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Angelic House of Hope

Name: Angelic House of Hope
Address: TX, US

Child care center · , TX · License 1763000

0Compliance score
Poor

Capacity 9. 5-17

Violation history (500)

Severity	Date	Standard / narrative	Corrected
5	—	748.125(g)(2)(B) - You must not leave the child alone until a mental health professional assesses the child, in the event of a suicide attempt. The operation allowed a child to lock herself in the bathroom after having a suicide attempt.	—
4	—	748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks Staff did not respond timely to a child verbally expressing suicide ideation.	—
3	—	748.363(6) - Personnel records-Include notarized Licensing Affidavit for Applicants for Employment form as specified in Human Resources Code, 42.059 The 2 staff records did not contain the notarized Licensing Affidavit for Applicants for Employment.	—
4	—	748.3421(3) - Poisons-Ensure poisonous/flammable material isstored in an area that is inaccessible to children unless child is capable to use responsibly. During the walkthrough it was discovered that poisonous/flammable material are stored under the cabinet sink unlocked and accessible to children.	Yes
3	—	748.311(6) - Serious Incident Documentation-Includes nature of the incident Serious incident report does not reflect the correct information/incident that took place.	—
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 Fire drill log was missing length of time for the evacuation or relocation to take place.	Yes
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 people with active backgrounds checks for the operation who no longer work for the operation.	—
3	—	748.3395(b)(4) - Hand-washing-Provide hand-washing sinks equipped with soap & a personal towel, single-use disposable towels, or hot air hand dryers During the walkthrough two bathrooms were observed to be without disposable towels, or any device to dry hands after use.	Yes
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 serious incident requiring treatment by a medical professional or hospitalization was not reported to licensing.	—
3	—	748.311 - Serious Incident Documentation-Documented in written report In the reviewing of the serious incident reports regarding an unauthorized absence from the facility, one serious incident report did not have the amount of time the child was away from the facility in the section labeled "How Long?"	—
3	—	748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction Upon request of staff records, they were unavailable.	—
4	—	748.125(f)(2)(A) - Protocols must include weekly screenings for the first 30 days or until the child is no longer reporting suicidal thoughts, whichever is longer. The operation did not conduct weekly screening post hospitalization.	—
3	—	748.363(7) - Personnel records- Include notarized Licensing Affidavit for Applicants for Employment form as specified in Human Resources Code, 42.059 During the review of employee files, it was noted that the required notarized employment affidavits were missing from one employee file at the time of the inspection.	—
3	—	748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair. During the walkthrough at the operation, there were observed decomposing pests caught in a trap in one of the bedrooms. There was also observed a hole in the wall in one of the comon areas utilized by youth and staff.	—
5	—	748.363(9) - Personnel records-Include proof of request for background checks A scrutiny of the files on 2 staff reveal that there was no request for the conduct of a background check prior to employment.	—
5	—	748.125(c)(1) - Suicide Training-All caregivers and employees must complete at least one hour of annual suicide prevention training. Four of four caregivers did not have suicide risk training.	—
4	—	748.4003(1)(C) - General requirements-When transporting a child the operation must ensure each driver has a current driver's license for the type of vehicle used A staff member transporting children does not have a valid Texas driver's license.	—
5	—	745.4151(c)(5)(B) - Drug testing procedures-Drug testing will use one of these drug-testing methods: certified lab, appropriate testing kit or other comparable method The staff records reviewed showed did not show the method used for the drug screening with the results	—
4	—	748.869(c) - Training on administering psych. medication must be instructor-led. The instructor must be a health-care professional or pharmacist. All staff records reviewed did not have the instructor led portion of the psych. medication training in their record.	—
5	—	748.125(g)(2)(A) - You must immediately call emergency services and render first aid until professional medical treatment can be given. Based on the review of the investigation, it was determined that the operation did not provide first aid to a child in care after contacting EMS.	—
1	—	748.1349(b)(2) - Initial Service Plan- When given to child then child must sign or operation document child's refusal to sign During the review of 3 service plans, all 3 of the child's service plans were not signed by the respected children, and there was also no justification on why the child was not able to sign their service plans.	—
4	—	748.2203(c) - Medication Error-Operation must meet documentation requirements within 24 hrs There is no documentation regarding missed doses of medication.	—
3	—	748.705(b)(10) - Reasonable & prudent parent standard-must consider the importance of providing the child with the most normal family-like living experience possible Childrens belongings were packed in trash bags when they moved from the operation.	—
1	—	748.1337(b)(1)(N) - Initial Service Plan-Include signatures of service planning team members that were involved in development of service plan Children's records reviewed did not have the signature page for their service plans.	—
3	—	748.363(8) - Personnel records - Include signed dated statement by the employee that he must immediately report suspected child abuse, neglect, or exploitation. The 2 staff records reviewed revealed that there was no signed and dated document pertaining to reporting suspected child abuse, neglect, and exploitation.	—
4	—	748.1545(a) - Vision and hearing screening-must ensure that each child is screened; must have professional exam if problems are detected There is no documentation in the children's files, that a vision or hearing exam has been completed.	—
