New Life Childrens Treatment Center

Childcare Center|650 SCARBOUROUGH, Canyon Lake, TX 78133|(830) 964-4390|upbring.org/new-life-childrens-c

License Information

Status
Licensed
License #
503875
Expires
September 16, 2026
Licensed Capacity
60 children
Licensing Agency
Texas HHSC

Data from Texas HHSC. Updated 2/24/2026.

State records

Inspection History

608 records
  • assessment#862394216

    No violations found. All areas in compliance.

    No violations

  • routine#862194734

    No violations found. All areas in compliance.

    No violations

  • routine#862194733

    No violations found. All areas in compliance.

    No violations

  • routine#862194732

    No violations found. All areas in compliance.

    No violations

  • complaint#862343870

    No violations found. All areas in compliance.

    No violations

  • routine#862194731

    No violations found. All areas in compliance.

    No violations

  • routine#862194730

    No violations found. All areas in compliance.

    No violations

  • routine#862194729

    No violations found. All areas in compliance.

    No violations

  • complaint#862343869

    No violations found. All areas in compliance.

    No violations

  • routine#862194728

    No violations found. All areas in compliance.

    No violations

  • routine#862194727

    No violations found. All areas in compliance.

    No violations

  • routine#862194726

    No violations found. All areas in compliance.

    No violations

  • routine#862194725

    No violations found. All areas in compliance.

    No violations

  • routine#862194724

    No violations found. All areas in compliance.

    No violations

  • routine#862194723

    No violations found. All areas in compliance.

    No violations

  • routine#862194722

    No violations found. All areas in compliance.

    No violations

  • routine#862194721

    No violations found. All areas in compliance.

    No violations

  • routine#862194720

    No violations found. All areas in compliance.

    No violations

  • self-report#862343868

    No violations found. All areas in compliance.

    No violations

  • routine#862194719

    No violations found. All areas in compliance.

    No violations

  • routine#862194718

    No violations found. All areas in compliance.

    No violations

  • routine#862194717

    No violations found. All areas in compliance.

    No violations

  • routine#862194716

    No violations found. All areas in compliance.

    No violations

  • assessment#862394215

    1 violation found (1 high severity).

    AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.

    High

    During a review conducted on August 19, 2025, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan; and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plan for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on June 6, 2025, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the administrator?s failure to ensure compliance include the following: Your operation received a high weighted citation in a pattern/trend category on June 6, 2025. Specifically, the operation was cited for 748.685(a)(4): Caregiver responsibility - During DFPS investigation staff reported having earphones on and admitted to having their eyes closed while working the overnight shift. The purpose of this standard is to protect the health, safety, and well-being of children by ensuring adequate supervision. Supervision is a basic element to the prevention of harm. The operation met compliance on 7/10/2025. - Operation failed to satisfy the conditions of the plan. - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring. - Operation was unable to meet compliance with high weighted licensing citation. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plan.

    748.535(2)Corrected 2025-08-20
  • routine#862194715

    No violations found. All areas in compliance.

    No violations

  • complaint#862343867

    No violations found. All areas in compliance.

    No violations

  • routine#862194714

    No violations found. All areas in compliance.

    No violations

  • self-report#862343866

    No violations found. All areas in compliance.

    No violations

  • routine#862194713

    No violations found. All areas in compliance.

    No violations

  • routine#862194712

    No violations found. All areas in compliance.

    No violations

  • complaint#862343865

    No violations found. All areas in compliance.

    No violations

  • complaint#862343864

    No violations found. All areas in compliance.

    No violations

  • routine#862194711

    No violations found. All areas in compliance.

    No violations

  • routine#862194710

    No violations found. All areas in compliance.

    No violations

  • routine#862194709

    No violations found. All areas in compliance.

    No violations

  • routine#862194708

    No violations found. All areas in compliance.

    No violations

  • complaint#862343863

    No violations found. All areas in compliance.

    No violations

  • complaint#862343862

    No violations found. All areas in compliance.

    No violations

  • self-report#862343861

    No violations found. All areas in compliance.

    No violations

  • routine#862194707

    No violations found. All areas in compliance.

    No violations

  • self-report#862343860

    No violations found. All areas in compliance.

    No violations

  • routine#862194706

    No violations found. All areas in compliance.

    No violations

  • self-report#862343859

    No violations found. All areas in compliance.

