Capacity 90. 5-17
| Severity | Date | Standard / narrative | Corrected |
|---|
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
It was determined through interviews that a staff member did push a child, making the child fall and hit their head. It was determined by DFPS this meets to definition for abuse. |
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| 4 | — |
748.535(3)(A) - Child-care administrator responsibilities-Overseeing staffing patterns to ensure supervision and child-care services meet the needs of children
By several caregiver's own admission, it was stated that administrative personnel have breached this standard by sending staff from cottage to cottage while under-staffed to create the illusion they are in ratio when Licensing personnel are on the Operation's premises. |
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| 5 | — |
748.2101(2) - Medication Storage-Keep medication inaccessible other than to employees responsible for stored medication
Medication was not kept inaccessible other than employees responsible for storing the medication, as a child was able to obtain 6 bottles of medication and ingested an unknown amount of medication, requiring that child to be hospitalized. |
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| 5 | — |
748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity
Two children were able to engage in consensual inappropriate sexual contact with each other. One of the children was on a side of the unit they were not assigned to and was in another child's bedroom, which is not allowed. Both children had history of inappropriate boundaries and due to a lack of being appropriately supervised, they were able to engage in inappropriate behavior. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
During interviews it was evident the operation had not maintained the required 1:5 ratio. Ratios documented were 4:31 with a child on 1 to 1 supervision and 2:32 with a child on 1 to 1 supervision. |
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| 1 | — |
748.1205(a)(15) - Admission Documentation-Includes a copy of the placement agreement, if applicable.
Two of two child files reviewed did not have a placement agreement. |
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| 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 demonstrate prudent judgment or self control when they threw a binder on to the ground and cornered a child for a negative comment the child made. |
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| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
Multiple staff and children in care indicated that a staff used profane language at a child in care. |
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| 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
Two of two child files reviewed did not have results of past dental exams that had been done. There is no documentation showing a dental exam had been completed within required time frames. |
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| 4 | — |
748.1011 - Child/caregiver ratio-Includes only qualified caregivers working directly with a child or group of children
Based on the staffing schedule and interviews, there were at least 6 times that unqualified caregivers were placed in ratio with the children. |
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| 4 | — |
748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
A child, admitted on 1.26.24, did not receive their ADHD medication until 2.6.24. While the medication was pending review on 1.26.24, it was approved by the psychiatrist on 1.27.24. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
Six children and three staff who were interviewed report on 7/7/24 three children were placed on 1:1 observation and the rest of the unit was out of ratio. |
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| 1 | — |
748.1341(a) - Initial Service Plan-Must give the child's parent(s) at least two weeks advance notice of the meeting
Three of three child files did not have documentation that parents were notified of service plan meeting at least two weeks before the meeting. Two files had documentation that had incorrect dates while the other file had no documentation at all. |
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| 5 | — |
748.1205(a)(13) - Admission Documentation-Includes copy of the placement agreement, if applicable
4 of the 4 child files read did not contain placement agreement documentation. |
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| 4 | — |
748.3441(a) - Food Preparation-Food & drinks must be of safe quality, stored, prepared, distributed, & served under sanitary & safe conditions
3 children and 3 staff have received undercooked and/or molded items served in the cafeteria. |
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| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
It was determined within this DFPS investigation that children in care were not free from abuse or neglect when staff allowed children to fight each other and staff dragged a child out of their room. |
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| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Staff did not intervene appropriately on children who were playing a potentially dangerous game of seeing how long they could hold their hands in fire ant beds. Multiple interviews indicate staff saw what the children were doing and redirected but did not continue to redirect or prevent children from gaining access to other ant beds. Two child had serious reactions to the ant bites and had to be taken to the emergency room. |
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| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
Through interviews it was determined that a staff member did engage in inappropriate contact with a child in care in such a way that meets Texas Family Code and Texas Administrative Code definitions of abuse. |
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| 5 | — |
748.2605(a)(2) - Personal Restraints Prohibited-Restraints that obstruct child's airway
