Texas › Rosenberg › Trinity Guidance Residential Treatment Center

Trinity Guidance Residential Treatment Center

Child care center · 8702 ROCKY KNOLL LN, Rosenberg, TX 77469-4896 · License 1760975

0Compliance score
Poor

Capacity 11. 7-17

Violation history (328)

Severity	Date	Standard / narrative	Corrected
3	—	748.363(1) - Personnel records-Include date of employment It was found in two out of two staff records did not have the date of employment.	—
1	—	748.1703(c) - Menus-must date menus and keep copies for 90 days It was found that the operation has not been updating their menu.	—
3	—	745.651(1) - Background Check Validation - You must inactivate a subject who is no longer associated with your operation within 7 days of leaving There are several staff personnel with active background checks that no long work for 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 Child was admitted 08/08/25 and child rights not signed till 01/29/2026.	Yes
4	—	748.1481(a) - Release of Child-Except in emergency, only release child to parent, parent's designee, law enforcement, or person authorized by law to take child It was determined that a child in care was spending the day and night at another placement and was being transferred by placement staff.	—
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. It was determined that the operation failed to report a child arrest. An intake (78855200) was received from law enforcement and not the operation to report a child arrest.	—
4	—	748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders While reviewing records at the facility a serious incident report was received by staff detailing an incident on 3/11/2026 that a child did not receive his AM medication as prescribed by a physician due to the pharmacy not being able to fill the prescription timely.	—
5	—	745.621(a)(1) - Initial background checks submitted - At the time you submit your application It was found at the inspection that there was no background check done for Administrator or owner.	—
4	—	748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication A medication record for a child in care is not accurately updated to advised if a medication was taken, missed or refused, however the remaining amount reflect as if one medication was taken.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records While reviewing serious incidents related to the investigation, it was noted that pertinent information was missing from the report such as time, date, person making the report, and the name of child.	—
5	—	748.2605(a)(5) - Personal Restraints Prohibited-Restraints that twist or place the child's limb(s) behind the child's back Multiple person interviewed advised of children being restrained with their hand behind their backs.	—
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. One of the two child caseworkers interviewed denied being told that the child's hand was fractured.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model During a review of medications, it was observed that two out of five medication logs did not match the corresponding medication counts.	—
4	—	748.685(c)(5) - Caregiver responsibility - ensure continuity of care by sharing information concerning each child with incoming caregivers A staff member reported they were not informed a child in care was not to drink soda after being discharged from the hospital and therefore allowed the child to drink soda. This resulted in the child returning to the hospital.	—
3	—	748.363(6) - Personnel records-Include notarized Licensing Affidavit for Applicants for Employment form as specified in Human Resources Code, 42.059 It was found in two out of two staff records reviewed that the Affidavit was not notarized.	—
4	—	748.981(a)(1) - First-aid-CPR training-Each caregiver must have current certification in first-aid It was found in 1 of the staff files reviewed that a direct care staff did not have a CPR certificate.	—
2	—	748.864(d) - Pre-Service Training-Document the completion of each training requirement in the appropriate personnel record. It was found in one of the two staff records reviewed that there was no documentation of preservice training.	—
4	—	748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed The medication log reviewed and staff interviewed confirmed a medication was not administered to a child as prescribed.	—
3	—	748.2151(c)(6) - Medication record - must include name & signature of person who administered each medication The medication log reviewed did not have a name and signature of the person who administered the medication.	—
3	—	748.311(5) - Serious Incident Documentation-Includes names or other means of identifying witnesses to the incident, if any Two serious incident reports were provided regarding two children being injured while playing basketball, that were missing (1) the telephone number for the operation, One of the two were missing the (2) time the incident occurred and (3) the date of admission. Both documents were missing (5) the other children involved/witnessing the incident and (9) the treating licensed health-care professional's name, findings, and treatment.	—
1	—	748.3701(b) - Recreation responsibility-must have a written plan for ensuring that a range of indoor & outdoor recreational & leisure opportunities are provided It was found that the operation did not have a written plan that included both indoor and outdoor activities per day.	—
5	—	748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation A caregiver failed to adhere to the child's rights to be free of abuse, neglect, and exploitation as defined in Texas Family Code 261.401.A staff member inappropriately supervised a child in care which led them to be able to jump out of a bedroom window.	—
3	—	748.2151(c)(6) - Medication record - must include name & signature of person who administered each medication While reviewing the medication log it was noted the name and signature of the person who administered the medication was not present on the log.	—
