Capacity 36. 3-17
| Severity | Date | Standard / narrative | Corrected |
|---|
| 3 | — |
748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
It was observed on the sidewalk outside of the gym there were animal feces in dog bags. |
— |
| 3 | — |
748.2855(a) - EBI Documentation-Caregiver must document EBI in child's record as soon as possible, but no later than 24 hours after initiation of the intervention
During an interviews staff stated that a child was escorted from the school building back to the Sierra Unit. This walk would take over 1 minute making it a personal restraint which is required to be documented. |
— |
| 2 | — |
748.949(a) - Annual Training Documentation-Keep documentation verifying completion of training in the personnel record
The facility was unable to provide documentation to show which trainings the staff took with the required information. |
— |
| 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 incident took place on 12.17.24 but was not reported to licensing until 12.27.24. |
— |
| 4 | — |
748.3441(a) - Food Preparation-Food & drinks must be of safe quality, stored, prepared, distributed, & served under sanitary & safe conditions
During a walk through of the operation, 9 large cans, an unopened box of ravioles and a plastic jar of liquid were observed to be expired in the Cafeteria's pantry area. |
— |
| 5 | — |
748.2307(15) - Other Prohibited Punishments-using or threatening to use emergency behavior intervention as discipline or punishment
During the investigation, a staff member reported that they used a threat of a personal restraint as tool for disciplining the child. |
— |
| 4 | — |
748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication
It was found that three future time and signature were documented in a medication record prior to administering the medication. One medication record had the incorrect count documented. It was also found that one medication record was missing information on who disbursed the medication. |
— |
| 5 | — |
748.2551(c)(1) - EBI Implementation-Caregiver must minimize risk of physical discomfort, harm, or pain to the child
During the course of this investigation, it was determined that a child in care was improperly restrained and not documented. |
— |
| 2 | — |
748.1331(b)(2) - Preliminary Service Plan-For child receiving treatment services, include a description of child's immediate educational, medical, and dental needs
During the course of the investigation, it was observed the master service plan, the initial nursing treatment plan, and the initial clinical review documents did not contain information regarding self-management of child's illness . |
— |
| 5 | — |
748.3301(a)(1) - Physical Site- Buildings must be structurally sound and not pose a risk to the health and safety of children.
Both Chaparral and Sierra Unit walls had extensive peeling. |
— |
| 4 | — |
748.3301(h) - Physical Site-The building must be free of rodents and insects
During the investigation, dead insects were observed enclosed in a ceiling light fixture in the break room and nurse?s station. It was also observed a large spider web above the child?s bed. The inspector observed two small black specks in the cabinet with the children's cereal and on the floor by the TV room which appeared to be consistent with rat droppings. |
— |
| 3 | — |
748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
During the investigation the inspector observed a black substance on the caulking and grout in both shower areas which appeared to be consistent with mold. The inspector also observed black sticky substance emerging through cracks between the floor tiles in the bedrooms of the children. It was also observed a ceiling light fixture or camera is damaged. The hallway floor near the TV room contained visible dust and debris and required sweeping. |
— |
| 4 | — |
748.930(b)(3) - Annual Training- Caregivers must have 1 hour normalcy training.