    No violations

  • routine#862194705

    No violations found. All areas in compliance.

    No violations

  • self-report#862343858

    No violations found. All areas in compliance.

    No violations

  • routine#862194704

    No violations found. All areas in compliance.

    No violations

  • routine#862194703

    No violations found. All areas in compliance.

    No violations

  • self-report#862343857

    No violations found. All areas in compliance.

    No violations

  • self-report#862343856

    2 violations found (1 high, 1 medium severity).

    Operational responsibilities - Maintain current, true, accurate, and complete records

    Medium

    Suicide screening that was provided was denied to have been completed by staff and child in care.

    748.151(3)Corrected 2025-07-31

    Suicide Screening- Must be administered immediately if the child exhibits warning signs that necessitate a suicide screening be conducted.

    High

    Suicide screening was not completed immediately after child in care was found with a t-shirt around their neck.

    748.125(d)(4)(E)Corrected 2025-07-31
  • routine#862194702

    No violations found. All areas in compliance.

    No violations

  • routine#862194701

    No violations found. All areas in compliance.

    No violations

  • routine#862194700

    No violations found. All areas in compliance.

    No violations

  • routine#862194699

    No violations found. All areas in compliance.

    No violations

  • routine#862194698

    No violations found. All areas in compliance.

    No violations

  • self-report#862343855

    No violations found. All areas in compliance.

    No violations

  • self-report#862343854

    No violations found. All areas in compliance.

    No violations

  • routine#862194697

    1 violation found (1 high severity).

    Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model

    High

    The medication count was documented incorrectly on the med log for a child s prescribed medication.

    748.2151(d)Corrected 2025-05-27
  • complaint#862343853

    1 violation found (1 high severity).

    Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being

    High

    During DFPS investigation staff reported having earphones on and admitted to having their eyes closed while working the overnight shift.

    748.685(a)(4)Corrected 2025-07-10
  • routine#862194696

    No violations found. All areas in compliance.

    No violations

  • routine#862194695

    No violations found. All areas in compliance.

    No violations

  • self-report#862343852

    1 violation found (1 high severity).

    Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being

    High

    A child in care, with identified high risk behaviors, was not provided 15-minute wellness checks and was left alone in the residence by a staff member.

    748.685(a)(4)Corrected 2025-06-13
  • complaint#862343851

    No violations found. All areas in compliance.

    No violations

  • routine#862194694

    No violations found. All areas in compliance.

    No violations

  • routine#862194693

    No violations found. All areas in compliance.

    No violations

  • complaint#862343850

    No violations found. All areas in compliance.

    No violations

  • routine#862194692

    No violations found. All areas in compliance.

    No violations

  • self-report#862343849

    No violations found. All areas in compliance.

    No violations

  • routine#862194691

    No violations found. All areas in compliance.

    No violations

  • self-report#862343848

    No violations found. All areas in compliance.

    No violations

  • routine#862194690

    No violations found. All areas in compliance.

    No violations

  • routine#862194689

    No violations found. All areas in compliance.

    No violations

  • routine#862194687

    No violations found. All areas in compliance.

    No violations

  • routine#862194688

    No violations found. All areas in compliance.

    No violations

  • routine#862194686

    No violations found. All areas in compliance.

    No violations

  • complaint#862343847

    No violations found. All areas in compliance.

    No violations

  • routine#862194685

    No violations found. All areas in compliance.

    No violations

  • routine#862194684

    1 violation found (1 medium severity).

    Fire Extinguisher-Must inspect fire extinguisher(s) monthly

    Medium

    Fire extinguisher are NOT being inspected monthly.

    748.3115Corrected 2025-03-17
  • routine#862194683

    No violations found. All areas in compliance.

    No violations

  • routine#862194682

    No violations found. All areas in compliance.

    No violations

  • routine#862194681

    No violations found. All areas in compliance.

    No violations

  • routine#862194680

    No violations found. All areas in compliance.

    No violations

  • self-report#862343846

    No violations found. All areas in compliance.

    No violations

  • assessment#862394214

    No violations found. All areas in compliance.

    No violations

  • complaint#862343845

    No violations found. All areas in compliance.

    No violations

  • complaint#862343844

    No violations found. All areas in compliance.

    No violations

  • complaint#862343843

    No violations found. All areas in compliance.

    No violations

  • routine#862194679

    No violations found. All areas in compliance.

