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Hill Country Youth Ranch

Child care center · , TX · License 813238

0Compliance score
Poor

Capacity 80. 4-17

Violation history (448)

SeverityDateStandard / narrativeCorrected
2 748.3393(d) - Toilets-Toilets must be equipped with toilet paper at all times
Two toilets were observed with no toilet paper.
4 748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
Child was given the wrong medication and on other occasions missed prescribed medication.
4 748.2101(3) - Medication Storage-Store medication covered by Schedule II of the Texas Controlled Substances Act under double lock in a separate container
Medications were observed in a child's bedroom.
4 748.2203(c) - Medication Error-Operation must meet documentation requirements within 24 hrs
It was confirmed that the operation did not complete documentation of medication errors within 24 hours.
3 748.3115 - Fire Extinguisher-Must inspect fire extinguisher(s) monthly
Three fire extinguishers observed have not been inspected since April 2022.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
The operation was made aware of concerns of an inappropriate relationship between a child in care and a staff member and failed to take action to protect the child. The child in care was sexually abused by the staff member.
4 748.3351(1) - Interior Space-Provide living space, appropriate furnishings, & bathroom facilities that are safe, clean and maintained in good repair
Children's bathrooms were observed to be missing soap, towels and trashcans. Trash cans were also observed to be overflowing needed to be emptied. Staff were notified of missing items and replaced them during inspection.
Yes
3 748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
Incident Reports contained conflicting date and time reporting. An incident report for the assault of a child selected "Yes" to the question "Was child taken to medical professional," but the next response noted the child "will be medically examined tomorrow." Additionally, an Incident Report labeled "type" as Verbal Aggression when the child was the victim of an assault by peers. In other Incident Reports, the type of incident includes that the child is the victim.
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
The last background check validation was completed 07/03/25, as of today 12/09/25 operation has not completed backcheck validation which is over a month past due.
5 748.4001(b) - General requirements-must ensure the safety of all children during any transportation that the operation provides
During walkthrough for Cannon House, Van 33 a seatbelt was found cut, unable to use by a child in care. In addition, a van was found with open rips at the time of inspection and this van was being utilized for transportation purposes of children in care.
3 748.303(a)(10)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
Operation did not report awareness of communicable disease timely.
5 HRC 42.049(a) - Operational Responsibilities- Maintain liability insurance coverage in the amount of $100,000 for each occurrence of negligence
Liability insurance information provided expired 1/28/26- operation does not have current liability insurance.
5 748.1531(a)(2) - Medical care-A child in care must receive medical care as needed for injury, illness, and pain
A child in care was not immediately taken to be evaluated by medical professionals following an assault by two peers. The Incident Report noted the caregiver finding "pooled blood" on the floor of the room where the assault took place, and the child sustained a knot on their head, a bloody nose, as well as bruising. Due to injuries and severity of assault, the child should have been evaluated for a concussion and broken bones.
4 748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
The information reviewed during this investigation indicated a medication was provided in the AM when it was supposed to be taken by the child in the PM. The error was noticed until a later date.
3 748.683(1) - Caregiver Supervision-Provide oversight of caregivers to protect children's health, safety and well-being
Operation did not provide adequate oversight and a caregiver provided children with illegal substances, alcoholic beverages and acted inappropriately with children while employed at the operation.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
It was confirmed that a staff member failed to demonstrate prudent judgement when they exchanged personal text messages with a child in care.
4 748.2003(b)(10) - Administration of prescription medication-must not borrow or administer prescription medication to a child that is prescribed to another person
A child was given another child?s prescribed PM medications.
3 748.303(b) - Serious Incident-Not required to report medically pertinent incident if not level of serious incident. Document same as a serious incident
A medical incident involving a child that did not rise to the level of a serious incident was not documented in the same manner as a serious incident report.
5 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Caregivers did not provide a level of supervision necessary to ensure a child's safety and to intervene when a child was assaulted in the annex of the cabin away from the main house..
3 748.723(a) - Volunteers and Contractors-if the person performs an employee function, he must meet the same requirements as an employee who performs that function
A volunteer did not have all the required trainings to be a caregiver for children and supervised 8 residents with a staff.
4 748.121 - Abuse and neglect policy - You must develop policies on preventing, recognizing, and responding to abuse and neglect of children
The operation did not have abuse and neglect policy available for review.
3 748.3443(b)(2) - Food Preparation-Must have a thermometer in freezers & store frozen food at 0 degrees Fahrenheit or below
Throughout the operation there were a total of 7 missing thermometers in the refridgerators.
Yes
5 745.621(a)(2) - AP Initial background checks submitted - At the time you hire someone
An initial background check was not submitted for multiple caregivers under the GRO.
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 sustained injury that required medical attention and incident was not called in until months after.
4 748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