Through interviews of children and staff it was determined a child's sweatshirt was pulled over a child's face/mouth during the course of a restraint. |
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| 4 | — |
748.1337(b)(1)(D)(ii) - Initial Service Plan-Include instructions to caregivers about level of supervision required
A child's service plan did not have specific information about the level of supervision the child would have at the operation. |
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| 3 | — |
748.453(a)(1) - Unauthorized Absence ? Annual summary log must include name, age, gender, date of admission
The log was requested 10 days after the runaway, the 5/27/2023 runs were not documented on the log. |
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| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
It was determined that two children in care were missing from the operation for about 15 minutes before staff realized they were gone. It was also determined that staff did not realize a door that was supposed to be secured was left opened and children were able to leave the building. |
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| 3 | — |
748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
Observation logs for several children note each child was inside the unit and calm during the same time the children were involved in an altercation outside the unit. Staff who report being inside the unit were completing observation logs on children who were reported to be outside the unit. A staff who says they were outside the unit, handling the physical altercation between children documented and initialed off on a child's observation log that the child was calm and inside and the same time the child was reportedly involved in an altercation outside the unit. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
One of the units had 28 children on the unit. One child required 1:1 supervision. For a period of time there were 3 other staff to supervise the remaining 27 children. |
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| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
On multiple occasions at the operation, a staff member sexually abused a child resident who was left in this staff member's care. |
Yes |
| 4 | — |
748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
Information gathered during the course of the investigation determined a child was restrained in order to get them to comply in two separate incidents. |
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| 4 | — |
748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
During the course of the investigation, it was determined that the caregiver restrained the child for an inappropriate reason. |
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| 4 | — |
748.930(b)(2) - Annual Training- Caregivers must have 2 hrs trauma informed care.
At least 2 caregivers did not have annual trauma informed care training. Refer to TIC annual training as well, 748.930(b)(3). |
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| 4 | — |
748.1101(b)(4)(A)(v) - Children's rights- To be free from being subjected to remarks that belittle or ridicule the child or the child's family
During the course of the investigation through interviews with children and staff it was determined staff members are making belittling remarks to children such as telling them to shut up, calling them bullies, saying their hair is "nappy", saying children are annoying, that children stink, and commenting that children have not "washed between their legs." |
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| 3 | — |
748.881(6) - General pre-service training curriculum-Includes trauma informed care
At least 3 caregivers did not have their pre-service training completed for trauma informed care. Refer to pre-service normalcy training as well, 748.748.881(7). |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
Through interviews of staff and children it was determined the residential treatment center units (1, 2, and 5) are frequentlly out of ratio, with times where one staff is supervising 20 children. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
Through interviews of children and staff it was determined when an incident occurred on 4/4/23 the unit was not in ratio. There were 30 children on the unit and only 4 direct care staff could be confirmed to be working when the incident occurred. |
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| 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
On the morning of 3/11/23, children in care reported allegations of sexual abuse of by a caregiver. This was not reported to Licensing until 3/13/23. A report made by one of the administrative staff did not include sufficient details of the abuse to be referred to the appropriate investigative program. |
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| 4 | — |
748.1337(b)(1)(D)(ii) - Initial Service Plan-Include instructions to caregivers about level of supervision required
Two children's service plans did not have any information regarding supervision requirements. |
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| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Two children were able to gain entry into a bathroom that is supposed to remain locked and only have one child at a time in there. While in the bathroom the two children had inappropriate contact with each other. |
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| 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.
After reviewing the information it was determined a child rose to the level of Suicide Attempt, but did not get assessed by a medical person that falls under the definition of a Mental Health Specialist. |
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| 5 | — |
748.1101(b)(4)(A) - Children's rights-The right to be free from any harsh, cruel, unusual, unnecessary, demeaning, or humiliating treatment or punishment.
During the course of the investigation, staff admitted to reaching hand down victim child's pants to retrieve bouncy ball. |
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| 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.
