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Pathways Youth & Family Services,Inc. dba Habilitative Homes

Child care center · 4040 HIGH RIDGE CIR, San Antonio, TX 78229-4143 · License 858505

0Compliance score
Poor

Capacity 32. 4-17

Violation history (232)

SeverityDateStandard / narrativeCorrected
4— 748.317(a)(2) - Serious incidents-Notify parents of each child admitted any time the operation is deficient for standards related to abuse/neglect or exploitation.
Parents of children in care were not notified of recent deficiency related to abuse/neglect.		 Yes
5— 748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Staff did not intervene when a child was repeatedly hitting head against wall.		 —
4— 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
The video footage and care giver interviews indicate the staff initiated hands on physical intervention with a child in care, who in that moment wasn't displaying physically aggressive or high risk behaviors and was only refusing directives to stay in their room and there was a concern for other children in care's safety based on the child in care's previous behaviors.		 —
4— 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
During an incident a staff member pulled a child by their arms, as a form of redirection.		 —
5— 748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
A child in care was physically disciplined.		 —
3— 748.303(e)(3)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness if an adult contracts a reportable communicable disease
The operation failed to make a report within the required timeframe after 3 staff tested positive for COVID-19.		 —
4— 748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication
One of the medication records for a child was not filled out and medication had been administered.		 —
4— 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
Staff did not try to deescalate the situation prior to implementing the emergency behavior intervention. The staff member was contradiction to trained de-escalation techniques.		 —
4— 748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards
Two windows being used for ventilation were found without screens.		 Yes
4— 748.1531(d) - Medical care-Obtain follow-up medical treatment as recommended by the health-care professional
During the course of the investigation, it was determined the operation did not make and complete follow up medical appointments for children in care, as referred by medical professionals.		 —
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.
In video footage staff members are taunting child in care as a way to get the child to comply.		 —
3— 748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction
Multiple documents were not accessible by adminsitrator during visit.		 —
4— 748.2551(e)(1) - EBI Implementation-As soon as possible, caregiver must explain to child the behaviors required for release or to have EBI reduced, as applicable
The video footage reveals a care giver offering little other instructions to a child in care in a restraint other than repeating "Are you done?" repeatedly during the restraint.		 —
3— 748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
Licensing observed and phiotographed a wall niche fire extinguisher housing with a broken plastic door and a protruding plastic shard. The operation removed the damaged plastic screen to the secured staff room during inspection.		 Yes
4— 748.3443(a)(4) - Food Preparation-Food items must be stored in a container that is protected from insects & rodents
Multiple food items were not stored securely.		 —
5— 748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
Staff used excessive force when preforming an emergency behavior intervention. Staff held child with knee on child's chest during restraint.		 —
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.		 —
5— 748.2307(6) - Other Prohibited Punishments-pinching, pulling hair, biting, or shaking a child
Through interviews it was confirmed a staff dragged a child in care by the hair to the bathroom to sprayed child off in shower as a form of punishment.		 —
4— 748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
2 out of 11 medication logs show a child in care did not discontinue their previous medication dosage soon after their doctor appointment which indicated a dosage change, but instead took anywhere from 3 to 11 days to comply with new dosage orders.		 —
3— 748.3395(b)(4) - Hand-washing-Provide hand-washing sinks equipped with soap & a personal towel, single-use disposable towels, or hot air hand dryers
During the walkthrough, observations revealed there was no hand soap available at any of the sinks in the children's rooms.		 —
4— 748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
Two of the childrens records reviewed had pill count incorrect.		 —
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
Multiple expired medication products were stored with current medications.		 —
4— 748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
The video footage shows a caregiver held a child in care in a supine position with the child in care's arms folded across their chest while the caregiver balanced on their own knee above the child in care. A collateral contact familiar with restraint training indicated this does not appear to be approved. The video also shows the caregiver use their legs to move the child in care's body across the floor similar to a shoveling motion.		 —