    No violations

  • assessment#862394213

    1 violation found (1 high severity).

    AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.

    High

    During a review conducted on February 13, 2025, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan; and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plan for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring.? As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plan, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on December 16th, 2024, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the administrator?s failure to ensure compliance include the following: Your operation received high weighted citation in a pattern/trend category on December 16, 2024. Specifically, the operation was cited for 748.685(a)(3): Caregiver responsibility - Child in care was left unsupervised inside the dorm. The purpose of this standard is to protect the health, safety, and well-being of children by ensuring adequate supervision. Supervision is a basic element to the prevention of harm. The operation met compliance on 1/01/2025. - Operation failed to satisfy the conditions of the plan. - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring. - Operation was unable to meet compliance with high weighted licensing citation. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plan.

    748.535(2)Corrected 2025-02-14
  • routine#862194678

    No violations found. All areas in compliance.

    No violations

  • routine#862194677

    No violations found. All areas in compliance.

    No violations

  • self-report#862343842

    No violations found. All areas in compliance.

    No violations

  • complaint#862343841

    No violations found. All areas in compliance.

    No violations

  • routine#862194676

    No violations found. All areas in compliance.

    No violations

  • routine#862194675

    No violations found. All areas in compliance.

    No violations

  • complaint#862343840

    2 violations found (2 high severity).

    Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks

    High

    Caregivers and children provided corroborating information that a staff member behaved inappropriately with children in care.

    748.507(1)Corrected 2025-03-04

    Children's rights-Adhere to the child's right to receive fair treatment

    High

    It was confirmed that a staff member gave gifts to a child and showed them preferential treatment.

    748.1101(b)(1)(C)Corrected 2025-03-04
  • routine#862194674

    No violations found. All areas in compliance.

    No violations

  • assessment#862394212

    No violations found. All areas in compliance.

    No violations

  • routine#862194673

    No violations found. All areas in compliance.

    No violations

  • complaint#862343839

    No violations found. All areas in compliance.

    No violations

  • routine#862194672

    No violations found. All areas in compliance.

    No violations

  • complaint#862343838

    No violations found. All areas in compliance.

    No violations

  • complaint#862343837

    No violations found. All areas in compliance.

    No violations

  • routine#862194671

    No violations found. All areas in compliance.

    No violations

  • routine#862194670

    No violations found. All areas in compliance.

    No violations

  • routine#862194669

    No violations found. All areas in compliance.

    No violations

  • self-report#862343836

    1 violation found (1 high severity).

    Other Prohibited Punishments-any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline/punishment

    High

    On video, a staff member was seen shoving a child to prevent them from going into the room of a peer.

    748.2307(1)Corrected 2025-02-17
  • routine#862194668

    No violations found. All areas in compliance.

    No violations

  • routine#862194667

    No violations found. All areas in compliance.

    No violations

  • routine#862194666

    No violations found. All areas in compliance.

    No violations

  • routine#862194665

    No violations found. All areas in compliance.

    No violations

  • routine#862194664

    No violations found. All areas in compliance.

    No violations

  • routine#862194663

    No violations found. All areas in compliance.

    No violations

  • self-report#862343835

    No violations found. All areas in compliance.

    No violations

  • self-report#862343834

    No violations found. All areas in compliance.

    No violations

  • routine#862194662

    No violations found. All areas in compliance.

    No violations

  • complaint#862343833

    1 violation found (1 high severity).

    Caregiver responsibility - being aware of and accountable for each child's on-going activity

    High

    Child in care was left unsupervised inside the dorm.

    748.685(a)(3)Corrected 2024-12-23
  • complaint#862343832

    No violations found. All areas in compliance.

    No violations

  • routine#862194661

    No violations found. All areas in compliance.

    No violations

  • routine#862194660

    No violations found. All areas in compliance.

    No violations

  • self-report#862343831

    No violations found. All areas in compliance.

    No violations

  • routine#862194659

    No violations found. All areas in compliance.

    No violations

  • self-report#862343830

    No violations found. All areas in compliance.

    No violations

  • routine#862194658

    No violations found. All areas in compliance.

    No violations

  • complaint#862343829

    No violations found. All areas in compliance.

    No violations

  • self-report#862343828

    No violations found. All areas in compliance.

    No violations

  • routine#862194657

    No violations found. All areas in compliance.

    No violations

  • routine#862194656

    No violations found. All areas in compliance.

