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Guardian Angels I Residential Treatment Center

Child care center · 9530 W MONTGOMERY RD, Houston, TX 77088-4706 · License 860873

0Compliance score
Poor

Capacity 24. 9-17

Violation history (500)

Severity	Date	Standard / narrative	Corrected
5	—	748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being A resident in care was able to ingest objects on multiple occasions. A safety plan was put into place after multiple self harming incidents occurred, resulting in repeated hospitalizations and surgery.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records Four of four reviewed Supervision sections of the children's Service Plans all have the same Supervision needs and goals.	—
4	—	748.535(3)(H) - Child-care administrator responsibilities-Ensuring persons whose behavior or health status presents danger to children are not allowed at operation A contract worker participated in the escalation of a verbal altercation with children in care leading to a child being triggered and injured.	—
3	—	748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction Licensing arrived at the facility at 10:30A to conduct an unannounced inspection. After a 2-hour waiting period there was access to active records.	—
4	—	748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child A staff member got into a verbal argument with a resident.	—
3	—	748.1205(a)(12) - Admission Documentation-Identification of child's high risk behaviors and related safety plan staff and caregivers will implement During a review of external documentation, the operation did not complete a suicide screening, as well as a safety plan at the time of admission.	—
3	—	748.303(a)(9)(B) - Serious Incident- Report to parents within 2 hours of determining absence of a child developmentally/chronologically 6 to 12yrs. During the investigation, it was discovered the operation failed to report the runaway to the parent entity within the two-hour time frame.	—
4	—	748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language A staff member used profanity directed at a child in care during a heated exchange between the two.	—
5	—	748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety Staff were not able to intervene which resulted in child self-harming herself with a sharp object.	—
4	—	748.303(a)(12)(A) - Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child A suicide attempt that occurred on 04/01/25 was not reported until 04/03/25. Suicide attempts that occurred on 04/21/25 and 05/05/25 were not reported to Licensing.	—
4	—	748.1101(b)(4)(A)(vii) - Children's rights- Free from demeaning behavior to embarrass/control/harm/intimidate/isolate the child Multiple children interviewed confirmed a member of staff made an inappropriate comment to a child in care.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records 3 out of 4 files child files reviewed were incomplete. 72-hour service plans, initial service plans, and a signed copy of the child rights was not in the file.	—
5	—	748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety Staff failed to intervene to separate children that were engaged in a physical altercation.	—
4	—	748.3161(e) - Heating Devices-May not use stove to heat any part of operation, including portable camp stoves Staff is using an oven to heat the home on multiple occasions.	—
4	—	748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language A staff member used profane language in an argument with a resident,	—
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 failed to exercise prudent judgment and self-control by engaging in an argument with a child in care.	—
4	—	748.981(c) - First-aid-CPR training-Any new caregiver not currently certified in first-aid must be trained and certified within 90 days of employment A caregiver did not get CPR/first aid training within the proper timeframe.	—
4	—	748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks During an inspection, it was observed that two staff members were not practicing self-control, as a child was exhibiting escalating behaviors.	—
3	—	748.311(8) - Serious Incident Documentation-Includes interventions made during and after the incident, i.e. medical interventions, contacts made, other actions Serious incident reports were reviewed and they did not contain the required minimal standard criteria. The serious incident reports did not discuss the interventions made after the child returned to the facility.	—
3	—	748.303(a)(10)(A) - Serious Incident-Report to Licensing no later than 6 hours after determining unauthorized absence of a child 13 yrs old or older. Three children left the operation on 05/30 in the 4pm hour and the unauthorized absence was not reported until 05/31 in the 8am hour.	—
4	—	748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model Medication was not accurately accounted for medication logs for children in care.	—
4	—	748.685(c)(5) - Caregiver responsibility - ensure continuity of care by sharing information concerning each child with incoming caregivers Based on the information gathered throughout the interviews, it was determined multiple employees were unaware of child's allergies.	—
5	—	745.635(3) - AP Background ck determination - If provisionally eligible w/conditions or eligible w/conditions you must restrict duties per conditions/restrictions The conditions to a staff members background checks are not being followed as the staff member was left alone with residence.	—
5	—	748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being A physical altercation between 2 children in care occurred and a staff member was unable to intervene as she was the only staff member on duty.	—