In one of the employee files reviewed, references were not documented to verify or discuss the applicant's suitability to work with or around children. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
There were multiple reports that ratio was not being maintained on a day when a child was found unresponsive with clothing around their neck. It was reported there was at least one child on 1:1 supervision, leaving 4 staff to supervise the remaining 28 children. |
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| 5 | — |
748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity
Staff sitting in the hallway observing children in their bedrooms did not notice when one child went into another child's room, where the two children appeared to have engaged in inappropriate physical contact with each other. This was observed by a different staff member. |
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| 3 | — |
748.311(4) - Serious Incident Documentation-Includes names of all adults involved and their role in relation to the child(ren)
In reviewing the Serious Incident Report several items were found to be missing. Names of all staff and children involved, names of all witnesses, description of the differences between the children in size, weight, mental level. |
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| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
A child in care was left unsupervised in a hallway by themselves. The child accessed a hospital gown and used the strings to tie around their neck. After the child was placed on 1:1 observation, the staff assigned to the child responded to incident involving another child and brought the child on 1:1 to the other child's room and was not providing 1:1 observation. |
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| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
Through interviews it was determined five children in care were able to assault another child in care due to a lack of supervision by caregivers. The child that was assaulted sustained serious injuries. |
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| 3 | — |
748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
The operation did not maintain true and accurate records as staff training records showed staff did 6 days of orientation in 2 days or less, that staff did 40 hours of observation in one day, staff signed that they did 40 hours of observation but no form was filled out, and training documentation noted staff did CPI training on 2/27/23 but the CPI card notes the training being done on 2/28/23. |
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| 3 | — |
748.311(9) - Serious Incident Documentation-Includes treating licensed health-care professional's name, findings, and treatment, if any
In reviewing the Serious Incident Reports from both incidents items were found to be missing such as treating doctor, names of police officer, names of child witnesses and how to identify them, complete information of staff involved. |
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| 5 | — |
745.635(2) - AP Background check determination - If ineligible then you must immediately remove subject from operation and confirm to CBCU receipt of notice letter
A staff member was determined by the background check unit to be ineligible to be at the operation on 1/9/25. The staff worked on 1/11/25. |
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| 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
An incident report reviewed showed an incident was documented on 5/7/23 that two children were involved in non consensual sexual activity and this was not reported to Licensing. |
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| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
This standard was found deficient as part of a DFPS investigation. |
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| 5 | — |
748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
A staff member admitted to threatening pulling the hair of a child in care. |
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| 4 | — |
748.1005 - Child/caregiver ratio-Each group must have enough caregivers for that group who are not caring for other children or doing administrative work
It was discovered that there were only two caregivers with 14 children. This left the group out of ratio. |
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| 3 | — |
748.311(5) - Serious Incident Documentation-Includes names or other means of identifying witnesses to the incident, if any
In reviewing the Serious Incident Reports, items were found to be missing; names of all staff involved and names of all witnesses (outside of children directly involved). |
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| 4 | — |
748.153(3)(B) - Notification - New controlling person
The operation has had a new CEO since April 2023 that would need to be added as a new controlling person. As of 5/18/23 this person still was not added as a controlling person. |
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| 4 | — |
748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
A child in care was restrained to keep them from going out of a fence. |
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| 3 | — |
748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
There was inappropriate graffiti on multiple bathroom walls in one of the units. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
Based on interviews and the staffing schedule, there were at least 3 times a unit was out of ratio due to not having enough workers in the unit. |
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| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Through interviews it was determined a staff member did not demonstrate prudent judgment when they violated professional boundaries between children in care and caregivers. Staff made promises to children in care of drugs, money, phones, jewelry, and marriage. Additionally, the staff promised to take the children out of the operation. |
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| 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 did not demonstrate prudent judgment when they allowed a child in care to use their personal phone to access social media platforms. Additionally the staff used social media while working. The staff brought fast food to a child in care without prior approval to do so and ignored the appearance of favoritism to one specific child in care. |
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| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
There's sufficient evidence to show that staff members were on their phones while counted in ratio and supervising children. |
— |
| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