4— 748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
Two medication logs reviewed did not have accurate counts.		 —
4— 748.930(b)(2) - Annual Training- Caregivers must have 2 hrs trauma informed care.
3 out of 4 training records reviewed showed current staff had expired Trauma Informed Care training while still in ratio.		 —
4— 748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication
Three medication logs were not updated with medication administered in required timeframe.		 —
4— 748.930(b)(5) - Annual Training- Caregivers must have psychotropic medication training if the caregiver administers psychotropic medication.
3 out of 4 training records reviewed showed staff had expired training for dispensing psychotropic medication.		 —
4— 748.2203(c)(1) - Medication Error-Document the time & date of the error
5 out of 11 records reviewed did not include time of medication for when the children missed a scheduled dose.		 —
4— 748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
Multiple bathrooms used by children in care had broken toilet paper holders.		 —
4— 748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
Two of the childrens records reviewed had pill count incorrect.		 —
3— 748.3395(b)(4) - Hand-washing-Provide hand-washing sinks equipped with soap & a personal towel, single-use disposable towels, or hot air hand dryers
During the walkthrough, observations revealed there was no hand soap available at any of the sinks in the children's rooms.		 —
4— 748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
Two medication logs reviewed did not have accurate counts.		 —
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.
In video footage staff members are taunting child in care as a way to get the child to comply.		 —
4— 748.930(b)(2) - Annual Training- Caregivers must have 2 hrs trauma informed care.
3 out of 4 training records reviewed showed current staff had expired Trauma Informed Care training while still in ratio.		 —
4— 748.317(a)(2) - Serious incidents-Notify parents of each child admitted any time the operation is deficient for standards related to abuse/neglect or exploitation.
Parents of children in care were not notified of recent deficiency related to abuse/neglect.		 Yes
4— 748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards
Two windows being used for ventilation were found without screens.		 Yes
3— 748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
Licensing observed and phiotographed a wall niche fire extinguisher housing with a broken plastic door and a protruding plastic shard. The operation removed the damaged plastic screen to the secured staff room during inspection.		 Yes
4— 748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
The video footage shows a caregiver held a child in care in a supine position with the child in care's arms folded across their chest while the caregiver balanced on their own knee above the child in care. A collateral contact familiar with restraint training indicated this does not appear to be approved. The video also shows the caregiver use their legs to move the child in care's body across the floor similar to a shoveling motion.		 —
4— 748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
2 out of 11 medication logs show a child in care did not discontinue their previous medication dosage soon after their doctor appointment which indicated a dosage change, but instead took anywhere from 3 to 11 days to comply with new dosage orders.		 —
4— 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
The video footage and care giver interviews indicate the staff initiated hands on physical intervention with a child in care, who in that moment wasn't displaying physically aggressive or high risk behaviors and was only refusing directives to stay in their room and there was a concern for other children in care's safety based on the child in care's previous behaviors.		 —
3— 748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction
Multiple documents were not accessible by adminsitrator during visit.		 —
4— 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
During an incident a staff member pulled a child by their arms, as a form of redirection.		 —
5— 748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
Staff used excessive force when preforming an emergency behavior intervention. Staff held child with knee on child's chest during restraint.		 —
4— 748.2551(e)(1) - EBI Implementation-As soon as possible, caregiver must explain to child the behaviors required for release or to have EBI reduced, as applicable
The video footage reveals a care giver offering little other instructions to a child in care in a restraint other than repeating "Are you done?" repeatedly during the restraint.		 —
4— 748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
Multiple bathrooms used by children in care had broken toilet paper holders.		 —
4— 748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication
One of the medication records for a child was not filled out and medication had been administered.		 —
4— 748.2203(c)(1) - Medication Error-Document the time & date of the error
5 out of 11 records reviewed did not include time of medication for when the children missed a scheduled dose.		 —
5— 748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
A child in care was physically disciplined.		 —
5— 748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Staff did not intervene when a child was repeatedly hitting head against wall.		 —