5	—	748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety Child was able to just out of window due to lack of supervision.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records It was found that the operations policy included treatment services which was not allowed due to providing only emergency services. The demographic served was inconsistent throughout the operation's policy.	—
5	—	745.621(a)(2) - AP Initial background checks submitted - At the time you hire someone A staff member did not have a completed background check prior to working at the operation.	—
4	—	748.303(a)(2)(A) - AP Serious Incdt-Report to Licensing no later than 24 hours after injury/illness that warrants treatment by a medical professional or hospitalization The operation failed to report an incident involving a child in care who was diagnosed with a concussion and fractured nose on 03/23/26 following an altercation with another resident on 03/22/26.	—
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. Case workers of the victim were not notified in a timely manner of medical treatment received by children.	—
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 It was found in two out of two staff records reviewed there was no documentation of high school diploma or GED.	—
3	—	748.831(a) - Orientation-Each caregiver or employee must have orientation prior to beginning job duties or having contact with children in care It was found that in two out of two staff records did not have documentation of an orientation.	—
4	—	748.3001(a)(2) - Sanitation Inspection-Sanitation official must conduct sanitation inspection at least once every 12 months from date of last inspection It was found that the last health inspection was completed 12/15/2021.	—
3	—	748.3117(a) - Fire Extinguisher-Company licensed by State Fire Marshal must inspect each fire extinguisher at least annually & conduct any service or testing Three fire extinguishers observed at the operations were last serviced in July of 2024.	—
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 diagnosed with a concussion and a fractured nose on 03/23/26; however, this was not reported to the child's caseworker until 03/24/26.	—
3	—	745.651(2)(A) - Background Check Validation ? Every 3 months each operation, other than a licensed, registered, or listed home, must validate current list It was found that the last time the operation validated background checks was in January 2023.	—
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 staff lacked prudent judgement by allowing a child in care to spend the day and nights at a sister RTC, which was not the child's permanent placement and there was no documentation in place allowing this.	—
1	—	748.3701(b) - Recreation responsibility-must have a written plan for ensuring that a range of indoor & outdoor recreational & leisure opportunities are provided It was found at inspection that the operation did not have a recreational calendar for residents.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records It was discovered that the SIR report for one child indicated the child was injured while horse playing at the park on the splash pad, and later states on the same document the child was injured as a result of trying to rebound the basketball. The second incident report indicates another child's hand was injured while playing basketball; however, the child's medical documentation indicated the child's hand was injured due to a physical assault.	—
5	—	748.363(9) - Personnel records-Include proof of request for background checks It was found in two out of two staff files that were reviewed that there was no proof of a request for a background check.	—
3	—	748.63(1) - Types of services-Operation must only provide services listed on permit The operation is not approved to provide treatment services for autism spectrum disorder, however during an investigation it was found that treatment services for autism spectrum disorder are being provided.	—
1	—	748.1703(b) - Menus-must document food substitutions on the menu that are of comparable food value It was found that no food substitutions were found on the menu provided by the operation at inspection.	—
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 review of the intake, serious incident report, and the medical records indicated that Licensing was notified outside the 24-hour time frame.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model During a review of medications, it was observed that two out of five medication logs did not match the corresponding medication counts.	—
5	—	745.621(a)(1) - Initial background checks submitted - At the time you submit your application It was found at the inspection that there was no background check done for Administrator or owner.	—
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 Child was admitted 08/08/25 and child rights not signed till 01/29/2026.	Yes
5	—	748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation A caregiver failed to adhere to the child's rights to be free of abuse, neglect, and exploitation as defined in Texas Family Code 261.401.A staff member inappropriately supervised a child in care which led them to be able to jump out of a bedroom window.	—
1	—	748.3701(b) - Recreation responsibility-must have a written plan for ensuring that a range of indoor & outdoor recreational & leisure opportunities are provided It was found that the operation did not have a written plan that included both indoor and outdoor activities per day.	—
3	—	748.363(6) - Personnel records-Include notarized Licensing Affidavit for Applicants for Employment form as specified in Human Resources Code, 42.059 It was found in two out of two staff records reviewed that the Affidavit was not notarized.	—
4	—	748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication A medication record for a child in care is not accurately updated to advised if a medication was taken, missed or refused, however the remaining amount reflect as if one medication was taken.	—
3	—	745.651(2)(A) - Background Check Validation ? Every 3 months each operation, other than a licensed, registered, or listed home, must validate current list It was found that the last time the operation validated background checks was in January 2023.	—