5	—	748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity A child in care left her bedroom and was located in a peer's bed during sleeping hours.	—
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 Scheduled II medication was improperly stored in a kitchen drawer that is not double locked.	—
4	—	748.2003(b)(11) - Administration of prescription medication-only the child for whom the prescription medication was prescribed may use the medication A child was given another child in care's medication.	—
4	—	748.125(d)(4)(E) - Suicide Screening- Must be administered immediately if the child exhibits warning signs that necessitate a suicide screening be conducted. Suicide screenings were not immediately administered on a child who attempted to self-harm on three occasions by swallowing inanimate objects.	—
3	—	748.311(1) - Serious Incident Documentation-Includes name of the operation, physical address, and telephone number The operations physical address, and telephone number were missing from a serious incident report that was submitted.	—
5	—	748.685(c)(2) - Caregiver responsibility - provide a safe environment Staff request help from a child in care to help separate two children engaged in a physical altercation resulting in the child engaging in the fight.	—
1	—	748.1339(a)(3) - Initial Service Plan-Service planning team must include at least one PLSP who provides direct services to the child The initial service plan for a child in care does not have the signatures or dates of participation for a professional level service provider or managing conservator. Therefore, it is unknown if they participated in the initial service plan meeting or reviewed the initial service plan.	—
3	—	748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction The operation did not provide the unauthorized absence log or triggered review documentation after CCR requested the documents.	—
5	—	748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work. During a review of the investigation it was determined that a staff member threatened a child in care was threatened with corporal punishment verbally and with hand gestures.	—
2	—	748.1385(9) - Service Plan Review-Must document in the child's record the review and update of the plan Four children's service plans were not updated at review to include therapy/skills training frequency, education changes, and/or medication changes.	—
3	—	748.313(3)(B) - Serious Incident child absent without permission-document notice to parents and law enforcement about child's absence and subsequent location/return 3 serious incident reports did not contain all required documentation regarding an elopement. This includes the time and date law enforcement, and parents were notified, along with the names of those notified.	—
4	—	748.601 - Treatment Director-Facility providing treatment services to 25 or more children or to more than 30% of children in care must have treatment director The operation does not have a Treatment Director to oversee the treatment program that provides treatment services for children with emotional disorders.	—
3	—	748.1205(a)(12) - Admission Documentation-Identification of child's high risk behaviors and related safety plan staff and caregivers will implement During a review of external documentation, the operation did not complete a suicide screening, as well as a safety plan at the time of admission.	—
4	—	748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks Prudent judgment was not applied to a situation where a staff member immediately noticed a change and did not verify the information before preforming assigned tasks.	—
3	—	748.3365(b)(2) - Bedding-must provide each child with a mattress cover or protector unless mattress is waterproof Two youth beds were observed to not have a mattress cover during a walkthrough of the operation.	Yes
4	—	748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks Staff was using profanity in front of the children in care.	—
4	—	748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child During the incident / physical altercation, a staff member was heard to be cursing.	—
5	—	748.2553(2)(B) - EBI Release-Child released from personal restraint within one minute of implementation of a prone or supine hold According to the Incident Report, a child was restrained in the supine position for 3-10 minutes.	—
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 A caregiver made a derogatory statement aimed at a child in care.	—
3	—	748.303(a)(10)(A) - Serious Incident-Report to Licensing no later than 6 hours after determining unauthorized absence of a child 13 yrs old or older. The incident occurred on 04/22/2026 and the incident was reported to Licensing on 04/24/2026, which outside of the required 6-hour reporting period.	—
4	—	748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language A caregiver became belligerent, yelled, and used profanity in reference to and at a child in care.	—
4	—	748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language Three children in care expressed that a DCS used inappropriate language when talking to them.	—
3	—	748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures A staff member failed to follow policy and procedures. The staff member admitted to not conducting checks every 20 minutes as per policy.	—
4	—	748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply A caregiver picked up a child and placed her in her bedroom when she refused to leave the living room area of the home.	—
1	—	748.3701(b) - Recreation responsibility-must have a written plan for ensuring that a range of indoor & outdoor recreational & leisure opportunities are provided During the monitoring inspection, the recreational chart provided did not contain a of indoor and outdoor recreational activities for the children daily.	—