    No violations

  • complaint#862343827

    No violations found. All areas in compliance.

    No violations

  • routine#862194655

    No violations found. All areas in compliance.

    No violations

  • routine#862194654

    No violations found. All areas in compliance.

    No violations

  • routine#862194653

    No violations found. All areas in compliance.

    No violations

  • routine#862194652

    No violations found. All areas in compliance.

    No violations

  • routine#862194650

    No violations found. All areas in compliance.

    No violations

  • routine#862194651

    No violations found. All areas in compliance.

    No violations

  • complaint#862343826

    No violations found. All areas in compliance.

    No violations

  • complaint#862343825

    1 violation found (1 medium severity).

    Serious Incident-Report to Licensing no later than 24 hours after awareness that a child contracts reportable communicable disease

    Medium

    The operation did not report a diagnosed communicable disease to licensing.

    748.303(a)(11)(A)Corrected 2024-11-13
  • routine#862194649

    No violations found. All areas in compliance.

    No violations

  • routine#862194648

    No violations found. All areas in compliance.

    No violations

  • routine#862194647

    No violations found. All areas in compliance.

    No violations

  • self-report#862343824

    No violations found. All areas in compliance.

    No violations

  • routine#862194646

    No violations found. All areas in compliance.

    No violations

  • routine#862194645

    No violations found. All areas in compliance.

    No violations

  • assessment#862394211

    1 violation found (1 high severity).

    AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.

    High

    During a review conducted on August 12, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on June 03, 2024, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: The operation received a medium high weighted citation in a pattern/trend category on June 03, 2024. Specifically, the operation was cited for 748.125(d)3: Suicide Screening - Document that any person conducting a suicide screening meets the conditions and training requirements. Compliance of deficiency was met on July 02, 2024. - Operation failed to satisfy the conditions of the plan - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring - Operation was unable to meet compliance with medium high weighted licensing citation. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans.

    748.535(2)Corrected 2024-08-13
  • routine#862194644

    No violations found. All areas in compliance.

    No violations

  • routine#862194643

    No violations found. All areas in compliance.

    No violations

  • routine#862194642

    No violations found. All areas in compliance.

    No violations

  • complaint#862343823

    No violations found. All areas in compliance.

    No violations

  • complaint#862343822

    No violations found. All areas in compliance.

    No violations

  • routine#862194641

    No violations found. All areas in compliance.

    No violations

  • routine#862194640

    No violations found. All areas in compliance.

    No violations

  • complaint#862343821

    No violations found. All areas in compliance.

    No violations

  • routine#862194639

    No violations found. All areas in compliance.

    No violations

  • self-report#862343820

    No violations found. All areas in compliance.

    No violations

  • self-report#862343819

    No violations found. All areas in compliance.

    No violations

  • routine#862194638

    No violations found. All areas in compliance.

    No violations

  • routine#862194637

    No violations found. All areas in compliance.

    No violations

  • routine#862194636

    No violations found. All areas in compliance.

    No violations

  • routine#862194634

    No violations found. All areas in compliance.

    No violations

  • routine#862194635

    No violations found. All areas in compliance.

    No violations

  • complaint#862343818

    No violations found. All areas in compliance.

    No violations

  • routine#862194633

    No violations found. All areas in compliance.

    No violations

  • routine#862194631

    No violations found. All areas in compliance.

    No violations

  • routine#862194632

    No violations found. All areas in compliance.

    No violations

  • routine#862194630

    No violations found. All areas in compliance.

    No violations

  • routine#862194629

    No violations found. All areas in compliance.

    No violations

  • complaint#862343817

    No violations found. All areas in compliance.

    No violations

  • routine#862194627

    No violations found. All areas in compliance.

    No violations

  • routine#862194628

    No violations found. All areas in compliance.

    No violations

  • complaint#862343816

    1 violation found (1 high severity).

    Suicide Screening- Document that any person conducting a suicide screening meets the conditions and training requirements.

    High

    The operation provided an intake suicide screening tool used at admission on a child in care with no documentation of the personnel who administered the tool having the training to do so.

    748.125(d)(3)Corrected 2024-06-17
  • complaint#862343815

    No violations found. All areas in compliance.

    No violations

  • routine#862194626

    No violations found. All areas in compliance.

    No violations

  • self-report#862343814

    1 violation found (1 high severity).