3	—	748.2151(c)(6) - Medication record - must include name & signature of person who administered each medication While reviewing the medication log it was noted the name and signature of the person who administered the medication was not present on the log.	—
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 diagnosed with a concussion and a fractured nose on 03/23/26; however, this was not reported to the child's caseworker until 03/24/26.	—
5	—	748.2605(a)(5) - Personal Restraints Prohibited-Restraints that twist or place the child's limb(s) behind the child's back Multiple person interviewed advised of children being restrained with their hand behind their backs.	—
5	—	748.363(9) - Personnel records-Include proof of request for background checks It was found in two out of two staff files that were reviewed that there was no proof of a request for a background check.	—
3	—	748.2151(c)(6) - Medication record - must include name & signature of person who administered each medication The medication log reviewed did not have a name and signature of the person who administered the medication.	—
4	—	748.1481(a) - Release of Child-Except in emergency, only release child to parent, parent's designee, law enforcement, or person authorized by law to take child It was determined that a child in care was spending the day and night at another placement and was being transferred by placement staff.	—
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. It was determined that the operation failed to report a child arrest. An intake (78855200) was received from law enforcement and not the operation to report a child arrest.	—
4	—	748.303(a)(2)(A) - AP Serious Incdt-Report to Licensing no later than 24 hours after injury/illness that warrants treatment by a medical professional or hospitalization The operation failed to report an incident involving a child in care who was diagnosed with a concussion and fractured nose on 03/23/26 following an altercation with another resident on 03/22/26.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records It was discovered that the SIR report for one child indicated the child was injured while horse playing at the park on the splash pad, and later states on the same document the child was injured as a result of trying to rebound the basketball. The second incident report indicates another child's hand was injured while playing basketball; however, the child's medical documentation indicated the child's hand was injured due to a physical assault.	—
1	—	748.3701(b) - Recreation responsibility-must have a written plan for ensuring that a range of indoor & outdoor recreational & leisure opportunities are provided It was found at inspection that the operation did not have a recreational calendar for residents.	—
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 It was found in two out of two staff records reviewed there was no documentation of high school diploma or GED.	—
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 review of the intake, serious incident report, and the medical records indicated that Licensing was notified outside the 24-hour time frame.	—
4	—	748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders While reviewing records at the facility a serious incident report was received by staff detailing an incident on 3/11/2026 that a child did not receive his AM medication as prescribed by a physician due to the pharmacy not being able to fill the prescription timely.	—
3	—	748.3117(a) - Fire Extinguisher-Company licensed by State Fire Marshal must inspect each fire extinguisher at least annually & conduct any service or testing Three fire extinguishers observed at the operations were last serviced in July of 2024.	—
4	—	748.3001(a)(2) - Sanitation Inspection-Sanitation official must conduct sanitation inspection at least once every 12 months from date of last inspection It was found that the last health inspection was completed 12/15/2021.	—
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. One of the two child caseworkers interviewed denied being told that the child's hand was fractured.	—
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 staff lacked prudent judgement by allowing a child in care to spend the day and nights at a sister RTC, which was not the child's permanent placement and there was no documentation in place allowing this.	—
4	—	748.981(a)(1) - First-aid-CPR training-Each caregiver must have current certification in first-aid It was found in 1 of the staff files reviewed that a direct care staff did not have a CPR certificate.	—
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. Case workers of the victim were not notified in a timely manner of medical treatment received by children.	—
3	—	748.63(1) - Types of services-Operation must only provide services listed on permit The operation is not approved to provide treatment services for autism spectrum disorder, however during an investigation it was found that treatment services for autism spectrum disorder are being provided.	—
3	—	745.651(1) - Background Check Validation - You must inactivate a subject who is no longer associated with your operation within 7 days of leaving There are several staff personnel with active background checks that no long work for the operation.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records It was found that the operations policy included treatment services which was not allowed due to providing only emergency services. The demographic served was inconsistent throughout the operation's policy.	—
1	—	748.1703(b) - Menus-must document food substitutions on the menu that are of comparable food value It was found that no food substitutions were found on the menu provided by the operation at inspection.	—
3	—	748.311(5) - Serious Incident Documentation-Includes names or other means of identifying witnesses to the incident, if any Two serious incident reports were provided regarding two children being injured while playing basketball, that were missing (1) the telephone number for the operation, One of the two were missing the (2) time the incident occurred and (3) the date of admission. Both documents were missing (5) the other children involved/witnessing the incident and (9) the treating licensed health-care professional's name, findings, and treatment.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records While reviewing serious incidents related to the investigation, it was noted that pertinent information was missing from the report such as time, date, person making the report, and the name of child.	—