It was observed 2 out of 2 staff files reviewed did not contain the required 1 hour of Normalcy training. |
— |
| 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 inspector eye witness and additional interviews with staff it was reported the nurses are being counted in ratio while completing nursing duties and administrative work. |
— |
| 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 investigation, it was determined that the operation failed to submit the serious incident report within the required timeframe. The incident occurred on 12/22/23 and was reported to Licensing on 12/26/23. |
— |
| 4 | — |
748.3301(c) - Physical Site-Windows & doors must be in good repair & free of broken glass or hazards
It was observed in the gym that three window panels were missing/broken, It was also found that one of the closets in the gym was unlocked and a hole in the ceiling along with the light fixture was not turning on properly was observed. |
— |
| 5 | — |
748.2605(a)(5) - Personal Restraints Prohibited-Restraints that twist or place the child's limb(s) behind the child's back
During the course of the investigation, it was determined that a child in care had their arm held behind their back during an emergency behavior intervention. |
— |
| 4 | — |
748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
It was observed the unit's showers had mildew on the ceilings and grout, as well as two cockroaches in the shower. |
— |
| 5 | — |
748.2461(a)(2) - Short Personal Restraint-Caregiver must use minimal amount of reasonable and necessary physical force
A child received a bloody, swollen nose during a restraint due to a staff member banging their head on the ground. |
— |
| 5 | — |
748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
This standards was found deficient as part of a DFPS investigation. |
— |
| 3 | — |
748.3115(2) - Fire Extinguisher-Must ensure fire extinguishers are accessible for immediate use by employees, caregivers, & volunteers
It was observed in the gym that there was no fire extinguisher found in the vicinity. This was corrected during the inspection when the maintenance worker sent a picture to the administrator of the fire extinguisher being posted in the gym. |
Yes |
| 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 concluded that a staff member subjected a child to an unnecessary EBI as a means to comply. |
— |
| 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 was reported to the hotline sixteen hours after the children in care were noticed missing and not reported within six hours. During the course of the investigation, it was noticed that only one victim was reported missing when two children in care eloped from the facility. |
— |
| 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 was observed 2 out of 2 staff files reviewed did not have the required annual training hours or courses. |
— |
| 4 | — |
748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
A child was restrained for attempting to walk out of the cafeteria without permission which does not constitute an emergency situation where the child or others safety was at risk. The child was not on any safety plan or precautions at the time of the restraint. |
— |
| 3 | — |
748.3443(a)(1) - Food Preparation-Food items must be covered & stored off the floor
During the walk-through of the cafeteria, it was noted that pork was kept uncovered in the freezer, a stainless-steel container of peaches in juice were kept uncovered on a cart located in a hallway in the cafeteria and a bowl of food was uncovered in the refrigerator located in the cafeteria entrance. |
— |
| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
Several people interviewed reported a staff member used profane language following a personal restraint in front of a children in care. |
— |
| 5 | — |
748.2461(b)(3) - Short Personal Restraint-Caregiver may not use restraint that obstructs child's airways or impairs child's breathing
While a child was being restrained by staff, another staff choked the child. |
— |
| 3 | — |
748.363(8) - Personnel records - Include signed dated statement by the employee that he must immediately report suspected child abuse, neglect, or exploitation.
During the monitoring inspection, four staff files were reviewed. One staff file did not contain a signed and dated statement in where an employee must immediately report any suspected incident of child abuse, neglect, or exploitation to the Texas Abuse and Neglect Hot line and to the operation s administrator and/or administrator s. 748.831(b): The same staff file did not contain orientation documentation. |
— |
| 4 | — |
748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication
8 noted times on 6 medication records/logs did not document administered medication. |
— |
| 3 | — |
748.2003(b)(4) - Administration of prescription medication-Administer each child's medication within one hour of preparation
It was determined that a nurse had multiple medications ready to disburse hours prior to the time the medication is labeled to be administered. |
— |
| 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 inspection, it was observed two caregivers were left with fifteen children for approximately ten minutes. This was corrected when the third caregiver returned to the unit. |
Yes |
| 5 | — |
748.2461(b)(1) - Short Personal Restraint-Caregiver may not use a prone or supine restraint
During the course of the investigation, a staff member and a child reported that the child was restrained briefly on their back (in a supine position). |
— |
| 5 | — |
745.641 - AP Background check results - Must receive notification prior to allowing subject to be present at your operation
A staff member has been working at the operation since 12.26.23 with an inactive background check. |
— |
| 5 | — |
748.2551(b)(1) - EBI Implementation-The caregiver must consider the characteristics of the immediate physical environment
It was determined that a child was restrained by staff in a wooded area in an attempt to stop them from elopement. This area was reported to be an open field with extensive brush, trees, frontage including thorns. After multiple attempts to restrain the child, there were four reported physical altercations between staff and child in where they fell on to the described brush. As such, the staff sustained several injuries. |
— |
| 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 determined there were only 2 staff present for multiple hours with 18 children. 2 additional staff were present but were providing 1:1 care and unable to be counted in ratio. |
— |
| 2 | — |
748.3397(d)(2) - Bathing-Provide sufficient hot water to meet the demands of the children
It was reported that all showers in the Chaparral and Sierra Unit were not in working condition as of three week prior to this date. Children in care take turns every other day to take showers in another building not subject to regulation. |
— |
| 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
