Child care center ·
12550 W STATE HIGHWAY 29, Liberty Hill, TX 78642-4733 ·
License 50218
Capacity 134. 5-17
| Severity | Date | Standard / narrative | Corrected |
|---|
| 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 determined an incident requiring medical attention was not reported timely. |
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| 4 | — |
748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child
5 staff and 2 children stated staff yell at children in care. |
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| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
3 staff and 1 child stated staff use profane language around and/or towards the children in care. |
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| 4 | — |
748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child
Children interviewed stated a particular staff member yelled/raised her voice at them triggering a conflict. |
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| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
Throughout the course of the investigation, it was determined that there are staff using profanity with children in care. |
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| 5 | — |
748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity
Staff failed to complete required 15 minute checks as 2 children were able to engage in inappropriate activity in a bathroom for 18 minutes. |
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| 3 | — |
748.3365(b)(2) - Bedding-must provide each child with a mattress cover or protector unless mattress is waterproof
Five mattresses in seventeen rooms inspected had torn mattress and mattress covers. One of the mattresses was being used by a child and it was replaced at the time of inspection. |
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| 3 | — |
748.363(7) - Personnel records-Include notarized Licensing Affidavit for Applicants for Employment form as specified in Human Resources Code, 42.059
3 Staff Charts were reviewed did not have Licensing Affidavits. |
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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, it was determined that two units were out of ratio having 20 residents with 2 staff and 11 residents with 2 staff. |
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| 5 | — |
748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity
In the course of the investigation it was determined staff was doing other duties and was not aware of the childrens' actions allowing them to leave the premises. |
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| 4 | — |
748.2307(4) - Other Prohibited Punishments-using sarcastic or cruel humor, and verbal abuse
A caregiver used inappropriate language to a child in care referring to their self-inflected wound scars, in addition to other comments about children's bodies and religion. |
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| 2 | — |
748.681(1)(B) - Caregiver qualifications-Must be at least 21 yrs old if all children in group are 13 yrs old or older
In reviewing the investigation it was found a person that was not a qualified caregiver was interacting with children and was left to supervise the children. |
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| 4 | — |
748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
Two children were observed arguing and then one of the children ran over to the other child's table to try and hit the second child. One of the staff placed themselves in between the two children and the other staff grabbed the child by the arms and jerked them back away. Staff admitted the restraint was inappropriate. |
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| 3 | — |
748.311 - Serious Incident Documentation-Documented in written report
10 of 10 serious incident reports were reviewed and none documented the operation's address or phone number, or the child's date of admission as required. |
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| 4 | — |
748.1011 - Child/caregiver ratio-Includes only qualified caregivers working directly with a child or group of children
During the investigation, it was determined the operation was using unqualified employees as caregivers on the unit due to staffing shortages. These employees were not properly trained in SAMA, normalcy, and/or trauma informed care. 8 staff training records were reviewed. 6 out of 8 records did not have proper SAMA training, 2 out of 8 records did not have normalcy training, and 3 out of 8 records did not have TIC training. |
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| 3 | — |
748.3365(a) - Bedding-must provide each child with an individual bed or bunk bed in child's room that elevates mattress off floor, or crib as appropriate
Based on preponderance there is evidence that children have slept on the hall floor on an unelevated mattress. |
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| 5 | — |
745.641 - AP Background check results - Must receive notification prior to allowing subject to be present at your operation
During the inspection, it was found that the Administrator doesn't have a background check under this operation. |
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| 3 | — |
748.535(3)(F) - Child-care administrator responsibilities-Ensuring that operation complies with applicable rules of chapter 748 and other applicable rules and laws.
