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Perfect Start Homes INC

Child care center · 16823 QUAIL CREST CT, Missouri City, TX 77489-5383 · License 1814618

0Compliance score
Poor

Capacity 7. 7-17

Violation history (312)

Severity	Date	Standard / narrative	Corrected
3	—	748.3115 - Fire Extinguisher-Must inspect fire extinguisher(s) monthly The fire extinguishers inspection is expired.	—
4	—	748.2151(c)(4) - Medication record - must include medication name, strength and dosage One child's medication log was missing the name of the medication.	—
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 During a review of records, it was found that one of the two children currently placed at the operation meets ED treatment services. The operation does not have a hired treatment director.	—
3	—	748.563(c) - Professional level service provider-must meet specific educational and professional qualifications It was found that one staff member does not meet the qualifications of a PLSP with the professional or educational qualifications. This staff member was completing the assessments and the plans for the children.	—
3	—	748.605(a) - Treatment director-must meet specific professional qualifications if prevalent population has intellectual disabilities or autism spectrum disorder The Case Manager was signing off as the treatment director. They do not possess the qualifications of a treatment director for children with ID, ASD, or ED.	—
2	—	748.119(2) - Volunteer policy - Address qualifications, screening, and selection procedures for the volunteers The operation's policy does not address screening and selection procedures.	—
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 Two employees were listed on the people list as active that are not employed at the operation.	Yes
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 the medication review, one OTC medciation was found to be expired in 8/2024. One prescription medication was also found to be expired in 4/2026.	—
4	—	748.3301(i) - Physical Site-Equipment and furniture must be safe for children and must be kept clean and in good repair The outside fence is in need of repair with protruding nails.	—
2	—	748.1337(a) - Initial Service Plan-Base on needs identified in admission assessment; justify delay in addressing needs if service planning team prioritizes goals Two child records reviewed were missing required information on both initial service plans.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Two child records reviewed didn't have the daily count listed on the medication log.	—
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 prescribed medication did not have any medicaiton log to note when the child was given the medicaiton.	—
3	—	748.111(11) - Child-care policy - Program expectations and rules that apply to all children, including discipline The policy does not state the program rules and expectations that apply to the children.	Yes
4	—	748.121 - Abuse and neglect policy - You must develop policies on preventing, recognizing, and responding to abuse and neglect of children The operation's policies are missing the required components of standards 2-5.	—
3	—	748.539 - Child-care administrator must designate a licensed child-care administrator responsible for the operation while the administrator is absent In a review of the provided operation schedule, it was found that the Administrator was out on leave for an extended period of time. There was no designated back up provider.	—
4	—	748.3107(c)(1) - Smoke Detector-Must be equipped with battery back-up The battery in the smoke detector in one of the victims room does not work.	—
4	—	748.2103(a) - Medication Storage & Destruction-Discontinued or expired meds & meds left at the operation must be inventoried & stored separately from current meds During the medication review, it was found that two medications that were no longer being provided to the child were still kept with the child's routine medication.	—
3	—	748.105(5) - Personnel Policies - Personnel Policies - Develop written policies on the training requirements for employees. The policy is missing the preservice training requirements for caregivers as well as EBI components	—
4	—	748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders In a review of children's medication logs, the following issues were noted: - Two children are noted to have missed the AM dose on 12/7 for multiple medications. - One child received a half dose on 11/28 - One child received a double dose in the AM on 11/22 - One child missed a dose on 11/29 - One child received a double dose on 11/28 and missed a dose on 11/29.	—
4	—	748.125(d)(2) - Suicide Screening- Suicide risk screening tools must be supported by evidence-based research. The operation's suicide screening tool was created by the operation and cannot be verified to be an approved tool that is supported by evidence-based research.	—
