements-There must be emergency transportation available at all times The operation's vehicle has been in the shop for a week and there is no emergency vehicle available.	—
3	—	748.1217(b)(2) - Admission Assessment-At admission, must include description of circumstances that led to child's referral for substitute care Three of five assessments had the same information as to the circumstances of why the child was placed in care.	—
4	—	748.2101(7) - Medication storage & destruction-remove medication on/before the expiration date & destroy it in a way that ensures children do not have access During a walk-through of the operation, there was several containers of over the counter medications that were expired.	—
5	—	748.125(c)(1) - Suicide Training-All caregivers and employees must complete at least one hour of annual suicide prevention training. Two of three employee records reviewed did not contain suicide prevention training.	—
4	—	748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards The locks on the window in a child's room is broken. Door handle missing on one door.	—
3	—	748.831(a) - Orientation-Each caregiver or employee must have orientation prior to beginning job duties or having contact with children in care Three of three records did not contain orientation.	—
5	—	748.3301(a)(1) - Physical Site- Buildings must be structurally sound and not pose a risk to the health and safety of children. During a walkthrough conducted at the operation, there was a broken electrical outlet, water leaking under a bathroom sink, exposed wiring inside a bathroom, broken window blind, screens that were torn on the porch area, broken tiles, and room transitions that pose a tripping hazard.	—
2	—	748.1217(c)(8) - Admission Assessment-Prior to initial service plan, add child's criminal history, if any Four of five assessments reviewed did not indicate if the children had any criminal history.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Three of eight medication logs did not have the accurate count of medication administered.	—
2	—	748.3239(d) - Evacuation-Must document fire and severe weather drills, including date, time, type of drill, and length of time for evacuation/relocation The severe weather drill form did not include a spot to document the length of time for the evacuation or relocation to take place.	—
2	—	748.941(a)(4) - Training Criteria- Must include a certificate, letter, or a signed and dated statement of successful completion from the training source. During inspection, it was noted that the training log for one staff did not contain a certificate, letter, or a signed and dated statement of successful completion from a training source on trainings held for the year 2021.	—
4	—	748.505(b)(5) - Minimum qualifications for employees- Must have cleared pre-employment screening assessment. One of two records reviewed did not contain a pre-employment screening assessment.	—
5	—	748.151(1) - Operational responsibilities - Designate a qualified full-time child-care administrator It was determined that the operation has been without an administrator for 90 days. The operation stated that they have two options that they will be sending an offer letter to by this week. Depending on which one accepts, the anticipated start date will be at the beginning of September.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records A record review of a child's admission assessment contained information regarding another resident.	—
4	—	748.981(a)(1) - First-aid-CPR training-Each caregiver must have current certification in first-aid It was determined that two caregivers do not have CPR certification.	—
3	—	748.105(2) - Personnel Policies - Develop written job descriptions including minimum qualifications and job responsibilities for each position One of two records reviewed did not contain a job description. The one job description reviewed needs more information in regards to the employee position.	—
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. It was determined the incident occurred and child was taken to the hospital 3/22/2026 at 3:30 pm. The operation notified Licensing on 3/23/2026 at 5:22 am; however, the child's case worker wasn't notified until 3/23/2026 at 10:41 am.	—
1	—	748.3351(4) - Interior Space-provide bedrooms with at least one window with outside exposure to natural light During a walkthrough of the operation, the windows in the bedroom do not have natural light to the room as the windows are now blocked with privacy panels due to an add-on room to the house for the case manager.	—
3	—	748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair. Several holes were observed in walls/closet during the walk through. In addition, an exposed electrically socket was observed in a downstairs bathroom.	—
3	—	748.531(a)(3) - Child-care administrator-Is full-time employee of the operation It is determined that the administrator was not working full-time at the operation. She was working another job as a CPS Investigator.	—
3	—	748.311 - Serious Incident Documentation-Documented in written report It was determined that there was no serious incident report documented.	—

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

Inspections (328)

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

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