4— 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
Staff did not try to deescalate the situation prior to implementing the emergency behavior intervention. The staff member was contradiction to trained de-escalation techniques.		 —
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.		 —
4— 748.930(b)(5) - Annual Training- Caregivers must have psychotropic medication training if the caregiver administers psychotropic medication.
3 out of 4 training records reviewed showed staff had expired training for dispensing psychotropic medication.		 —
4— 748.3443(a)(4) - Food Preparation-Food items must be stored in a container that is protected from insects & rodents
Multiple food items were not stored securely.		 —
4— 748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication
Three medication logs were not updated with medication administered in required timeframe.		 —
4— 748.1531(d) - Medical care-Obtain follow-up medical treatment as recommended by the health-care professional
During the course of the investigation, it was determined the operation did not make and complete follow up medical appointments for children in care, as referred by medical professionals.		 —
5— 748.2307(6) - Other Prohibited Punishments-pinching, pulling hair, biting, or shaking a child
Through interviews it was confirmed a staff dragged a child in care by the hair to the bathroom to sprayed child off in shower as a form of punishment.		 —
3— 748.303(e)(3)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness if an adult contracts a reportable communicable disease
The operation failed to make a report within the required timeframe after 3 staff tested positive for COVID-19.		 —
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
Multiple expired medication products were stored with current medications.		 —
4— 748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
Multiple bathrooms used by children in care had broken toilet paper holders.		 —
4— 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
The video footage and care giver interviews indicate the staff initiated hands on physical intervention with a child in care, who in that moment wasn't displaying physically aggressive or high risk behaviors and was only refusing directives to stay in their room and there was a concern for other children in care's safety based on the child in care's previous behaviors.		 —
4— 748.2203(c)(1) - Medication Error-Document the time & date of the error
5 out of 11 records reviewed did not include time of medication for when the children missed a scheduled dose.		 —
4— 748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
Two of the childrens records reviewed had pill count incorrect.		 —
4— 748.3443(a)(4) - Food Preparation-Food items must be stored in a container that is protected from insects & rodents
Multiple food items were not stored securely.		 —
3— 748.303(e)(3)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness if an adult contracts a reportable communicable disease
The operation failed to make a report within the required timeframe after 3 staff tested positive for COVID-19.		 —
4— 748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
2 out of 11 medication logs show a child in care did not discontinue their previous medication dosage soon after their doctor appointment which indicated a dosage change, but instead took anywhere from 3 to 11 days to comply with new dosage orders.		 —
4— 748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards
Two windows being used for ventilation were found without screens.		 Yes
4— 748.930(b)(5) - Annual Training- Caregivers must have psychotropic medication training if the caregiver administers psychotropic medication.
3 out of 4 training records reviewed showed staff had expired training for dispensing psychotropic medication.		 —
4— 748.1531(d) - Medical care-Obtain follow-up medical treatment as recommended by the health-care professional
During the course of the investigation, it was determined the operation did not make and complete follow up medical appointments for children in care, as referred by medical professionals.		 —
4— 748.2551(e)(1) - EBI Implementation-As soon as possible, caregiver must explain to child the behaviors required for release or to have EBI reduced, as applicable
The video footage reveals a care giver offering little other instructions to a child in care in a restraint other than repeating "Are you done?" repeatedly during the restraint.		 —
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.		 —
5— 748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Staff did not intervene when a child was repeatedly hitting head against wall.		 —
4— 748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
Two medication logs reviewed did not have accurate counts.		 —
4— 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
Staff did not try to deescalate the situation prior to implementing the emergency behavior intervention. The staff member was contradiction to trained de-escalation techniques.		 —
4— 748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication
Three medication logs were not updated with medication administered in required timeframe.		 —
3— 748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
Licensing observed and phiotographed a wall niche fire extinguisher housing with a broken plastic door and a protruding plastic shard. The operation removed the damaged plastic screen to the secured staff room during inspection.		 Yes