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 was hospitalized and it was not reported as required.	—
4	—	748.3301(h) - Physical Site-The building must be free of rodents and insects There are multiple individuals who have stated seeing rodents in the building.	—
3	—	748.311 - Serious Incident Documentation-Documented in written report The Serious Incident Form did not include required information such as the operation's address, phone number and the treating licensed health-care professional?s name, findings, and treatment.	—
1	—	748.1703(b) - Menus-must document food substitutions on the menu that are of comparable food value During the follow-up inspection, it was noticed that substitutions were still missing from the menu.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records In the review of documents, one of the child's service plans has 3 medications listed in the health section, and there are 3 different medications added on the Transitional to Adulthood portion. No medication error reports were provided for the following days: 10/8, 10/22, 10/23, 10/24, 10/29, 10/30, 10/31, 11/5, 11/7, 11/8, 11/11 indicating that the errors were most likely not documented. A second child service plan had conflicted information regarding their last annual medical with the first service plan stating that the medical was completed on 12/19/24 while the updated one says 12/5/24, this child also did not have the high-risk section checked for running away on the updated service plan. Lastly, a fourth child's service plan was completed and the service plan stated that the child receives Special Education, but there is no documentation of the child's 504 plan.	—
3	—	748.863(a)(1) - Pre-Service Training-All caregivers must receive 8 hrs of general pre-service training & 4hrs before being counted in child/caregiver ratio. All three staff records reviewed were missing some components for the general preservice training such as - normalcy, trauma informed care, and spread of communicable diseases.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model It was observed that the medication count documented on the medication log was not accurate.	—
2	—	748.1331(a) - Preliminary Service Plan-Complete plan that addresses child's immediate needs within 72 hours of admission A 72-hour Service plan was not completed for a child in care.	—
3	—	748.311(5) - Serious Incident Documentation-Includes names or other means of identifying witnesses to the incident, if any Incident report did not document all staff involved or children.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records Medication logs were observed with inaccurate information such as the directions.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records The Physician named on children pill packs are different than the Physicians listed on the medication record. On another medication, the pill pack advises that the quantity is 30, however the medication record advises starting with 28.	Yes
4	—	748.2151(a) - Medication Record-Maintain cumulative record of prescription medications dispensed to child, include nonprescription meds for child under five yrs old One out of the three children's records observed was missing a medication log for a psychotropic medication. The operation created the medication log for this medication during the inspection.	Yes
4	—	748.930(b)(1)(A) - Annual Training-Caregivers in operations other than cottage homes must have 4 hrs of EBI every 6 months. A staffs file shows that the staff member has not completed four hours of EBI every 6 months.	—
1	—	748.1341(a) - Initial Service Plan-Must give the child's parent(s) at least two weeks advance notice of the meeting There was no documentation provided by the facility on sending the notification of the service plan meetings to the children's caseworkers. Furthermore, 2 caseworkers interviewed stated that they have not sat in on any of the service plan meetings.	—
4	—	748.457(a) - Unauthorized Absence?Triggered Review of child?s unauth absences must occur ASAP, but no later than 30 days after third absence within 60-days During the investigation it was found that the operation did not conduct a triggered review for a child in care.	—
4	—	748.1531(d) - Medical care-Obtain follow-up medical treatment as recommended by the health-care professional There is no documentation to show that a child attended the recommended follow appointment after the child's 7/1/24 medical appointment.	—
1	—	748.1703(b) - Menus-must document food substitutions on the menu that are of comparable food value During the ANE investigation, menus were provided and noted to be missing documented food substitutions for the children.	—
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 A child resided at the operation for 3 months prior to child rights being reviewed with the child.	—
5	—	748.125(e)(1)(A) - You must immediately refer a child to a MH professional for a suicide risk assessment if screening finds child to be at a high risk for suicide. A child in care was not referred to a mental health professional after scoring high on the suicide risk assessment completed at admission.	—
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 One of the child's records reviewed did not address their high risk behaviors.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records It was observed that a child's file is not current due to the initial service plan not being in the file as well as the reviews thereafter.	—
2	—	748.1225(b) - Admission-Dental exam for child 3 years old or older scheduled in 30 days and done in 90 days unless documentation of one within past year on file There is no documentation in the child's file reflecting that the child has had a Dental Exam completed.	—
3	—	748.363(7) - Personnel records - Include statement signed and dated by the employee that he has read a copy of the operational policies The 2 staff records reviewed did not include the date and signature of the employees evidencing that they have read the facility's operational policies.	—
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 The 2 files reviewed did not contain the requisite drug test results prior to child access.	—