Through multiple interviews of staff and children it was determined that staff have been heard using profane and abusive language towards children. |
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| 5 | — |
748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
It was observed by staff that another staff struck a child in care after that child hit that staff. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
During interviews with caregivers and children it was evident the operation had not maintained the required 1:5 ratio. |
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| 4 | — |
748.1545(a) - Vision and hearing screening-must ensure that each child is screened; must have professional exam if problems are detected
4 of the 4 child files reviewed did not have documentation that a vision or hearing screening was conducted. |
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| 5 | — |
748.2307(1) - Other Prohibited Punishments-any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline/punishment
Throughout the course of the investigation five children and four staff interviewed stated that a staff member purposely spilled iced coffee on a child in care. |
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| 5 | — |
748.151(1) - Operational responsibilities - Designate a qualified full-time child-care administrator
The administrator of record is not a full time employee of the operation. |
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| 4 | — |
748.863(a)(3) - Caregiver for child-care or prog. svcs only must have 8 hours EBI training, 4 before counted in ratio, rest in 90 days; 16hrs for treatment svcs
A caregiver did not have 16 hours of preservice EBI training within 90 days of being hired. |
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| 4 | — |
748.685(c)(1) - Caregiver responsibility - be aware of children's habits, interests, and any special needs including supervision
Two children in care were put on a safety plan that included them to remain 10ft apart at all times. It was determined that this was not implemented at all times. |
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| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
Through interviews it was determined that several children and one staff reported that another staff member encouraged a child to fight another child who had been bullying and antagonizing other residents. |
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| 5 | — |
748.2003(a) - Administration of prescription medication-inform medical consenter of benefits/risks/side effects/treatment/consequences of refusing them
A child in care was injected with Toradol 3 times in a 3 day span without their parent being notified they were being administered the medication. The operation noted the medication was covered by the "Consent for Emergency Medical Treatment/ Advance Directive" form, however, the medication was administered 2 days after the child initially began feeling chest pains and shortness of pain. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
During the walk through of Unit I 24 children were observed with 3 staff. Two children were in the hall out of the sight of staff. |
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| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
Statements provided by both children in care and staff members stated that profane language is being used and directed at children in care. |
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| 5 | — |
745.641 - AP Background check results - Must receive notification prior to allowing subject to be present at your operation
A current staff member providing direct care services did not have an active background check. The background check was inactivated on 4.20.23. |
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| 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
After reviewing documentation, it was determined that this was reported after 24 hours of being injured and receiving medical care. |
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| 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.
Rubbing alcohol was not stored in a way that was inaccessible to children in care. A child in care was able to obtain access to the bottle. Several children then ingested the rubbing alcohol. One of the children became sick and required medical attention. |
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| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
It was determined through the course of the investigation two children were in a physical altercation. During the time of separation in an attempt to de-escalate, one of the children came in where the other child was still upset and staff admitted to not intervening to ensure there would be no further altercations which allowed another altercation to occur and left one of the children with an injury. |
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| 3 | — |
748.3365(c)(1) - Bedding-must provide each child with pillow/bed linens appropriate for temperature including pillowcase, top sheet, fitted or bottom sheet
It was noted there were several pillows being used by children that did not have pillow cases. The pillows had vinyl coverings that were ripped. Several beds did not have sheets. |
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| 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 exercise prudent judgment when having children in care clean up another child's excrement as incentive for those children to be able to go on an outing. |
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| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Through interviews of staff and children it was determined that during a physical altercation between children at least one, possibly two staff responding to the incident did not assist in intervening on the children fighting. One of the children involved sustained multiple injuries including bruising and swelling to their face. |
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| 2 | — |
748.1225(c) - Admission-Report and findings of dental exam must be documented in child's record
4 of the 4 child files read did not contain documentation/reports of dental exams in the child's records. |
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| 4 | — |
748.1005 - Child/caregiver ratio-Each group must have enough caregivers for that group who are not caring for other children or doing administrative work
Through interviews it was determined that appropriate ratio was not being maintained when one staff was left alone on one side of the unit with 12 children. |
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| 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