Documented and verbal complaints regarding ratio, child safety, and staff behaviors have been made by both children and staff, however, issues continue to be ongoing. |
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| 5 | — |
748.2605(b)(1) - Personal Restraints Prohibited-Prone and supine restraints except as a transitional hold that lasts no longer than 1 minute
A caregiver was observed on video placing a child in care in a supine restraint that lasted over 4 minutes. |
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| 4 | — |
748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
A caregiver was observed on video using an improper restraint that was not a permitted technique allowed by the operation. |
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| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
It was documented and made known that a child was not adequately supervised as they were able to open locked doors, leave the unit and climb the building?s roof multiple times without staff being aware he was absent from the unit. It was also recorded that the child was able to leave the unit and jump the property?s fence in which resulted in injuries. |
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| 5 | — |
748.2101(2) - Medication Storage-Keep medication inaccessible other than to employees responsible for stored medication
The medication room door was broken and staff did not ensure it was properly closed and a child was able to enter the room and obtain and ingest OTC medication. |
Yes |
| 3 | — |
748.311(5) - Serious Incident Documentation-Includes names or other means of identifying witnesses to the incident, if any
Interviews confirmed a child reported this incident to a staff but the child was not listed on the Serious Incident Report. There was also another victim involved but this child was not listed. Only one of the staff involved were listed on the Serious Incident Report. |
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| 4 | — |
748.1531(d) - Medical care-Obtain follow-up medical treatment as recommended by the health-care professional
A child in care was to receive follow-up within 1 week from 1.16.22. No follow-up was completed. |
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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 determined that Bunk House was out of ratio, 17:2, for more than 15 minutes as one staff was in the Nurse s station conducting administrative duties and speaking to children individually, and another staff left Bunk House to drop off her personal items in the Admin building. A nurse was in the Med room performing medication/administrative duties. |
Yes |
| 1 | — |
748.1341(a) - Initial Service Plan-Must give the child's parent(s) at least two weeks advance notice of the meeting
Six out of six child files reviewed did not have documentation showing two weeks advance notice to the parents for the initial service plan. |
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| 4 | — |
748.393(b)(2) - Active child record-Includes known allergies and chronic conditions or "no known allergies" on exterior of record or in a clearly visible location
Four out of ten child records did not list the known allergies or chronic conditions in a prominent place on the child file and one child record reviewed did not list a medication allergy. |
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| 5 | — |
745.641 - AP Background check results - Must receive notification prior to allowing subject to be present at your operation
Review of the backgrounds found an employee had their background inactivated on 7-9-24 and is still having access to children in care. |
Yes |
| 4 | — |
748.1337(b)(1)(D)(ii) - Initial Service Plan-Include instructions to caregivers about level of supervision required
In reviewing the Initial Service Plan there was no direction on supervision provided. |
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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
Residents interviewed consistently mentioned a staff member used profane language. One staff member was told by several residents that a staff member has use profane language. Another staff member stated he had heard a staff member used profane language. |
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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 child in care was physically abused by a caregiver when he was choked. |
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| 2 | — |
748.1337(b) - Initial Service Plan-Document in child's record and include preliminary service plan requirements
In reviewing the Admission Assessment, Preliminary Service Plans, and Initial Service Plans, several items that are required were found not to be included. |
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| 4 | — |
748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
During the inspection thirteen out of sixteen bathrooms had mildew. |
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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
Children interviewed consistently mentioned a staff member mumbling profane language and derogatory words under his breathing about the children in care. |
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| 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
Interviews validated there was no documentation written for the restraint. |
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| 4 | — |
748.685(c)(1) - Caregiver responsibility - be aware of children's habits, interests, and any special needs including supervision
A child in care was left unsupervised in the bathroom for several minutes with the door closed. This was not consistent with the child?s precaution plan, which requires staff to maintain line of sight supervision and keep the bathroom door open for safety. |
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| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
During the course of the investigation, a staff member admitted they did not intervene when an altercation took place between two children in care. |
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| 4 | — |
748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child
Interviews from 6 persons validated that staff yelled at children when behaviors started to escalate. |
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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 investigation, it was determined the operation was not in compliance in regard to ratio on numerous occasions the last month and a half. Specifically, the operation was out of compliance 19 times out of a 16 day time period. |
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| 3 | — |
748.3365(c)(3) - Bedding-must provide each child with clean bed linens once a week or as needed for cleanliness; linens changed/laundered if used by different child
During the course of the investigation several staff stated children would wet their beds and not get clean sheets. There was a bedroom observed during the walk through with soiled linens. |
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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 staff member was observed on video to swing and hit a child in care multiple times, wrestled with the child and placed the child in an improper restraint where the child appeared to be knocked to the ground and have the staff member's arm across their neck. |
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| 3 | — |
748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
Three of Seven Units were found to have repairs needed, peeling paint, broken furniture, broken or missing air vents, and trash in several rooms and on the grounds around the homes. |
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| 4 | — |
748.1531(d) - Medical care-Obtain follow-up medical treatment as recommended by the health-care professional
Documenation and interviews verified the child was recommended for a follow-up on 1/23/24 and did not receive it. |
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| 5 | — |
748.685(a)(3) - Caregiver responsibility - being aware of and accountable for each child's on-going activity
During the walkthrough of the operation a child was observed in his room alone with no caregiver within visual or auditory range of the child. |
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| 5 | — |
748.1553 - Child must be immediately treated by health prof, contact emergency svs or take child to ER for injury/illness requiring treatment by a health prof.