1	—	748.1349(a)(1) - Initial Service Plan-Give copy or summary of plan to child, when appropriate. At minimum must give copy to child 14 years and older In a review of the two service plans, neither child was provided a copy, nor was the plan signed by the children. There was also no justification documented for not sharing the plan with the child.	—
4	—	748.113(5)(A) - EBI policy - For orientation, explain and document to a child in a manner that the child can understand The required components were missing regarding orientation with a child in regards to EBI requirements. Missing (A)(i)-(ix)	—
4	—	748.3115(3) - Fire Extinguisher-Must ensure fire extinguishers are serviced as required by manufacturer's instructions, or as required by fire inspector The fire extinguisher in the in the front area of the house was observed to be expired.	—
4	—	748.3107(c)(1) - Smoke Detector-Must be equipped with battery back-up The battery in the smoke detector is expired in one of the residents' bedrooms.	—
3	—	748.3443(b)(2) - Food Preparation-Must have a thermometer in freezers & store frozen food at 0 degrees Fahrenheit or below During the inspection, the thermometer in the freezer was observed to be missing.	—
4	—	748.1661(b) - Tobacco Products-Adult may not smoke tobacco products, e-cigarettes, or vaporizers in children's living areas/inside any building on premises w/ kids A staff member was observed with a vape at the dining table upon arrival for the inspection.	—
3	—	748.115 - Discipline policy - The discipline policies you develop for children in care must be consistent with Subchapter M of this chapter The operation was missing the components in the policy--(2)-(5).	—
3	—	748.109(2) - Admission Policies - include characteristics of the population the program serves The operation's policy reflected they will be accepting girls, however the operation will be licensed to care for boys only, which wasn't correct on the operation's policies.	—
4	—	748.113(9)(A) - A person for filing a complaint, presenting grievance, or providing information relating to the misuse of EBI at the operation The required information wasn't included in the operation's policies.	—
3	—	748.107(2) - Conflict of interest policies-statement that majority of members of the governing body must consist of persons who do not have a conflict of interest The requqired statement that the majority of the voting members of the governing body must consist of persons who do not have a conflict of interest that would potentially interfere with objective decision making was missing in the policies.	—
3	—	748.2151(c)(3) - Medication record - must include reason medication was prescribed, for prescription medication Two child records reviewed didn't have the reason the child was taken the medication listed on the medication log.	—
4	—	748.303(a)(5)(A) - Serious Incident-Report to Licensing soon as aware of an incident of sexual abuse of a child against another child In a review of Serious Incident Reports, it was found that one child witnessed a sexual act conducted by a child of an opposite gender.	—
3	—	748.311 - Serious Incident Documentation-Documented in written report In a review of the serious incident report, it was missing the following components: 3: The name, age, gender, and date of admission of the child or children involved. 4: The name of all adults involved and their role in relation to the child(ren) 7: The circumstances surrounding the incident. 10: The resolution of the incident	—
3	—	748.109(1) - Admission Policies - Include program's goals and services provided, including whether emergency admissions accepted The policies reflected that the operation will not accept emergency placements which needs to be corrected, the operation will be accepting emergency placements, but the operation isn't an emergency shelter.	—
3	—	748.105(8) - Personnel Policies - Ensure employees report serious incidents and suspected abuse/neglect and exploitation directly to DFPS The required statement of employee may not delegate the responsibility to make a report wasn't included in the policies.	Yes
4	—	748.113(1) - EBI policy - a complete description of EBIs that you permit caregivers to use The operation's policies has conflicting information regarding the use of restraints as well as missing information on the specific description of the interventions that are permitted.	—
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 A 19-year-old caregiver was working with children over the age of 13 years old.	—
1	—	748.1215(b) - Admission Assessment-Professional level service provider must sign & date assessment, which must be in child's record In two child records, the PLSP did not sign and date the assessments.	—
3	—	748.123(4) - Vaccine preventable policy - include employee procedures for exemption based on medical conditions or CDC precautions The operation policies is missing Medical contraindications and religious beliefs.	—
4	—	748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders In a review of children's medication logs, the following issues were noted: - Two children are noted to have missed the AM dose on 12/7 for multiple medications. - One child received a half dose on 11/28 - One child received a double dose in the AM on 11/22 - One child missed a dose on 11/29 - One child received a double dose on 11/28 and missed a dose on 11/29.	—