A restraint was used on a child in care during a situation which was not considered an emergency.
4 748.303(a)(9)(A) - Serious Incident-Report to CCL within 2 hours of notifying LE the absence of a child developmentally/chronologically 6 to 12 years old.
Operation did not report within two hours to licensing timely when four residents ran from the operation. The residents were under age 13. Incident report indicates the residents ran at 4:45 pm and reported to hot line at 9:02 pm.
5 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
Two children in care engaged in sexual behaviors due to neglectful supervision of a staff member.
3 748.311(9) - Serious Incident Documentation-Includes treating licensed health-care professional's name, findings, and treatment, if any
Review of the serious incident reported did not include the name of the medical provider.
4 748.3351(1) - Interior Space-Provide living space, appropriate furnishings, & bathroom facilities that are safe, clean and maintained in good repair
During an unannounced investigation inspection a bathroom was seen to be unirderly, clothes, paper towels and hygiene items were seen to be on the floor, along with no trash can in the bathrooms in the entire house 3/3 bathrooms.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Caregivers did not report to their administrative staff a serious incident in which a child was assaulted by two other children in care. In addition, the caregivers allowed a child in care to go to the annex and be in the presence of other children who had assaulted them two days prior. In a separate incident, a volunteer/frequent visitor to the operation aggressively approached and verbally assaulted a child in care at an outside location.
4 748.4005(1) - General requirements-child in care may transport other children in care if the child has a valid drivers license
Operation staff allowed two children in care to transport other children in care, who are not licensed drivers.
4 748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child
Children in care were yelled at by a caregiver.
4 748.3441(a) - Food Preparation-Food & drinks must be of safe quality, stored, prepared, distributed, & served under sanitary & safe conditions
Food in a freezer was found to be open.
5 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Children in care engaged in inappropriate activity due to improper supervision by staff. One staff member supervising the children at the time of incident had knowledge of the children's high risks behaviors but did not convey this information to the other staff member present.
5 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
A child in care was sexually abused by a staff member.
4 748.3441(a) - Food Preparation-Food & drinks must be of safe quality, stored, prepared, distributed, & served under sanitary & safe conditions
Food in a refridgerator was found to be expired.
4 748.507(2) - Employee general responsibilities-Report suspected abuse, neglect, and exploitation to Child Abuse Hotline and the designated employee/administrator
Three staff members were made aware of allegations of abuse toward children in care, yet failed to report as per timeframes.
3 748.3443(a)(5) - Food Preparation-Food items must be refrigerated immediately after use & after meals, if the food requires refrigeration
A plate of fish was observed left out on the kitchen counter at cannon cottage. A dish of meat and noodles was obsevered uncovered in the refrigerator and food was observed on the floor in the pantry at meadow cottage. An open containter of raw meat was observed in the refrigerator at mabee cottage.
Yes
3 748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
Two refrigerators, a dishwasher, two ovens, one sink, and two bathrooms were observed to be dirty or not in good repair.
3 748.3001(C)(2) - Sanitation inspection- inspection unavailable must maintain documentation at operation and make available to us
Yearly updated documentation showing inspections are unavailable at the operation has not been provided.
5 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
Evidence and information gathered support that a staff member inappropriately touched, provided substances to and inadequately supervised children in care.
5 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
During an investigation it was determined a direct care staff did not intervene when two children in care engaged in a physical altercation leading to one child sustaining injuries.
5 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
It was confirmed by the operation that a staff member fell asleep while providing supervision to children in care.
5 748.685(c)(2) - Caregiver responsibility - provide a safe environment
Staff member was inappropriate with children and provided illegal substances to minors.
3 748.311 - Serious Incident Documentation-Documented in written report
While reviewing the incident report it was found that the names of all adults involved, their role in relation to the child and the circumstances surrounding the incident were not documented.
3 748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
Two ovens and one sink were observed to be dirty.
3 748.453(a)(1) - Unauthorized Absence ? Annual summary log must include name, age, gender, date of admission
The operation failed to provide the Annual Summary Log of Unauthorized Absences after it was requested.
3 748.3309(2) - Communication-Operation must have communication system to allow employees to contact other employees in the operation as needed
It was noted that both on and off campus communication is not reliable at the operation, there was information that you can?t call on or off the campus. There were problems with staff communication and ability to contact Emergency Care Services when a child and staff member were involved in an ATV accident.
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 admitted to smoking in the children's living quarters.
3 748.3719(b) - All-Terrain Vehicles-Only a child 16 years or older may ride on or operate a four-wheel all-terrain vehicle
Children under the age of 16 have been routinely riding on All Terrain Vehicles at the operation.
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
A report of abuse, neglect and/or exploitation of a child in care was not made following an incident of a child being pulled off of a couch, having their pants pulled down, and an inappropriate image was drawn on their face. Images of the child's face were shared with peers and staff before an intervention was made.