During the investigation, it was determined that a child sustained a head injury while playing basketball and showed symptoms of a concussion at 2:15 PM. Despite earlier instructions from a doctor that the child needed emergency room treatment, the child was not taken to the ER until 9:37 PM |
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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 |
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| 2 | — |
748.1349(a)(3) - Initial Service Plan-Give copy or summary of plan to child's caregivers
It was determined that staff caring for children do are not easily able to access the Service Plans for the children they are caring for. |
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| 4 | — |
748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
Caregivers conducted an unwarranted restraint on a child in care as the child was running away. |
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| 4 | — |
748.2463(3) - Emergency Behavior Intervention-Never used as a means to get a child to comply
The staff in question stated they did an escort when the victim refused to leave the Dayroom. 3 Collateral Staff stated an escort was done because the victim refused to leave the Dayroom. |
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| 4 | — |
748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
During the walkthrough of the operation childrens bathrooms were observed with mildew in the shower and bathroom sinks have excessive gunk. |
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| 4 | — |
748.930(b)(1)(A) - Annual Training-Caregivers in operations other than cottage homes must have 4 hrs of EBI every 6 months.
Two staff files were reviewed for EBI training documentation and both were missing documentation verifying annual EBI training was completed. |
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| 2 | — |
748.949(b)(4) - Annual Training Documentation-Includes the trainer's name and qualifications, or the source of the training for self-instructional training
3 of 5 staff's certificates submitted for review, specifically in regard to SAMA, did not have the trainers' qualifications documented. |
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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
A child's injury and ER visit was reported to the hotline late. |
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| 3 | — |
748.151(3) - Operational responsibilities - Maintain current, true, accurate, and complete records
During the investigation, it was discovered that a child's records was not documented accurately. |
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| 5 | — |
748.1553 - Child must be immediately treated by health prof, contact emergency svs or take child to ER for injury/illness requiring treatment by a health prof.
Documentation reviewed determined a child was assessed and concerns of a serious injury were suspected on 7/29/30 but the child was not given treatement until 7/30/24. Upon Follow up it has been determined the facility will continue with their current protocols. |
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| 4 | — |
748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
An inappropriate restraint was completed by a staff on a child. Staff lunged at the child tackling the child to the ground. A proper hold could not be completed, but staff continued to wrestle with the child for 30-45 seconds until another staff responded. |
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| 5 | — |
748.685(c)(2) - Caregiver responsibility - provide a safe environment
Staff were iinterviewed and were unaware and unable to tell the protocol of knowing which staff would handle incidents and which would monitor the kids. |
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| 3 | — |
748.535(3)(F) - Child-care administrator responsibilities-Ensuring that operation complies with applicable rules of chapter 748 and other applicable rules and laws.
It was confirmed that a memo had been provided to all staff noting no staff member shall contact any outside entity without prior communication with a program supervisor, manager, and/or Director regarding any ratio related concern. All staff members confirmed that they have been directly told not to speak to Licensing and/or provide information. It was also reported that all incidents are to be reported to the nurses and they will inform the administration to be advised whether or not the incident is to be documented in the operation?s system. |
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| 4 | — |
748.3391(a) - Bathrooms-Must be maintained in good repair & kept clean
In conducting a walk through of the facility a clogged toilet with feces, mildew in the bathroom, and toilet paper covered in bodily fluids. |
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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
An administrative penalty will be recommended as a result of this citation, per HRC ?42.078 |
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| 2 | — |
748.1331(b)(3) - Preliminary Service Plan-For child receiving treatment services, include description of how operation will meet child's needs
During the inspection, two of six child files reviewed did not identify the level of observation required in the preliminary service plan. |
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| 4 | — |
748.2455(a)(2) - Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
Documentation determined the victim was walking away from the situation when the staff chose to restrain the child. |
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| 5 | — |
748.3301(a)(1) - Physical Site- Buildings must be structurally sound and not pose a risk to the health and safety of children.