5	—	748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work. During the investigation, there were multiple accounts of a caregiver pushing a child in care.	—
4	—	748.2151(a) - Medication Record-Maintain cumulative record of prescription medications dispensed to child, include nonprescription meds for child under five yrs old The operation did not have medication logs for five prescription medication.	—
4	—	748.4703(b) - Child/caregiver ratio-Caregiver must remain awake during night-time sleeping hours A caregiver admitted to dozing off while supervising the children in care at nighttime.	—
5	—	748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being Two children and one agency staff witnessed an agency staff member sleeping.	—
5	—	748.1013(a) - Child/caregiver ratio-A caregiver must be awake when caring for a child needing constant supervision Staff were observed sleeping by 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 During the investigation, a caregiver failed to maintain self-control when they positioned themselves for a physical confrontation with a child, and verbally provoked the child.	—
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 had a high-risk behavior of suicidal ideation and was able to grab multiple objects and self-harm.	—
4	—	748.2101(6) - Medication storage & destruction-remove discontinued medication immediately & destroy it in a way that ensures children do not have access to it There operation had expired over the counter medication, medication for a child whom has been discharge and current children stored in the same box.	—
5	—	748.2307(13) - Other Prohibited Punishments-denying basic child rights as discipline or punishment Child's belongings/ clothing was taken away as a form discipline.	—
5	—	748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being The child's supervision requirements were not followed which resulted in a self-harming.	—
4	—	748.303(a)(2)(B) - AP Serious Incdt- Report to parents any injury/illness that warrants treatment from a medical prof. directly after ensuring the safety of the child. Parent was not notified of child being seen by emergency services.	—
5	—	748.2461(a)(1) - Short Personal Restraint-Caregiver must minimize risk of physical discomfort, harm, or pain to child Caregiver conducted restraint on a youth utilizing unapproved technique.	—
5	—	748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force Staff used unnecessary force when pushing a child before restraining her three separate times.	—
5	—	748.2307(13) - Other Prohibited Punishments-denying basic child rights as discipline or punishment Children's clothing are still being taken away as a form discipline.	—
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 The incident report does not contain the required elements for reporting non serious medical incidents as required. The document does not have the physical address or phone number of the operation.	—
4	—	748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language During the investigation, it was found that a child was cursed at by a caregiver during a confrontation.	—
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 were able to run away from the facility while being supervised by staff.	—
5	—	748.2301(b)(2) - Disciplinary Measures-must not be physically or emotionally damaging to the child A caregiver physically pushed and used a close fist to punch a child in care.	—
4	—	748.2003(b)(6) - Administration of prescription medication-ensure a person trained in & authorized to administer prescription medication administers the medication An unauthorized staff gave a child the wrong medication.	—
3	—	748.303(a)(10)(A) - Serious Incident-Report to Licensing no later than 6 hours after determining unauthorized absence of a child 13 yrs old or older. Child in care went on AWOL on 5-16-24 immediately after child got down from the school bus at about 3:25pm and did not return until the next day. Operation staff stated that AWOL report was made on 5-16-24 around 11:50pm which is more than 6 hours report timeframe.	—
3	—	748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records A caregiver documented inaccurate information related to a child's whereabouts during overnight hours.	—
4	—	748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child A staff member yelled at and subjected a child in care to humiliation by referencing the child's family and weight in a demeaning manner.	—
3	—	748.311(11) - Serious Incident Documentation-Must include an update regarding the unauthorized absence and the child?s return. Only 3 serious incident reports out of 8 children who went on an unauthorized leave of absence on two different days were provided to licensing.	—
5	—	748.685(c)(2) - Caregiver responsibility - provide a safe environment Caregivers at the operation are not physically intervening when children are engaging in a physical altercation.	—
3	—	748.303(a)(10)(A) - Serious Incident-Report to Licensing no later than 6 hours after determining unauthorized absence of a child 13 yrs old or older. The operation failed to notify licensing of a child's elopement from the operation.	—
4	—	748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks Multiple children and staff interviewed confirmed an inappropriate was made to a child by staff.	—
4	—	748.461(1) - Unauthorized Absence-Triggered Review must include review of child?s records abt previous unauth absences, including previous debriefings 4 triggered reviews did not contain all required documentation. This includes a review of the previous unauthorized absences and previous debriefings required in 748.461(1) and level of supervision as required in 748.461(2).	—