3 748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
During a monitoring inspection, it was found that the operation is reporting Emergency Behavior Intervention (EBI) data to include EBI performed at the Residential Treatment Center (RTC). This is inaccurate record keeping as the data must only include data from the GRO.
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
The operation did not report to Licensing concerns of an inappropriate relationship between a child in care and a staff member for possible sexual abuse.
5 748.1661(a) - Tobacco Products and E-Cigarettes -Children may not use or possess tobacco products, e-cigarettes or any type of vaporizers
A staff member provided children in care with vaporizer pens on multiple occasions.
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
It was confirmed that service plans for children receiving treatment services for emotional disorders were not updated within 90 days.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff member employed by the operation provided illegal substances to children while charged with caring for them. A staff member was made aware of these allegations of abuse against a staff member and failed to act in protecting children in care.
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 sustained injury that required medical attention and incident was not called in until months after.
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
A report of abuse, neglect and/or exploitation of a child in care was not made following an incident of a child being pulled off of a couch, having their pants pulled down, and an inappropriate image was drawn on their face. Images of the child's face were shared with peers and staff before an intervention was made.
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
The operation did not report to Licensing concerns of an inappropriate relationship between a child in care and a staff member for possible sexual abuse.
3 748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
Two ovens and one sink were observed to be dirty.
5 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
It was confirmed by the operation that a staff member fell asleep while providing supervision to children in care.
4 748.121 - Abuse and neglect policy - You must develop policies on preventing, recognizing, and responding to abuse and neglect of children
The operation did not have abuse and neglect policy available for review.
3 748.3309(2) - Communication-Operation must have communication system to allow employees to contact other employees in the operation as needed
It was noted that both on and off campus communication is not reliable at the operation, there was information that you can?t call on or off the campus. There were problems with staff communication and ability to contact Emergency Care Services when a child and staff member were involved in an ATV accident.
3 748.453(a)(1) - Unauthorized Absence ? Annual summary log must include name, age, gender, date of admission
The operation failed to provide the Annual Summary Log of Unauthorized Absences after it was requested.
4 748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
A restraint was used on a child in care during a situation which was not considered an emergency.
4 748.2003(b)(5) - Administration of prescription medication-Ensure the child has taken the medication as prescribed
Child was given the wrong medication and on other occasions missed prescribed medication.
3 748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
Two refrigerators, a dishwasher, two ovens, one sink, and two bathrooms were observed to be dirty or not in good repair.
5 748.1531(a)(2) - Medical care-A child in care must receive medical care as needed for injury, illness, and pain
A child in care was not immediately taken to be evaluated by medical professionals following an assault by two peers. The Incident Report noted the caregiver finding "pooled blood" on the floor of the room where the assault took place, and the child sustained a knot on their head, a bloody nose, as well as bruising. Due to injuries and severity of assault, the child should have been evaluated for a concussion and broken bones.
5 748.1661(a) - Tobacco Products and E-Cigarettes -Children may not use or possess tobacco products, e-cigarettes or any type of vaporizers
A staff member provided children in care with vaporizer pens on multiple occasions.
4 748.2003(b)(10) - Administration of prescription medication-must not borrow or administer prescription medication to a child that is prescribed to another person
A child was given another child?s prescribed PM medications.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Caregivers did not report to their administrative staff a serious incident in which a child was assaulted by two other children in care. In addition, the caregivers allowed a child in care to go to the annex and be in the presence of other children who had assaulted them two days prior. In a separate incident, a volunteer/frequent visitor to the operation aggressively approached and verbally assaulted a child in care at an outside location.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A staff member employed by the operation provided illegal substances to children while charged with caring for them. A staff member was made aware of these allegations of abuse against a staff member and failed to act in protecting children in care.
4 748.303(a)(9)(A) - Serious Incident-Report to CCL within 2 hours of notifying LE the absence of a child developmentally/chronologically 6 to 12 years old.
Operation did not report within two hours to licensing timely when four residents ran from the operation. The residents were under age 13. Incident report indicates the residents ran at 4:45 pm and reported to hot line at 9:02 pm.
3 748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
During a monitoring inspection, it was found that the operation is reporting Emergency Behavior Intervention (EBI) data to include EBI performed at the Residential Treatment Center (RTC). This is inaccurate record keeping as the data must only include data from the GRO.
4 748.2203(c) - Medication Error-Operation must meet documentation requirements within 24 hrs
It was confirmed that the operation did not complete documentation of medication errors within 24 hours.