It was observed 2 Direct Care staff supervising 13 residents at lunch and were out of ratio while the other Direct Care staff took a lunch break. |
— |
| 5 | — |
745.8411(a) - Responsibilities - Not interfere with an inspection or investigation
An internal investigation was completed on 12.19.24 for an incident that occurred on 12.17.24. This incident should have been reported to statewide intake for an abuse investigation. |
— |
| 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
It was determined the unit was out of ratio. |
— |
| 4 | — |
748.2455(a)(1) - Emergency Behavior Intervention-Before using EBI, the caregiver must attempt less restrictive interventions that prove to be ineffective
Instead of permitting other staff to manage and defuse the situation, a staff member exacerbated the situation by intervening even though they were aware the child was upset with them. |
— |
| 4 | — |
748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
A child was inappropriately restrained by a staff member who placed their arm around the child's neck. |
— |
| 5 | — |
748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
During the course of the investigation, it was determined that the caregiver used more force causing injury to a child. |
— |
| 5 | — |
748.2307(14) - Other Prohibited Punishments-withholding food that meets the child's nutritional requirements
A staff threw away a child's food in response to the child spitting at their feet. |
— |
| 5 | — |
748.2551(c)(1) - EBI Implementation-Caregiver must minimize risk of physical discomfort, harm, or pain to the child
During the course of this investigation, it was determined that a staff member conducted an unnecessary EBI and used unnecessary strength forcing a child in care to the ground causing a bruise on their face. It was determined that the child was not a danger to self and/or others. |
— |
| 3 | — |
748.311(4) - Serious Incident Documentation-Includes names of all adults involved and their role in relation to the child(ren)
It was found that sections [748.311(2), (4), (5), (7), and (8)] of the incident report documentation were missing required information. |
— |
| 4 | — |
748.930(b)(2) - Annual Training- Caregivers must have 2 hrs trauma informed care.
It was observed 2 out of 2 staff files reviewed did not contain the required 2 hours of Trauma Informed Care training. |
— |
| 4 | — |
748.2203(c) - Medication Error-Operation must meet documentation requirements within 24 hrs
It was discovered the child was administered the wrong medication accidently, one they were documented to be allergic to. The child did not have a reaction to the medication, so it was added to their daily medication regimen. |
— |
| 4 | — |
748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
During the course of the investigation, it was determined that the caregiver used a type of restraint that was not allowed. |
— |
| 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 hit and choked by a staff member. This incident meets Texas Family Code and Texas Administrative Code definition of abuse. |
— |
| 5 | — |
748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
During a restraint, a staff used excessive force to take a child to the ground, causing the child to chip a tooth upon impact. |
— |
| 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
There were two staff members 13 resident in the Sierra Unit. As per staff the nurse was counted in ration. There were 14 residents to 2 staff members in the Chaparral Unit. Both nurses were seen in the locked nurse s station administering medication. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Two children in care spent several days creating a hole big enough to escape unnoticed. During the time the children in care eloped, caretakers conducted routine 15-minute checks and marked them in their rooms. |
— |
| 5 | — |
748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
2 children interviewed mentioned a staff threatened at least 1 child with corporal punishment. |
— |
| 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
It was found that the incident occurred on 11/5/24 and staff were aware of the child?s right-hand injury on this day, however the incident wasn?t reported to the A/N Hotline until 11/8/24. |
— |
| 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
It was determined staff were out of ratio when a physical altercation occurred between children in care. 2 children, 3 staff, and parent stated the ratio was 2:15 when the incident occurred. |
— |
| 2 | — |
748.191(2) - Required Postings-Post Licensing notice Keeping Children Safe in prominent and publicly accessible place where others may easily view it at all times
There was no Keeping Children Safe poster located anywhere in the Chaparral Unit. |
— |
| 4 | — |
748.931(a)(1)(B)(i) - Annual Training-Must include 2 hours on trauma informed care
During the monitoring inspection, four staff files were reviewed. It was noted that four of the four staff files did not provide documentation regarding Normalcy training. 748.749(b)(5): One of the four staff files reviewed had training certificated that did not specify the training hours. |
— |
| 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 incident occurred on 1.23.24 and the child made the allegations the same day during the debriefing. However, the incident was not reported to Licensing until 2.29.24. |
— |
| 3 | — |
748.311(8) - Serious Incident Documentation-Includes interventions made during and after the incident, i.e. medical interventions, contacts made, other actions
The facility failed to provide RCCL Inspectors with a serious incident report or formal facility report for the incident. Requests for an incident report were made on 06/15/2023, 06/28/2023, and 07/19/2023, requests were made in person and through email. |
— |
| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
During interviews 3 out of 3 children stated staff use profane language around them. 2 staff memebers also admitted to using profane language. |
— |
| 4 | — |
748.3351(1) - Interior Space-Provide living space, appropriate furnishings, & bathroom facilities that are safe, clean and maintained in good repair
Mold was observed in the Sierra unit showers. |
— |
| 5 | — |
748.2461(b)(1) - Short Personal Restraint-Caregiver may not use a prone or supine restraint
During the course of the investigation, a staff member and a child reported that the child was restrained briefly on their back (in a supine position). |
— |
| 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
It was determined staff were out of ratio when a physical altercation occurred between children in care. 2 children, 3 staff, and parent stated the ratio was 2:15 when the incident occurred. |
— |
| 4 | — |
748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
A child was inappropriately restrained by a staff member who placed their arm around the child's neck. |
— |
| 4 | — |
748.930(b)(2) - Annual Training- Caregivers must have 2 hrs trauma informed care.