4	—	748.1205(a)(10) - Admission Documentation-Includes known contraindications to the use of restraint The children records reviewed did not address known contraindications of restraints.	—
3	—	748.1531(b)(4) - Medical Care-If exam is due to injury or illness, record of medical exam documents date/time & circumstances of injury/illness There are a number of medical appointment reports that are missing multiple pages of information relating the reason for the medical visit.	—
2	—	748.533(a)(5) - Child-care administrator-Can be administrator for two operations if the Operations are contiguous Records reveal that the present Administrator is currently an Administrator for another operation. Both operations are not contiguous.	—
3	—	748.505(b)(4) - Minimum qualifications for employees-Complete notarized Licensing Affidavit for Applicants for Employment form Staff files were observed to not have the required affidavits required by the minimum standards (Form 2912 & Form 2985)	—
4	—	748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child It was reported by an employee and children that an employee had a history of cursing and yelling at and around the children.	—
3	—	748.1583(a) - TB exam-Persons over 1 yr old who live, work, volunteer at facility have exam w/in 30 days, unless person had previous exam that meets requirements Records reveal that the TB test result for the Treatment Director is not on file.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records The remaining amount section of the medication log reflects and inaccurate count of remaining pills in the pill back.	—
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 was hospitalized and it was not reported as required.	—
2	—	748.1387 - Service Plan Review-Must comply with notification, participation, implementation, and documentation requirements for an initial service plan The service plan review requirements such as notification was not observed. In addition, the service plan review was not signed by any of the parties who were supposed to participate. There was no signature or date to indicate that participation took place or that a copy was provided.	—
3	—	748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction Hospital records were not available for review when requested.	—
3	—	748.363(6) - Personnel records-Include notarized Licensing Affidavit for Applicants for Employment form as specified in Human Resources Code, 42.059 The staff record did not contain the required affidavit for employment.	Yes
4	—	748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed A child did not take their medication as indicated in the directions.	—
4	—	748.981(a)(1) - First-aid-CPR training-Each caregiver must have current certification in first-aid A caregiver who has been employed since May of 2024 did not have a valid First Aid/ CPR certification until September 2024, as the caregivers last certification expired in November of 2023.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records It was observed that a child's file is not current due to the initial service plan not being in the file as well as the reviews thereafter.	—
5	—	748.1531(a)(2) - Medical care-A child in care must receive medical care as needed for injury, illness, and pain An incident report advises that a doctors appointment was made for a child who required medical attention, however there is no documentation of a medical appointment being completed.	—
3	—	748.751(a)(1) - Pre-Employment Screening- You must obtain in writing an applicant's employment history for the last five years before hiring. Staff file was observed not to have documentation of the employees last 5 years of employment.	—
4	—	748.303(a)(2)(A) - AP Serious Incdt-Report to Licensing no later than 24 hours after injury/illness that warrants treatment by a medical professional or hospitalization The operation failed to report a child being hospitalized after self-harming.	—
2	—	748.1335 - Initial Service Plan-Complete the initial service plan within 45 days after admission 4 of the service plans was not competed within the required timeframe. The child was placed at the facility on 6/18/24 and the 45 day was on 8/2/24, however the service plan was completed late on 10/23/24. A second child's first service plan was completed on 1/23/25 and the child was placed at the facility on 4/23/24, and there is no documentation of a previous service plan being completed. The third child's service plan was completed on 10/29/24 and the child was placed at the operation on 12/23/23, in which the 45-day completion should have been on 2/6/24. The fourth child's service plan reviewed showed that the child was placed on 10/25/23 and the initial service plan was completed on 1/24/25, in which the 45-day completion should have been on 12/9/2023.	—
3	—	748.2953(b) - Evaluation-Operation's quarterly data on EBI's must be reported to Licensing no later than 15 days after the end of each quarter. The operation has not submitted the quarterly EBI report to Licensing after quarter one concluded.	—
2	—	748.753(d)(1) - Pre-Employment-You must document in the employee record each references name, relation, date completed, info obtained and name of interviewer. Staff record is missing pre employment reference check documentation.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Medication records reviewed did not have a written area for the number of meds left after administration.	—
3	—	748.453(a)(1) - Unauthorized Absence ? Annual summary log must include name, age, gender, date of admission During the investigation it was found that the operation does not have an unauthorized absence log.	—
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 observed that the health-care professional's orders were to administer a cream to the affected area 2 times per day however the child has not been taking it daily and the times the child did apply the cream it was done once a day. In addition, the same child is not receiving one of their medications.	—
4	—	748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed The medication records remaining amount does not match the amount of pills left in the pill packs.	—
3	—	748.1205(a)(12) - Admission Documentation-Identification of child's high risk behaviors and related safety plan staff and caregivers will implement During the course of the observation, it was found that a safety plan was not implemented to address the child's high-risk behavior at the time of admission.	—