    Medical care-A child in care must receive medical care as needed for injury, illness, and pain

    High

    A child in care did not receive medical treatment for a fracture until two days after their injury.

    748.1531(a)(2)Corrected 2024-07-12
  • complaint#862343813

    No violations found. All areas in compliance.

    No violations

  • routine#862194625

    No violations found. All areas in compliance.

    No violations

  • routine#862194624

    No violations found. All areas in compliance.

    No violations

  • routine#862194623

    No violations found. All areas in compliance.

    No violations

  • self-report#862343812

    No violations found. All areas in compliance.

    No violations

  • routine#862194622

    No violations found. All areas in compliance.

    No violations

  • routine#862194621

    No violations found. All areas in compliance.

    No violations

  • routine#862194620

    No violations found. All areas in compliance.

    No violations

  • self-report#862343811

    No violations found. All areas in compliance.

    No violations

  • self-report#862343810

    No violations found. All areas in compliance.

    No violations

  • complaint#862343809

    No violations found. All areas in compliance.

    No violations

  • routine#862194619

    No violations found. All areas in compliance.

    No violations

  • routine#862194618

    No violations found. All areas in compliance.

    No violations

  • routine#862194617

    1 violation found (1 high severity).

    Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child

    High

    According to an incident report reviewed, a child disclosed of past sexual abuse. A report was not made to licensing until three days after a staff member and therapist became aware.

    748.303(a)(3)(A)Corrected 2024-04-16
  • complaint#862343808

    No violations found. All areas in compliance.

    No violations

  • self-report#862343807

    No violations found. All areas in compliance.

    No violations

  • complaint#862343806

    No violations found. All areas in compliance.

    No violations

  • self-report#862343805

    No violations found. All areas in compliance.

    No violations

  • routine#862194616

    No violations found. All areas in compliance.

    No violations

  • routine#862194615

    No violations found. All areas in compliance.

    No violations

  • routine#862194614

    No violations found. All areas in compliance.

    No violations

  • self-report#862343804

    No violations found. All areas in compliance.

    No violations

  • routine#862194613

    No violations found. All areas in compliance.

    No violations

  • complaint#862343803

    No violations found. All areas in compliance.

    No violations

  • complaint#862343802

    No violations found. All areas in compliance.

    No violations

  • complaint#862343801

    No violations found. All areas in compliance.

    No violations

  • routine#862194611

    No violations found. All areas in compliance.

    No violations

  • routine#862194612

    No violations found. All areas in compliance.

    No violations

  • routine#862194610

    No violations found. All areas in compliance.

    No violations

  • complaint#862343800

    No violations found. All areas in compliance.

    No violations

  • self-report#862343799

    No violations found. All areas in compliance.

    No violations

  • routine#862194609

    No violations found. All areas in compliance.

    No violations

  • complaint#862343798

    No violations found. All areas in compliance.

    No violations

  • complaint#862343797

    No violations found. All areas in compliance.

    No violations

  • complaint#862343796

    1 violation found (1 high severity).

    Administration of Medication-Must obtain a general written consent to administer routine, preventive, & emergency medications

    High

    Medical consenter was not notified child in care received prescription medication until after the medication was given.

    748.2001(a)Corrected 2024-05-03
  • routine#862194608

    No violations found. All areas in compliance.

    No violations

  • self-report#862343795

    No violations found. All areas in compliance.

    No violations

  • self-report#862343794

    No violations found. All areas in compliance.

    No violations

  • self-report#862343793

    1 violation found (1 high severity).

    Caregiver responsibility - being able to intervene when necessary to ensure child's safety

    High

    Two children in care were involved in a physical altercation. When staff separated the children, this left other residents unsupervised leading to another child in care being assaulted.

    748.685(a)(5)Corrected 2024-05-10
  • routine#862194607

    No violations found. All areas in compliance.

    No violations

  • routine#862194606

    No violations found. All areas in compliance.

    No violations

  • complaint#862343792

    No violations found. All areas in compliance.

    No violations

  • self-report#862343791

    No violations found. All areas in compliance.

    No violations

  • routine#862194605

    No violations found. All areas in compliance.

    No violations

  • routine#862194603

    No violations found. All areas in compliance.

    No violations

  • routine#862194604

    No violations found. All areas in compliance.

    No violations

  • complaint#862343790

    No violations found. All areas in compliance.

    No violations

  • self-report#862343789

    No violations found. All areas in compliance.