4	—	748.685(c)(5) - Caregiver responsibility - ensure continuity of care by sharing information concerning each child with incoming caregivers A staff member reported they were not informed a child in care was not to drink soda after being discharged from the hospital and therefore allowed the child to drink soda. This resulted in the child returning to the hospital.	—
1	—	748.1703(c) - Menus-must date menus and keep copies for 90 days It was found that the operation has not been updating their menu.	—
3	—	748.363(1) - Personnel records-Include date of employment It was found in two out of two staff records did not have the date of employment.	—
5	—	745.621(a)(2) - AP Initial background checks submitted - At the time you hire someone A staff member did not have a completed background check prior to working at the operation.	—
5	—	748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety Child was able to just out of window due to lack of supervision.	—
3	—	748.831(a) - Orientation-Each caregiver or employee must have orientation prior to beginning job duties or having contact with children in care It was found that in two out of two staff records did not have documentation of an orientation.	—
4	—	748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed The medication log reviewed and staff interviewed confirmed a medication was not administered to a child as prescribed.	—
2	—	748.864(d) - Pre-Service Training-Document the completion of each training requirement in the appropriate personnel record. It was found in one of the two staff records reviewed that there was no documentation of preservice training.	—
1	—	748.1703(c) - Menus-must date menus and keep copies for 90 days It was found that the operation has not been updating their menu.	—
4	—	748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed The medication log reviewed and staff interviewed confirmed a medication was not administered to a child as prescribed.	—
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 staff lacked prudent judgement by allowing a child in care to spend the day and nights at a sister RTC, which was not the child's permanent placement and there was no documentation in place allowing this.	—
3	—	748.3117(a) - Fire Extinguisher-Company licensed by State Fire Marshal must inspect each fire extinguisher at least annually & conduct any service or testing Three fire extinguishers observed at the operations were last serviced in July of 2024.	—
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 It was found in two out of two staff records reviewed there was no documentation of high school diploma or GED.	—
4	—	748.685(c)(5) - Caregiver responsibility - ensure continuity of care by sharing information concerning each child with incoming caregivers A staff member reported they were not informed a child in care was not to drink soda after being discharged from the hospital and therefore allowed the child to drink soda. This resulted in the child returning to the hospital.	—
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. Case workers of the victim were not notified in a timely manner of medical treatment received by children.	—
5	—	745.621(a)(1) - Initial background checks submitted - At the time you submit your application It was found at the inspection that there was no background check done for Administrator or owner.	—
3	—	748.831(a) - Orientation-Each caregiver or employee must have orientation prior to beginning job duties or having contact with children in care It was found that in two out of two staff records did not have documentation of an orientation.	—
5	—	748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety Child was able to just out of window due to lack of supervision.	—
3	—	748.2151(c)(6) - Medication record - must include name & signature of person who administered each medication The medication log reviewed did not have a name and signature of the person who administered the medication.	—
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. One of the two child caseworkers interviewed denied being told that the child's hand was fractured.	—
4	—	748.303(a)(2)(A) - AP Serious Incdt-Report to Licensing no later than 24 hours after injury/illness that warrants treatment by a medical professional or hospitalization The operation failed to report an incident involving a child in care who was diagnosed with a concussion and fractured nose on 03/23/26 following an altercation with another resident on 03/22/26.	—
4	—	748.3001(a)(2) - Sanitation Inspection-Sanitation official must conduct sanitation inspection at least once every 12 months from date of last inspection It was found that the last health inspection was completed 12/15/2021.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records While reviewing serious incidents related to the investigation, it was noted that pertinent information was missing from the report such as time, date, person making the report, and the name of child.	—
1	—	748.3701(b) - Recreation responsibility-must have a written plan for ensuring that a range of indoor & outdoor recreational & leisure opportunities are provided It was found at inspection that the operation did not have a recreational calendar for residents.	—
3	—	745.651(1) - Background Check Validation - You must inactivate a subject who is no longer associated with your operation within 7 days of leaving There are several staff personnel with active background checks that no long work for the operation.	—
5	—	745.621(a)(2) - AP Initial background checks submitted - At the time you hire someone A staff member did not have a completed background check prior to working at the operation.	—

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

Inspections (152)

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

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