It was observed 2 out of 2 staff files reviewed did not contain the required 2 hours of Trauma Informed Care training. |
— |
| 3 | — |
748.3443(a)(1) - Food Preparation-Food items must be covered & stored off the floor
During the walk-through of the cafeteria, it was noted that pork was kept uncovered in the freezer, a stainless-steel container of peaches in juice were kept uncovered on a cart located in a hallway in the cafeteria and a bowl of food was uncovered in the refrigerator located in the cafeteria entrance. |
— |
| 4 | — |
748.931(a)(1)(B)(i) - Annual Training-Must include 2 hours on trauma informed care
During the monitoring inspection, four staff files were reviewed. It was noted that four of the four staff files did not provide documentation regarding Normalcy training. 748.749(b)(5): One of the four staff files reviewed had training certificated that did not specify the training hours. |
— |
| 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
It was found that the incident occurred on 11/5/24 and staff were aware of the child?s right-hand injury on this day, however the incident wasn?t reported to the A/N Hotline until 11/8/24. |
— |
| 5 | — |
745.641 - AP Background check results - Must receive notification prior to allowing subject to be present at your operation
A staff member has been working at the operation since 12.26.23 with an inactive background check. |
— |
| 5 | — |
748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
During a restraint, a staff used excessive force to take a child to the ground, causing the child to chip a tooth upon impact. |
— |
| 5 | — |
748.2307(15) - Other Prohibited Punishments-using or threatening to use emergency behavior intervention as discipline or punishment
During the investigation, a staff member reported that they used a threat of a personal restraint as tool for disciplining the child. |
— |
| 3 | — |
748.363(8) - Personnel records - Include signed dated statement by the employee that he must immediately report suspected child abuse, neglect, or exploitation.
During the monitoring inspection, four staff files were reviewed. One staff file did not contain a signed and dated statement in where an employee must immediately report any suspected incident of child abuse, neglect, or exploitation to the Texas Abuse and Neglect Hot line and to the operation s administrator and/or administrator s. 748.831(b): The same staff file did not contain orientation documentation. |
— |
| 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 incident occurred on 1.23.24 and the child made the allegations the same day during the debriefing. However, the incident was not reported to Licensing until 2.29.24. |
— |
| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
Several people interviewed reported a staff member used profane language following a personal restraint in front of a children in care. |
— |
| 4 | — |
748.3301(h) - Physical Site-The building must be free of rodents and insects
During the investigation, dead insects were observed enclosed in a ceiling light fixture in the break room and nurse?s station. It was also observed a large spider web above the child?s bed. The inspector observed two small black specks in the cabinet with the children's cereal and on the floor by the TV room which appeared to be consistent with rat droppings. |
— |
| 5 | — |
748.2461(a)(2) - Short Personal Restraint-Caregiver must use minimal amount of reasonable and necessary physical force
A child received a bloody, swollen nose during a restraint due to a staff member banging their head on the ground. |
— |
| 4 | — |
748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication
8 noted times on 6 medication records/logs did not document administered medication. |
— |
| 5 | — |
748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
During the course of the investigation, it was determined that the caregiver used more force causing injury to a child. |
— |
| 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
It was observed 2 Direct Care staff supervising 13 residents at lunch and were out of ratio while the other Direct Care staff took a lunch break. |
— |
| 5 | — |
748.2307(14) - Other Prohibited Punishments-withholding food that meets the child's nutritional requirements
A staff threw away a child's food in response to the child spitting at their feet. |
— |
| 4 | — |
748.3351(1) - Interior Space-Provide living space, appropriate furnishings, & bathroom facilities that are safe, clean and maintained in good repair
Mold was observed in the Sierra unit showers. |
— |
| 3 | — |
748.311(4) - Serious Incident Documentation-Includes names of all adults involved and their role in relation to the child(ren)
It was found that sections [748.311(2), (4), (5), (7), and (8)] of the incident report documentation were missing required information. |
— |
| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
During interviews 3 out of 3 children stated staff use profane language around them. 2 staff memebers also admitted to using profane language. |