    No violations

  • self-report#862343788

    No violations found. All areas in compliance.

    No violations

  • self-report#862343787

    No violations found. All areas in compliance.

    No violations

  • routine#862194602

    No violations found. All areas in compliance.

    No violations

  • complaint#862343786

    No violations found. All areas in compliance.

    No violations

  • self-report#862343785

    No violations found. All areas in compliance.

    No violations

  • routine#862194601

    No violations found. All areas in compliance.

    No violations

  • complaint#862343784

    No violations found. All areas in compliance.

    No violations

  • complaint#862343783

    No violations found. All areas in compliance.

    No violations

  • self-report#862343782

    No violations found. All areas in compliance.

    No violations

  • routine#862194600

    No violations found. All areas in compliance.

    No violations

  • routine#862194599

    No violations found. All areas in compliance.

    No violations

  • self-report#862343781

    No violations found. All areas in compliance.

    No violations

  • assessment#862394210

    1 violation found (1 high severity).

    AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.

    High

    During a review conducted on February 8, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on February 1, 2024, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: The operation received a medium weighted citation in a pattern/trend category on February 1, 2024. Specifically, the operation was cited for 748.2151(c)(6): Medication record - must include name & signature of person who administered each medication. The purpose of the signature is to be able to identify the person who administered a specific medication to a child if a concern arises later about that medication. Compliance of deficiency remains pending. - Operation failed to satisfy the conditions of the plan - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans.

    748.535(2)Corrected 2024-02-09
  • routine#862194598

    1 violation found (1 medium severity).

    Medication record - must include name & signature of person who administered each medication

    Medium

    The name/sigature of the staff who administered medications to a child in care was missing from the medication log.

    748.2151(c)(6)Corrected 2024-02-07
  • complaint#862343780

    No violations found. All areas in compliance.

    No violations

  • self-report#862343779

    No violations found. All areas in compliance.

    No violations

  • routine#862194597

    No violations found. All areas in compliance.

    No violations

  • routine#862194596

    No violations found. All areas in compliance.

    No violations

  • complaint#862343778

    No violations found. All areas in compliance.

    No violations

  • routine#862194595

    No violations found. All areas in compliance.

    No violations

  • self-report#862343777

    No violations found. All areas in compliance.

    No violations

  • complaint#862343776

    No violations found. All areas in compliance.

    No violations

  • complaint#862343775

    2 violations found (2 high severity).

    Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being

    High

    Five children in care were left unattended on unit for ten minutes. During this time, one child pushes two children.

    748.685(a)(4)Corrected 2024-02-16

    Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child

    High

    Multiple staff became aware of indications of neglectful supervision on the day it occurred. An incident report was not written at this time. The incident was called into the hotline 3 days after awareness.

    748.303(a)(3)(A)Corrected 2024-02-16
  • self-report#862343774

    No violations found. All areas in compliance.

    No violations

  • routine#862194594

    No violations found. All areas in compliance.

    No violations

  • self-report#862343773

    No violations found. All areas in compliance.

    No violations

  • routine#862194593

    No violations found. All areas in compliance.

    No violations

  • routine#862194592

    No violations found. All areas in compliance.

    No violations

  • self-report#862343772

    No violations found. All areas in compliance.

    No violations

  • self-report#862343771

    No violations found. All areas in compliance.

    No violations

  • complaint#862343770

    No violations found. All areas in compliance.

    No violations

  • routine#862194591

    No violations found. All areas in compliance.

    No violations

  • complaint#862343769

    No violations found. All areas in compliance.

    No violations

  • routine#862194590

    No violations found. All areas in compliance.

    No violations

  • routine#862194589

    No violations found. All areas in compliance.

    No violations

  • self-report#862343768

    No violations found. All areas in compliance.

    No violations

  • complaint#862343767

    No violations found. All areas in compliance.

    No violations

  • complaint#862343766

    No violations found. All areas in compliance.

    No violations

  • complaint#862343765

    No violations found. All areas in compliance.

    No violations

  • routine#862194588

    No violations found. All areas in compliance.

    No violations

  • routine#862194587

    No violations found. All areas in compliance.

    No violations

  • complaint#862343764

    No violations found. All areas in compliance.

    No violations

  • routine#862194585

    No violations found. All areas in compliance.

    No violations

  • routine#862194586

    No violations found. All areas in compliance.