1	—	748.1349(b)(2) - Initial Service Plan- When given to child then child must sign or operation document child's refusal to sign Both service plans reviewed did not contain signatures nor reasoning for not having the resident sign their service plan.	—
5	—	745.8411(b)(3) - Responsibilities - Provides access to all records During the team inspection, complete children's files, and the EBI annual evaluation were not available for review.	—
5	—	748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation A staff member became both verbally and physically aggressive with a child in care. A staff member with protective capacity physically positioned herself between the staff and child in care in an attempt to protect the child.	—
4	—	748.2003(b)(11) - Administration of prescription medication-only the child for whom the prescription medication was prescribed may use the medication A child was given another child in care's medication.	—
3	—	748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction Licensing arrived at the facility at 10:30A to conduct an unannounced inspection. After a 2-hour waiting period there was access to active records.	—
3	—	748.303(a)(9)(B) - Serious Incident- Report to parents within 2 hours of determining absence of a child developmentally/chronologically 6 to 12yrs. During the investigation, it was discovered the operation failed to report the runaway to the parent entity within the two-hour time frame.	—
4	—	748.2003(b)(6) - Administration of prescription medication-ensure a person trained in & authorized to administer prescription medication administers the medication An unauthorized staff gave a child the wrong medication.	—
4	—	748.303(a)(2)(B) - AP Serious Incdt- Report to parents any injury/illness that warrants treatment from a medical prof. directly after ensuring the safety of the child. Parent was not notified of child being seen by emergency services.	—
5	—	748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety Staff were not able to intervene which resulted in child self-harming herself with a sharp object.	—
5	—	745.635(3) - AP Background ck determination - If provisionally eligible w/conditions or eligible w/conditions you must restrict duties per conditions/restrictions The conditions to a staff members background checks are not being followed as the staff member was left alone with residence.	—
3	—	748.303(a)(10)(A) - Serious Incident-Report to Licensing no later than 6 hours after determining unauthorized absence of a child 13 yrs old or older. The operation failed to notify licensing of a child's elopement from the operation.	—
4	—	748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child A staff member got into a verbal argument with a resident.	—
5	—	745.8411(b)(3) - Responsibilities - Provides access to all records During the team inspection, complete children's files, and the EBI annual evaluation were not available for review.	—
5	—	748.2301(b)(2) - Disciplinary Measures-must not be physically or emotionally damaging to the child A caregiver physically pushed and used a close fist to punch a child in care.	—
5	—	748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being The child's supervision requirements were not followed which resulted in a self-harming.	—
4	—	748.4703(b) - Child/caregiver ratio-Caregiver must remain awake during night-time sleeping hours A caregiver admitted to dozing off while supervising the children in care at nighttime.	—
4	—	748.981(c) - First-aid-CPR training-Any new caregiver not currently certified in first-aid must be trained and certified within 90 days of employment A caregiver did not get CPR/first aid training within the proper timeframe.	—
4	—	748.1101(b)(4)(A)(vii) - Children's rights- Free from demeaning behavior to embarrass/control/harm/intimidate/isolate the child Multiple children interviewed confirmed a member of staff made an inappropriate comment to a child in care.	—
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 failed to exercise prudent judgment and self-control by engaging in an argument with a child in care.	—
5	—	748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being A physical altercation between 2 children in care occurred and a staff member was unable to intervene as she was the only staff member on duty.	—
4	—	748.461(1) - Unauthorized Absence-Triggered Review must include review of child?s records abt previous unauth absences, including previous debriefings 4 triggered reviews did not contain all required documentation. This includes a review of the previous unauthorized absences and previous debriefings required in 748.461(1) and level of supervision as required in 748.461(2).	—
3	—	748.126(b) - All employees and caregivers must be aware of and follow your policies and procedures A staff member failed to follow policy and procedures. The staff member admitted to not conducting checks every 20 minutes as per policy.	—
4	—	748.125(d)(4)(E) - Suicide Screening- Must be administered immediately if the child exhibits warning signs that necessitate a suicide screening be conducted. Suicide screenings were not immediately administered on a child who attempted to self-harm on three occasions by swallowing inanimate objects.	—
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 were able to run away from the facility while being supervised by staff.	—

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

Inspections (440)

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

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