3	—	748.123(4) - Vaccine preventable policy - include employee procedures for exemption based on medical conditions or CDC precautions The operation policies is missing Medical contraindications and religious beliefs.	—
4	—	748.3301(i) - Physical Site-Equipment and furniture must be safe for children and must be kept clean and in good repair The outside fence is in need of repair with protruding nails.	—
3	—	748.111(11) - Child-care policy - Program expectations and rules that apply to all children, including discipline The policy does not state the program rules and expectations that apply to the children.	Yes
3	—	748.3115 - Fire Extinguisher-Must inspect fire extinguisher(s) monthly The fire extinguishers inspection is expired.	—
4	—	748.3107(c)(1) - Smoke Detector-Must be equipped with battery back-up The battery in the smoke detector in one of the victims room does not work.	—
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 Two employees were listed on the people list as active that are not employed at the operation.	Yes
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 A 19-year-old caregiver was working with children over the age of 13 years old.	—
4	—	748.121 - Abuse and neglect policy - You must develop policies on preventing, recognizing, and responding to abuse and neglect of children The operation's policies are missing the required components of standards 2-5.	—
3	—	748.109(1) - Admission Policies - Include program's goals and services provided, including whether emergency admissions accepted The policies reflected that the operation will not accept emergency placements which needs to be corrected, the operation will be accepting emergency placements, but the operation isn't an emergency shelter.	—
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 During a review of records, it was found that one of the two children currently placed at the operation meets ED treatment services. The operation does not have a hired treatment director.	—
3	—	748.107(2) - Conflict of interest policies-statement that majority of members of the governing body must consist of persons who do not have a conflict of interest The requqired statement that the majority of the voting members of the governing body must consist of persons who do not have a conflict of interest that would potentially interfere with objective decision making was missing in the policies.	—
3	—	748.605(a) - Treatment director-must meet specific professional qualifications if prevalent population has intellectual disabilities or autism spectrum disorder The Case Manager was signing off as the treatment director. They do not possess the qualifications of a treatment director for children with ID, ASD, or ED.	—
4	—	748.113(9)(A) - A person for filing a complaint, presenting grievance, or providing information relating to the misuse of EBI at the operation The required information wasn't included in the operation's policies.	—
2	—	748.1337(a) - Initial Service Plan-Base on needs identified in admission assessment; justify delay in addressing needs if service planning team prioritizes goals Two child records reviewed were missing required information on both initial service plans.	—
4	—	748.2151(c)(4) - Medication record - must include medication name, strength and dosage One child's medication log was missing the name of the medication.	—
4	—	748.1661(b) - Tobacco Products-Adult may not smoke tobacco products, e-cigarettes, or vaporizers in children's living areas/inside any building on premises w/ kids A staff member was observed with a vape at the dining table upon arrival for the inspection.	—
3	—	748.539 - Child-care administrator must designate a licensed child-care administrator responsible for the operation while the administrator is absent In a review of the provided operation schedule, it was found that the Administrator was out on leave for an extended period of time. There was no designated back up provider.	—
1	—	748.1215(b) - Admission Assessment-Professional level service provider must sign & date assessment, which must be in child's record In two child records, the PLSP did not sign and date the assessments.	—
3	—	748.105(8) - Personnel Policies - Ensure employees report serious incidents and suspected abuse/neglect and exploitation directly to DFPS The required statement of employee may not delegate the responsibility to make a report wasn't included in the policies.	Yes
4	—	748.113(1) - EBI policy - a complete description of EBIs that you permit caregivers to use The operation's policies has conflicting information regarding the use of restraints as well as missing information on the specific description of the interventions that are permitted.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Two child records reviewed didn't have the daily count listed on the medication log.	—