    No violations

  • complaint#862343763

    No violations found. All areas in compliance.

    No violations

  • complaint#862343762

    No violations found. All areas in compliance.

    No violations

  • routine#862194584

    No violations found. All areas in compliance.

    No violations

  • complaint#862343761

    1 violation found (1 high severity).

    On Call Staff-A person designated to handle emergencies must be on call and accessible to caregivers

    High

    Two children were in a physical altercation and the staff supervising was unable to intervene successfully to prevent harm to a child. Support staff was not available to respond immediately to the incident. The child involved had a history of physical altercations requiring safety precautions.

    748.537(a)Corrected 2023-12-28
  • routine#862194582

    No violations found. All areas in compliance.

    No violations

  • routine#862194583

    No violations found. All areas in compliance.

    No violations

  • routine#862194581

    No violations found. All areas in compliance.

    No violations

  • routine#862194580

    No violations found. All areas in compliance.

    No violations

  • assessment#862394209

    1 violation found (1 high severity).

    Interior Space-Provide living space, appropriate furnishings, & bathroom facilities that are safe, clean and maintained in good repair

    High

    During a walkthrough of the cottage, hair and other debris was found on the bathroom sink counter and the floor.

    748.3351(1)Corrected 2023-11-22
  • self-report#862343760

    No violations found. All areas in compliance.

    No violations

  • self-report#862343759

    No violations found. All areas in compliance.

    No violations

  • routine#862194579

    No violations found. All areas in compliance.

    No violations

  • complaint#862343758

    No violations found. All areas in compliance.

    No violations

  • complaint#862343757

    No violations found. All areas in compliance.

    No violations

  • complaint#862343756

    No violations found. All areas in compliance.

    No violations

  • routine#862194578

    No violations found. All areas in compliance.

    No violations

  • routine#862194577

    No violations found. All areas in compliance.

    No violations

  • routine#862194576

    1 violation found (1 high severity).

    Evacuation-Emergency evacuation & relocation diagram must include designated location outside operation where all caregivers & children meet

    High

    Emergency evacuation signs did not notate a designated relocation area outside the operation.

    748.3233(b)(2)Corrected 2023-11-10
  • complaint#862343755

    No violations found. All areas in compliance.

    No violations

  • routine#862194575

    No violations found. All areas in compliance.

    No violations

  • routine#862194574

    No violations found. All areas in compliance.

    No violations

  • complaint#862343754

    No violations found. All areas in compliance.

    No violations

  • complaint#862343753

    No violations found. All areas in compliance.

    No violations

  • complaint#862343752

    No violations found. All areas in compliance.

    No violations

  • routine#862194573

    No violations found. All areas in compliance.

    No violations

  • routine#862194572

    No violations found. All areas in compliance.

    No violations

  • routine#862194571

    No violations found. All areas in compliance.

    No violations

  • complaint#862343751

    No violations found. All areas in compliance.

    No violations

  • routine#862194570

    2 violations found (2 high severity).

    Protective Surfacing-If loose-fill surfacing materials are used, the operation must install 9 inches or more of uncompressed loose-fill material

    High

    Licensing observed and photographed the surfacing material under the swings to be worn to down to the earth and the surrounding surfacing material to be compacted.

    748.3563(c)Corrected 2023-10-18

    Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks

    High

    Two direct care staff admitted to using profane language in the presence of children in care.

    748.507(1)Corrected 2023-11-03
  • complaint#862343750

    No violations found. All areas in compliance.

    No violations

  • complaint#862343749

    No violations found. All areas in compliance.

    No violations

  • routine#862194569

    No violations found. All areas in compliance.

    No violations

  • complaint#862343748

    1 violation found (1 high severity).

    Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks

    High

    A child was escorted by police to a psychiatric hospital. Operation staff did not accompany the child. At the hospital, the child filled out the admission's paperwork and listed an unauthorized parent. The individual was able to gain knowledge of the incident and child?s whereabouts.

    748.507(1)Corrected 2023-11-10
  • self-report#862343747

    2 violations found (2 high severity).

    Nutrition-Provide food of adequate variety, quality, and in sufficient quantity to supply the nutrients needed for proper growth and development

    High

    During face to face interviews of the victim and collateral children, all five children in care stated they do not receive a sufficient quantity of food at meal times and are not allowed seconds even if they state they are hungry. All five also stated alternatives are not provided.