In a serious incident report reviewed it was noted a child swallowed a zipper and was taken to the emergency room for X-rays. This was not reported to RCCR. |
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| 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
During the course of the investigation it was found one of the victim's and another child were in an altercation and the other child was choked. This was not reported to Licensing and was found during the investigation process. |
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| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
It was found two staff got into a verbal altercation waking children up in the middle of the night due to yelling and cussing. |
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| 3 | — |
748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
Based on interviews and the staffing schedule, there were at least 4 occasions where staff were documented to have worked who did not actually work that unit. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
During the walk through of the operation all 3 units were observed, there were more than five children being cared for by one staff member in several units. It was stated in interviews that staff members were aware of the 1 to 5 ratio but couldn't account for what youth they were responsible for while on duty. |
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| 3 | — |
748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction
Documentation was requested in person, through phone call, and through email over multiple times throughout this investigation and two other investigations. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
Two out of two staff interviewed regarding ratio report ratio was not being maintained during an incident as there were more than 10 children outside with two staff. One of two children interviewed regarding ratio report ratio was not being maintained during an incident as there were more than ten children outside with two staff. |
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| 4 | — |
748.930(a)(2) - Caregivers at operations with 25 or more children or 30% or more of their population receiving treatment services must have 50hrs annual training
It could not be verified that a staff had 50 hours of annual training for 2023. The staff's onling training showed less than 15 hours and other trainings did not have the number of hours. |
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| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
During the course of the investigation it was determined a staff member encouraged children in care to show staff their private parts and requested that the children engage in inappropriate sexual activity. Additionally, the staff was observed touching themselves inappropriately. |
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| 5 | — |
748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity
Staff were not aware and accountable of a child's activities when the child was able to obtain a razor and cut themselves seriously enough to where the child required medical attention and had stitches for the injury. |
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| 4 | — |
748.1101(b)(1)(A) - Children's rights-rights to good care and treatment that meets the child's needs in the most family-like setting possible
During the course of interviewing children four of five indicated that staff is using derogatory language that is belittling to children in care. The children also indicated that staff curse in general. |
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| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Two children engaged in an altercation for several minutes. Staff were present and did not intervene to separate the children to ensure their safety. Both children sustained injuries from this altercation. |
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| 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 not free from abuse when a staff member pulled the child to the ground by their hair. |
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| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
During the course of this investigation through interviews of children and staff it was determined that some staff did not demonstrate prudent judgment or self control when they got mad, yelled, and punched a wall or meal cart. Additionally, another staff member has made threatening comments to children in care which does not demonstrate prudent judgment. |
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| 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 with a history of inappropriate boundaries was able to gain access to another child's room and acted out on that child. It was during a time when the hallway was not monitored by staff. |
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| 4 | — |
748.2455(a)(1) - Emergency Behavior Intervention-Before using EBI, the caregiver must attempt less restrictive interventions that prove to be ineffective
It was observed that a caregiver restrained a child in care without an emergency situation occuring and did not attempt to de-escaltate. |
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| 4 | — |
748.1003(a) - Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
Statements from children in care and staff members stated that the operation only had one staff member for twelve residents. |
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| 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
During review of operation documentation, a nurse's note was reviewed regarding an incident where a child was hit by a staff member on 1/17/24. This was not reported by the operation until 1/20/24. The staff that witnessed the incident did not report at all. |
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| 4 | — |
748.303(a)(12)(A) - Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child
A child in care had a suicide attempt on 9/30/23. This was not reported until 10/3/23. |
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| 4 | — |
748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
A caregiver did not demonstrate prudent judgment or self-control when they cursed around a child, made intimating comments and stood in front of a child in an intimidating way. |
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| 4 | — |
748.303(a)(12)(A) - Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child
A child in care made a suicide attempt in November 2023 by wrapping something around their neck and their face was discolored as a result of this. This was not reported by the operation to Child Care Regulation. |
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560 inspection record(s) on file from TX-HHSC.
Licensed facilities near this one, highest compliance score first.