— |
| 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 determined there were only 2 staff present for multiple hours with 18 children. 2 additional staff were present but were providing 1:1 care and unable to be counted in ratio. |
— |
| 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 hit and choked by a staff member. This incident meets Texas Family Code and Texas Administrative Code definition of abuse. |
— |
| 4 | — |
748.2455(a)(1) - Emergency Behavior Intervention-Before using EBI, the caregiver must attempt less restrictive interventions that prove to be ineffective
Instead of permitting other staff to manage and defuse the situation, a staff member exacerbated the situation by intervening even though they were aware the child was upset with them. |
— |
| 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
It was determined the unit was out of ratio. |
— |
| 2 | — |
748.1331(b)(2) - Preliminary Service Plan-For child receiving treatment services, include a description of child's immediate educational, medical, and dental needs
During the course of the investigation, it was observed the master service plan, the initial nursing treatment plan, and the initial clinical review documents did not contain information regarding self-management of child's illness . |
— |
| 5 | — |
748.2551(b)(1) - EBI Implementation-The caregiver must consider the characteristics of the immediate physical environment
It was determined that a child was restrained by staff in a wooded area in an attempt to stop them from elopement. This area was reported to be an open field with extensive brush, trees, frontage including thorns. After multiple attempts to restrain the child, there were four reported physical altercations between staff and child in where they fell on to the described brush. As such, the staff sustained several injuries. |
— |
| 2 | — |
748.3397(d)(2) - Bathing-Provide sufficient hot water to meet the demands of the children
It was reported that all showers in the Chaparral and Sierra Unit were not in working condition as of three week prior to this date. Children in care take turns every other day to take showers in another building not subject to regulation. |
— |
| 4 | — |
748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
It was observed the unit's showers had mildew on the ceilings and grout, as well as two cockroaches in the shower. |
— |
| 3 | — |
748.2003(b)(4) - Administration of prescription medication-Administer each child's medication within one hour of preparation
It was determined that a nurse had multiple medications ready to disburse hours prior to the time the medication is labeled to be administered. |
— |
| 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 investigation, it was determined that the operation failed to submit the serious incident report within the required timeframe. The incident occurred on 12/22/23 and was reported to Licensing on 12/26/23. |
— |
| 5 | — |
748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
Two children in care spent several days creating a hole big enough to escape unnoticed. During the time the children in care eloped, caretakers conducted routine 15-minute checks and marked them in their rooms. |
— |
| 3 | — |
748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
It was observed on the sidewalk outside of the gym there were animal feces in dog bags. |
— |
| 3 | — |
748.311(8) - Serious Incident Documentation-Includes interventions made during and after the incident, i.e. medical interventions, contacts made, other actions
The facility failed to provide RCCL Inspectors with a serious incident report or formal facility report for the incident. Requests for an incident report were made on 06/15/2023, 06/28/2023, and 07/19/2023, requests were made in person and through email. |
— |
| 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 inspector eye witness and additional interviews with staff it was reported the nurses are being counted in ratio while completing nursing duties and administrative work. |
— |
| 5 | — |
748.2551(c)(1) - EBI Implementation-Caregiver must minimize risk of physical discomfort, harm, or pain to the child
During the course of this investigation, it was determined that a staff member conducted an unnecessary EBI and used unnecessary strength forcing a child in care to the ground causing a bruise on their face. It was determined that the child was not a danger to self and/or others. |
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| 2 | — |
748.191(2) - Required Postings-Post Licensing notice Keeping Children Safe in prominent and publicly accessible place where others may easily view it at all times
There was no Keeping Children Safe poster located anywhere in the Chaparral Unit. |
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268 inspection record(s) on file from TX-HHSC.
Licensed facilities near this one, highest compliance score first.