4 748.3441(a) - Food Preparation-Food & drinks must be of safe quality, stored, prepared, distributed, & served under sanitary & safe conditions
Food in a freezer was found to be open.
4 748.2101(3) - Medication Storage-Store medication covered by Schedule II of the Texas Controlled Substances Act under double lock in a separate container
Medications were observed in a child's bedroom.
3 748.723(a) - Volunteers and Contractors-if the person performs an employee function, he must meet the same requirements as an employee who performs that function
A volunteer did not have all the required trainings to be a caregiver for children and supervised 8 residents with a staff.
2 748.3393(d) - Toilets-Toilets must be equipped with toilet paper at all times
Two toilets were observed with no toilet paper.
3 748.3443(b)(2) - Food Preparation-Must have a thermometer in freezers & store frozen food at 0 degrees Fahrenheit or below
Throughout the operation there were a total of 7 missing thermometers in the refridgerators.
Yes
3 748.683(1) - Caregiver Supervision-Provide oversight of caregivers to protect children's health, safety and well-being
Operation did not provide adequate oversight and a caregiver provided children with illegal substances, alcoholic beverages and acted inappropriately with children while employed at the operation.
4 748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child
Children in care were yelled at by a caregiver.
3 748.311(9) - Serious Incident Documentation-Includes treating licensed health-care professional's name, findings, and treatment, if any
Review of the serious incident reported did not include the name of the medical provider.
5 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
Two children in care engaged in sexual behaviors due to neglectful supervision of a staff member.
5 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Caregivers did not provide a level of supervision necessary to ensure a child's safety and to intervene when a child was assaulted in the annex of the cabin away from the main house..
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
The operation was made aware of concerns of an inappropriate relationship between a child in care and a staff member and failed to take action to protect the child. The child in care was sexually abused by the staff member.
3 748.303(a)(10)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
Operation did not report awareness of communicable disease timely.
4 748.3441(a) - Food Preparation-Food & drinks must be of safe quality, stored, prepared, distributed, & served under sanitary & safe conditions
Food in a refridgerator was found to be expired.
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
It was confirmed that service plans for children receiving treatment services for emotional disorders were not updated within 90 days.
4 748.4005(1) - General requirements-child in care may transport other children in care if the child has a valid drivers license
Operation staff allowed two children in care to transport other children in care, who are not licensed drivers.
3 748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
Incident Reports contained conflicting date and time reporting. An incident report for the assault of a child selected "Yes" to the question "Was child taken to medical professional," but the next response noted the child "will be medically examined tomorrow." Additionally, an Incident Report labeled "type" as Verbal Aggression when the child was the victim of an assault by peers. In other Incident Reports, the type of incident includes that the child is the victim.
5 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Children in care engaged in inappropriate activity due to improper supervision by staff. One staff member supervising the children at the time of incident had knowledge of the children's high risks behaviors but did not convey this information to the other staff member present.
3 748.311 - Serious Incident Documentation-Documented in written report
While reviewing the incident report it was found that the names of all adults involved, their role in relation to the child and the circumstances surrounding the incident were not documented.
5 HRC 42.049(a) - Operational Responsibilities- Maintain liability insurance coverage in the amount of $100,000 for each occurrence of negligence
Liability insurance information provided expired 1/28/26- operation does not have current liability insurance.
5 748.4001(b) - General requirements-must ensure the safety of all children during any transportation that the operation provides
During walkthrough for Cannon House, Van 33 a seatbelt was found cut, unable to use by a child in care. In addition, a van was found with open rips at the time of inspection and this van was being utilized for transportation purposes of children in care.
5 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
Evidence and information gathered support that a staff member inappropriately touched, provided substances to and inadequately supervised children in care.
4 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
It was confirmed that a staff member failed to demonstrate prudent judgement when they exchanged personal text messages with a child in care.
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
The last background check validation was completed 07/03/25, as of today 12/09/25 operation has not completed backcheck validation which is over a month past due.
3 748.3443(a)(5) - Food Preparation-Food items must be refrigerated immediately after use & after meals, if the food requires refrigeration
A plate of fish was observed left out on the kitchen counter at cannon cottage. A dish of meat and noodles was obsevered uncovered in the refrigerator and food was observed on the floor in the pantry at meadow cottage. An open containter of raw meat was observed in the refrigerator at mabee cottage.
Yes
4 748.507(2) - Employee general responsibilities-Report suspected abuse, neglect, and exploitation to Child Abuse Hotline and the designated employee/administrator
Three staff members were made aware of allegations of abuse toward children in care, yet failed to report as per timeframes.

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

Inspections (272)

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

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