Multiple walls in units had derogatory writing on them. There were several bathrooms that had trash items in the sinks. One ceiling vent had what appeared to be mold or heavy dust on it. A bulletin board was observed to be broken in one of the rooms. Multiple units had large areas of peeled paint on the doors and walls. |
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| 3 | — |
748.833(a)(2) - Orientation exemption-Ensure required abuse/neglect training has been completed in the past 12 months.
Three out of ten staff files reviewed were missing the signed policy related to reporting abuse and neglect. |
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| 5 | — |
748.685(c)(2) - Caregiver responsibility - provide a safe environment
An unsafe environment was created when all staff intervened in one incident leaving other children with previous physical altercation issues unsupervised allowing a third altercation between the two 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
It was determined children were exposed to explicit content when a staff member screened their phone to the television. |
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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
3 staff and 3 children noted staff are passive aggressive and/or rude towards the children. |
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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
During the investigation, documents reviewed show the census and staffing schedule show several days in February where the Hacienda unit was out of ratio. |
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| 4 | — |
748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
It was determined staff were unable to restrain the child using techniques that were approved by the facility. The staff and 3 collateral witnesses verified this information. |
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| 4 | — |
748.930(b)(2) - Annual Training- Caregivers must have 2 hrs trauma informed care.
7 of 8 direct care staff files pulled are missing 1 or all of the annual required trainings: Normalcy, Trauma Informed Care and EBI |
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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 caregiver failed to adhere to the child's rights to be free of abuse, neglect, and exploitation as defined in Texas Family Code 261.401. |
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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
Four of the Seven Units were observed out of ratio and a group was observed out of ratio while walking to dinner. |
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| 4 | — |
748.2307(9) - Other Prohibited Punishments-subjecting a child to abusive or profane language
Three out of five children interviewed stated a staff member will cuss at them. |
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| 4 | — |
748.2307(8) - Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child
Through the course of the investigation it was determined a child was called a brat in front of other staff and children. |
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| 4 | — |
748.930(b)(1)(A) - Annual Training-Caregivers in operations other than cottage homes must have 4 hrs of EBI every 6 months.
It was found the staff involved in this case had EBI training 7/27/23 which expired in January and did not have current training at the time of the incident. |
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| 3 | — |
748.3365(c)(3) - Bedding-must provide each child with clean bed linens once a week or as needed for cleanliness; linens changed/laundered if used by different child
During the walk-through of Eagle unit located in Liberty Hall, it was noted that one child s pillow was complete stained and had red circular stains on it. Please refer to 748.3015, if applicable. |
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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 course of the investigation, it was determined that caregivers are not following the child/caregiver ratio expectations on a regular basis. It was noted 1-2 caregivers are left to supervise up to 17 children. |
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| 4 | — |
748.303(a)(4)(A) - Serious Incident-Report to Licensing as soon as aware of an incident of physical abuse of a child against another child
In reviewing Serious Incidents it was found a fght occurred in which a child was iinjured and taken to the doctor, but never reported. |
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| 5 | — |
745.641 - AP Background check results - Must receive notification prior to allowing subject to be present at your operation
In reviewing background checks if was found two employees did not have active backgrounds checks. |
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| 5 | — |
748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety
Several nurses were observed on video to not intervene when a child was placed in a supine hold and when another caregiver was hitting a child. They also did not continuously observe the child during the restraint to ensure safety and were observed leaving the room multiple times leaving the escalated caregiver alone with the child. |
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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
The video of this incident showed that a caregiver got in a child's face for about 18 seconds and did not make any attempts to de-escalate the situation. The child also had stopped the destructive behavior when the caregiver walked into the room so the EBI use may not have been necessary. |
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| 3 | — |
748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.