3	—	748.363(3) - Personnel records-Include current job description One staff record on file did not include the current job description for each.	—
1	—	748.1205(a)(4) - Admission Documentation-Includes names, addresses, telephone numbers of siblings The admission assessment was missing a space for sibling contact information and suicide screenings.	Yes
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model The medication record for a bedtime medication reflects that there are 24 remaining pills, however the pill pack only has 23 pills.	—
5	—	748.125(e)(1)(A) - You must immediately refer a child to a MH professional for a suicide risk assessment if screening finds child to be at a high risk for suicide. A child in care was not referred to a mental health professional after scoring high on the suicide risk assessment completed at admission.	—
4	—	748.1545(a) - Vision and hearing screening-must ensure that each child is screened; must have professional exam if problems are detected There is no documentation in the children's files, that a vision or hearing exam has been completed.	—
3	—	748.2953(b) - Evaluation-Operation's quarterly data on EBI's must be reported to Licensing no later than 15 days after the end of each quarter. The operation has not submitted the quarterly EBI report to Licensing after quarter one concluded.	—
3	—	748.1583(a) - TB exam-Persons over 1 yr old who live, work, volunteer at facility have exam w/in 30 days, unless person had previous exam that meets requirements Records reveal that the TB test result for the Treatment Director is not on file.	—
4	—	748.869(c) - Training on administering psych. medication must be instructor-led. The instructor must be a health-care professional or pharmacist. All staff records reviewed did not have the instructor led portion of the psych. medication training in their record.	—
3	—	748.751(a)(1) - Pre-Employment Screening- You must obtain in writing an applicant's employment history for the last five years before hiring. Staff file was observed not to have documentation of the employees last 5 years of employment.	—
3	—	748.363(7) - Personnel records - Include statement signed and dated by the employee that he has read a copy of the operational policies The 2 staff records reviewed did not include the date and signature of the employees evidencing that they have read the facility's operational policies.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model The medication record for a bedtime medication reflects that there are 24 remaining pills, however the pill pack only has 23 pills.	—
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 The 2 files reviewed did not contain the requisite drug test results prior to child access.	—
2	—	748.1331(a) - Preliminary Service Plan-Complete plan that addresses child's immediate needs within 72 hours of admission A 72-hour Service plan was not completed for a child in care.	—
4	—	748.2151(a) - Medication Record-Maintain cumulative record of prescription medications dispensed to child, include nonprescription meds for child under five yrs old One out of the three children's records observed was missing a medication log for a psychotropic medication. The operation created the medication log for this medication during the inspection.	Yes
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 was hospitalized and it was not reported as required.	—
5	—	748.1531(a)(2) - Medical care-A child in care must receive medical care as needed for injury, illness, and pain An incident report advises that a doctors appointment was made for a child who required medical attention, however there is no documentation of a medical appointment being completed.	—
5	—	748.125(c)(1) - Suicide Training-All caregivers and employees must complete at least one hour of annual suicide prevention training. Four of four caregivers did not have suicide risk training.	—
2	—	748.753(d)(1) - Pre-Employment-You must document in the employee record each references name, relation, date completed, info obtained and name of interviewer. Staff record is missing pre employment reference check documentation.	—
4	—	748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child It was reported by an employee and children that an employee had a history of cursing and yelling at and around the children.	—
3	—	748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction Upon request of staff records, they were unavailable.	—
2	—	748.1335 - Initial Service Plan-Complete the initial service plan within 45 days after admission 4 of the service plans was not competed within the required timeframe. The child was placed at the facility on 6/18/24 and the 45 day was on 8/2/24, however the service plan was completed late on 10/23/24. A second child's first service plan was completed on 1/23/25 and the child was placed at the facility on 4/23/24, and there is no documentation of a previous service plan being completed. The third child's service plan was completed on 10/29/24 and the child was placed at the operation on 12/23/23, in which the 45-day completion should have been on 2/6/24. The fourth child's service plan reviewed showed that the child was placed on 10/25/23 and the initial service plan was completed on 1/24/25, in which the 45-day completion should have been on 12/9/2023.	—
4	—	748.3301(h) - Physical Site-The building must be free of rodents and insects There are multiple individuals who have stated seeing rodents in the building.	—
3	—	748.505(b)(4) - Minimum qualifications for employees-Complete notarized Licensing Affidavit for Applicants for Employment form Staff files were observed to not have the required affidavits required by the minimum standards (Form 2912 & Form 2985)	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Medication records reviewed did not have a written area for the number of meds left after administration.	—
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 One of the child's records reviewed did not address their high risk behaviors.	—

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

Inspections (224)

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

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