3— 748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction
Multiple documents were not accessible by adminsitrator during visit.		 —
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.
In video footage staff members are taunting child in care as a way to get the child to comply.		 —
5— 748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
A child in care was physically disciplined.		 —
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
Multiple expired medication products were stored with current medications.		 —
4— 748.317(a)(2) - Serious incidents-Notify parents of each child admitted any time the operation is deficient for standards related to abuse/neglect or exploitation.
Parents of children in care were not notified of recent deficiency related to abuse/neglect.		 Yes
4— 748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
The video footage shows a caregiver held a child in care in a supine position with the child in care's arms folded across their chest while the caregiver balanced on their own knee above the child in care. A collateral contact familiar with restraint training indicated this does not appear to be approved. The video also shows the caregiver use their legs to move the child in care's body across the floor similar to a shoveling motion.		 —
5— 748.2307(6) - Other Prohibited Punishments-pinching, pulling hair, biting, or shaking a child
Through interviews it was confirmed a staff dragged a child in care by the hair to the bathroom to sprayed child off in shower as a form of punishment.		 —
4— 748.930(b)(2) - Annual Training- Caregivers must have 2 hrs trauma informed care.
3 out of 4 training records reviewed showed current staff had expired Trauma Informed Care training while still in ratio.		 —
5— 748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
Staff used excessive force when preforming an emergency behavior intervention. Staff held child with knee on child's chest during restraint.		 —
4— 748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication
One of the medication records for a child was not filled out and medication had been administered.		 —
4— 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
During an incident a staff member pulled a child by their arms, as a form of redirection.		 —
3— 748.3395(b)(4) - Hand-washing-Provide hand-washing sinks equipped with soap & a personal towel, single-use disposable towels, or hot air hand dryers
During the walkthrough, observations revealed there was no hand soap available at any of the sinks in the children's rooms.		 —
3— 748.3395(b)(4) - Hand-washing-Provide hand-washing sinks equipped with soap & a personal towel, single-use disposable towels, or hot air hand dryers
During the walkthrough, observations revealed there was no hand soap available at any of the sinks in the children's rooms.		 —
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
Multiple expired medication products were stored with current medications.		 —
3— 748.303(e)(3)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness if an adult contracts a reportable communicable disease
The operation failed to make a report within the required timeframe after 3 staff tested positive for COVID-19.		 —
4— 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
Staff did not try to deescalate the situation prior to implementing the emergency behavior intervention. The staff member was contradiction to trained de-escalation techniques.		 —
4— 748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
Two of the childrens records reviewed had pill count incorrect.		 —
4— 748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
Multiple bathrooms used by children in care had broken toilet paper holders.		 —
4— 748.930(b)(2) - Annual Training- Caregivers must have 2 hrs trauma informed care.
3 out of 4 training records reviewed showed current staff had expired Trauma Informed Care training while still in ratio.		 —
4— 748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
Two medication logs reviewed did not have accurate counts.		 —
4— 748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards
Two windows being used for ventilation were found without screens.		 Yes
4— 748.930(b)(5) - Annual Training- Caregivers must have psychotropic medication training if the caregiver administers psychotropic medication.
3 out of 4 training records reviewed showed staff had expired training for dispensing psychotropic medication.		 —
4— 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed
The video footage and care giver interviews indicate the staff initiated hands on physical intervention with a child in care, who in that moment wasn't displaying physically aggressive or high risk behaviors and was only refusing directives to stay in their room and there was a concern for other children in care's safety based on the child in care's previous behaviors.		 —
4— 748.1531(d) - Medical care-Obtain follow-up medical treatment as recommended by the health-care professional
During the course of the investigation, it was determined the operation did not make and complete follow up medical appointments for children in care, as referred by medical professionals.		 —
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.		 —

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

Inspections (120)

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

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