4	—	748.3107(c)(1) - Smoke Detector-Must be equipped with battery back-up The battery in the smoke detector is expired in one of the residents' bedrooms.	—
3	—	748.115 - Discipline policy - The discipline policies you develop for children in care must be consistent with Subchapter M of this chapter The operation was missing the components in the policy--(2)-(5).	—
4	—	748.303(a)(5)(A) - Serious Incident-Report to Licensing soon as aware of an incident of sexual abuse of a child against another child In a review of Serious Incident Reports, it was found that one child witnessed a sexual act conducted by a child of an opposite gender.	—
4	—	748.125(d)(2) - Suicide Screening- Suicide risk screening tools must be supported by evidence-based research. The operation's suicide screening tool was created by the operation and cannot be verified to be an approved tool that is supported by evidence-based research.	—
3	—	748.3443(b)(2) - Food Preparation-Must have a thermometer in freezers & store frozen food at 0 degrees Fahrenheit or below During the inspection, the thermometer in the freezer was observed to be missing.	—
3	—	748.2151(c)(3) - Medication record - must include reason medication was prescribed, for prescription medication Two child records reviewed didn't have the reason the child was taken the medication listed on the medication log.	—
4	—	748.3115(3) - Fire Extinguisher-Must ensure fire extinguishers are serviced as required by manufacturer's instructions, or as required by fire inspector The fire extinguisher in the in the front area of the house was observed to be expired.	—
3	—	748.105(5) - Personnel Policies - Personnel Policies - Develop written policies on the training requirements for employees. The policy is missing the preservice training requirements for caregivers as well as EBI components	—
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 prescribed medication did not have any medicaiton log to note when the child was given the medicaiton.	—
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 the medication review, one OTC medciation was found to be expired in 8/2024. One prescription medication was also found to be expired in 4/2026.	—
2	—	748.119(2) - Volunteer policy - Address qualifications, screening, and selection procedures for the volunteers The operation's policy does not address screening and selection procedures.	—
4	—	748.2103(a) - Medication Storage & Destruction-Discontinued or expired meds & meds left at the operation must be inventoried & stored separately from current meds During the medication review, it was found that two medications that were no longer being provided to the child were still kept with the child's routine medication.	—
3	—	748.563(c) - Professional level service provider-must meet specific educational and professional qualifications It was found that one staff member does not meet the qualifications of a PLSP with the professional or educational qualifications. This staff member was completing the assessments and the plans for the children.	—
1	—	748.1349(a)(1) - Initial Service Plan-Give copy or summary of plan to child, when appropriate. At minimum must give copy to child 14 years and older In a review of the two service plans, neither child was provided a copy, nor was the plan signed by the children. There was also no justification documented for not sharing the plan with the child.	—
4	—	748.113(5)(A) - EBI policy - For orientation, explain and document to a child in a manner that the child can understand The required components were missing regarding orientation with a child in regards to EBI requirements. Missing (A)(i)-(ix)	—
3	—	748.109(2) - Admission Policies - include characteristics of the population the program serves The operation's policy reflected they will be accepting girls, however the operation will be licensed to care for boys only, which wasn't correct on the operation's policies.	—
3	—	748.311 - Serious Incident Documentation-Documented in written report In a review of the serious incident report, it was missing the following components: 3: The name, age, gender, and date of admission of the child or children involved. 4: The name of all adults involved and their role in relation to the child(ren) 7: The circumstances surrounding the incident. 10: The resolution of the incident	—
4	—	748.1661(b) - Tobacco Products-Adult may not smoke tobacco products, e-cigarettes, or vaporizers in children's living areas/inside any building on premises w/ kids A staff member was observed with a vape at the dining table upon arrival for the inspection.	—
4	—	748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders In a review of children's medication logs, the following issues were noted: - Two children are noted to have missed the AM dose on 12/7 for multiple medications. - One child received a half dose on 11/28 - One child received a double dose in the AM on 11/22 - One child missed a dose on 11/29 - One child received a double dose on 11/28 and missed a dose on 11/29.	—