Grates in 4 of the doors at the gym were found to be bent. The pool was found to be dirty and the bottom could not be seen. Trash was foun through out all of the buildings. |
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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
In the course of the investigation it was found a staff member left the key to all doors accessible to a child in care allowing them the opportunity to elope from the facility. |
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| 3 | — |
748.685(c)(6) - Implement and follow the children's service plans.
Treatment Plans, Interviews, and video were reviewed during the investigation and determined children were to be checked on every 15 minutes and two of those checks were missed. |
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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
A child went to the emergency room on 8/19/23 after having a seizure. Another child went to the emergency room on 9/17/23 after having a seizure. Another child went to urgent care on 8/12/23 for a fractured finger. These incidences were not reported to Licensing. |
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| 3 | — |
748.2301(c) - Disciplinary Measures-goal must be to teach a child acceptable behavior and self-control; caregiver must explain reason for discipline when imposed
A staff member pushed a child after the child hit them with a stuffed animal. |
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| 4 | — |
748.113(8) - EBI policy - Training for emergency behavior intervention
During the course of the investigation, it was determined that caregivers reported they were unsure how to handle the emergency situation and did not have proper training. |
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| 4 | — |
748.1007(b)(1) - Child/caregiver ratio-Awake caregiver may care for 15 children if any child in group requires treatment services
Overnight staff interviewed stated the operation has been out of ratio multiple times overnight in the last 2 months. |
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| 3 | — |
748.303(a)(6)(A) - Serious Incident-Report to Licensing no later than 24 hours after becoming aware that child is indicted, charged, or arrested or when police respond.
During the course of the investigation, it was determined that the incident resulted in a child being arrested on February 20, 2026. However, the operation did not notify Licensing til the 22nd. |
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| 3 | — |
748.303(a)(11)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
A child in care tested positive for a communicable disease on 7/10/22, the illness was not reported until 7/12/2022. |
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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
The operation was out of ratio during the day on at least 3 occurrences in 1-2 units. |
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| 3 | — |
748.3319(a) - Required Postings-Residential Treatment Center's must have
Operation did not have required No Trespassing signs posted at entrance of facility. |
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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
Throughout the course of the investigation multiple staff admitted to the operation being out of ratio. Nurses at the operation were working as direct care givers and as nurse at the same time while being counted in ratio. |
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| 3 | — |
748.303(a)(10)(A) - Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease
When reviewing documents, it was determined that at least one child tested positive for COVID and was not called in on time. |
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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
A child in care sustained a fracture to their hand as confirmed by X Rays results that were provided to the operation on 5/11/24. The operation did not report this to Licensing until 5/14/24. |
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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
During the interview, both the Administrator and the therapist stated the resident was left unsupervised. |
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| 3 | — |
748.1331(b)(4) - Preliminary Service Plan-For child receiving treatment services, identify any issues or concerns child may have that could escalate child's behavior
Six out of six child records reviewed did not include issues that could escalate the child in cares behavior in the preliminary service plan. |
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| 5 | — |
748.1009 - Child/caregiver ratio-Must employ an adequate number of caregivers to meet the needs of children
Through interviews of children and staff as well as documentation provided, it is determined one of the units on campus was out of ratio on 9/13 and 9/14. |
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| 5 | — |
748.1009 - Child/caregiver ratio-Must employ an adequate number of caregivers to meet the needs of children
A physical altercation occurred on 3.28.24 in a unit that was out of ratio. Due to this, a child had to call the code to get additional staff to respond. Not having enough staff to respond to codes was brought up numerous times during interviews with children and staff. Additionally, an incident occurred where a child was left in a unit for approximately 15 minutes without a staff. The nurse was double covering that day and staff believed the nurse was inside, however, she had left to check on the other unit. |
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| 1 | — |
748.1339(c) - Initial Service Plan-Child & parent must be invited to meeting to develop service plan & discuss participation in childhood activities
Six out of six child records reviewed did not document an invitation for the parent or child to participate in the development of the service plan. |
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569 inspection record(s) on file from TX-HHSC.
Licensed facilities near this one, highest compliance score first.