4	—	748.3107(c)(1) - Smoke Detector-Must be equipped with battery back-up The battery in the smoke detector is expired in one of the residents' bedrooms.	—
3	—	748.109(1) - Admission Policies - Include program's goals and services provided, including whether emergency admissions accepted The policies reflected that the operation will not accept emergency placements which needs to be corrected, the operation will be accepting emergency placements, but the operation isn't an emergency shelter.	—
2	—	748.119(2) - Volunteer policy - Address qualifications, screening, and selection procedures for the volunteers The operation's policy does not address screening and selection procedures.	—
3	—	748.563(c) - Professional level service provider-must meet specific educational and professional qualifications It was found that one staff member does not meet the qualifications of a PLSP with the professional or educational qualifications. This staff member was completing the assessments and the plans for the children.	—
4	—	748.113(5)(A) - EBI policy - For orientation, explain and document to a child in a manner that the child can understand The required components were missing regarding orientation with a child in regards to EBI requirements. Missing (A)(i)-(ix)	—
3	—	748.2151(c)(3) - Medication record - must include reason medication was prescribed, for prescription medication Two child records reviewed didn't have the reason the child was taken the medication listed on the medication log.	—
3	—	748.111(11) - Child-care policy - Program expectations and rules that apply to all children, including discipline The policy does not state the program rules and expectations that apply to the children.	Yes
4	—	748.3301(i) - Physical Site-Equipment and furniture must be safe for children and must be kept clean and in good repair The outside fence is in need of repair with protruding nails.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Two child records reviewed didn't have the daily count listed on the medication log.	—
4	—	748.113(1) - EBI policy - a complete description of EBIs that you permit caregivers to use The operation's policies has conflicting information regarding the use of restraints as well as missing information on the specific description of the interventions that are permitted.	—
3	—	748.123(4) - Vaccine preventable policy - include employee procedures for exemption based on medical conditions or CDC precautions The operation policies is missing Medical contraindications and religious beliefs.	—
3	—	748.3443(b)(2) - Food Preparation-Must have a thermometer in freezers & store frozen food at 0 degrees Fahrenheit or below During the inspection, the thermometer in the freezer was observed to be missing.	—
2	—	748.1337(a) - Initial Service Plan-Base on needs identified in admission assessment; justify delay in addressing needs if service planning team prioritizes goals Two child records reviewed were missing required information on both initial service plans.	—
4	—	748.121 - Abuse and neglect policy - You must develop policies on preventing, recognizing, and responding to abuse and neglect of children The operation's policies are missing the required components of standards 2-5.	—
3	—	748.107(2) - Conflict of interest policies-statement that majority of members of the governing body must consist of persons who do not have a conflict of interest The requqired statement that the majority of the voting members of the governing body must consist of persons who do not have a conflict of interest that would potentially interfere with objective decision making was missing in the policies.	—
3	—	748.105(5) - Personnel Policies - Personnel Policies - Develop written policies on the training requirements for employees. The policy is missing the preservice training requirements for caregivers as well as EBI components	—
4	—	748.125(d)(2) - Suicide Screening- Suicide risk screening tools must be supported by evidence-based research. The operation's suicide screening tool was created by the operation and cannot be verified to be an approved tool that is supported by evidence-based research.	—
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 During a review of records, it was found that one of the two children currently placed at the operation meets ED treatment services. The operation does not have a hired treatment director.	—
4	—	748.3115(3) - Fire Extinguisher-Must ensure fire extinguishers are serviced as required by manufacturer's instructions, or as required by fire inspector The fire extinguisher in the in the front area of the house was observed to be expired.	—
3	—	748.109(2) - Admission Policies - include characteristics of the population the program serves The operation's policy reflected they will be accepting girls, however the operation will be licensed to care for boys only, which wasn't correct on the operation's policies.	—

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

Inspections (48)

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

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