    748.1693(a)(1)Corrected 2023-10-25

    EBI Release-Child released from personal restraint as soon as child is not a danger to self or others

    High

    During the second restraint the child was observed being quiet and still for several minutes. Staff did not provide an opportunity for the child to be released.

    748.2553(2)(C)Corrected 2023-10-25
  • routine#862194568

    No violations found. All areas in compliance.

    No violations

  • complaint#862343746

    No violations found. All areas in compliance.

    No violations

  • complaint#862343745

    No violations found. All areas in compliance.

    No violations

  • routine#862194567

    No violations found. All areas in compliance.

    No violations

  • complaint#862343744

    No violations found. All areas in compliance.

    No violations

  • routine#862194566

    No violations found. All areas in compliance.

    No violations

  • routine#862194565

    No violations found. All areas in compliance.

    No violations

  • routine#862194564

    No violations found. All areas in compliance.

    No violations

  • routine#862194562

    No violations found. All areas in compliance.

    No violations

  • routine#862194563

    No violations found. All areas in compliance.

    No violations

  • self-report#862343743

    No violations found. All areas in compliance.

    No violations

  • routine#862194561

    No violations found. All areas in compliance.

    No violations

  • routine#862194560

    No violations found. All areas in compliance.

    No violations

  • routine#862194559

    No violations found. All areas in compliance.

    No violations

  • complaint#862343742

    No violations found. All areas in compliance.

    No violations

  • routine#862194558

    No violations found. All areas in compliance.

    No violations

  • self-report#862343741

    No violations found. All areas in compliance.

    No violations

  • self-report#862343740

    1 violation found (1 high severity).

    Caregiver responsibility - being able to intervene when necessary to ensure child's safety

    High

    Video footage showed that staff allowed resident to walk past them while at the same time a dispute between residents in their room was happening and another staff was trying to handle the situation behind them. Staff in the hallway didn't attempt to prevent the resident from running into the other resident's dorm which led to punching the victim.

    748.685(a)(5)Corrected 2023-10-18
  • assessment#862394208

    1 violation found (1 high severity).

    AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.

    High

    During a review conducted on August 8, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on August 3, 2023, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: The operation received a high weighted citation in a pattern/trend category on August 3,2023. Specifically, the operation was cited for 748.685(a)(4) Caregiver responsibility - being able to intervene when necessary to ensure child's safety. The operation has until August 16, 2023, to meet compliance on. - Operation failed to satisfy the conditions of the plan - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring - Operation was unable to meet compliance with High weighted licensing citations Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans.

    748.535(2)Corrected 2023-08-09
  • self-report#862343739

    No violations found. All areas in compliance.

    No violations

  • routine#862194557

    No violations found. All areas in compliance.

    No violations

  • routine#862194556

    No violations found. All areas in compliance.

    No violations

  • self-report#862343738

    No violations found. All areas in compliance.

    No violations

  • routine#862194555

    No violations found. All areas in compliance.

    No violations

  • routine#862194554

    No violations found. All areas in compliance.

    No violations

  • routine#862194553

    No violations found. All areas in compliance.

    No violations

  • routine#862194552

    No violations found. All areas in compliance.

    No violations

  • self-report#862343737

    No violations found. All areas in compliance.

    No violations

  • complaint#862343736

    No violations found. All areas in compliance.

    No violations

  • routine#862194551

    No violations found. All areas in compliance.

    No violations

  • self-report#862343735

    1 violation found (1 high severity).

    Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being

    High

    Direct care staff admitted a child in care was left behind in a residential area for 30 minutes. The child in care was not supposed to be alone for more than 15 minutes as per the child in care's service plan. Video footage also confirms this.

    748.685(a)(4)Corrected 2023-08-16
  • routine#862194549

    No violations found. All areas in compliance.

    No violations

  • routine#862194550

    No violations found. All areas in compliance.

    No violations

  • routine#862194548

    No violations found. All areas in compliance.

    No violations

  • routine#862194547

    No violations found. All areas in compliance.

    No violations

  • self-report#862343734

    No violations found. All areas in compliance.

    No violations

  • routine#862194546

    No violations found. All areas in compliance.

    No violations

  • routine#862194545

    1 violation found (1 high severity).

    Medication record - must include date (day/month/year) & time each medication was administered

    High

    Medication administration was observed between 8:40 am and 8:51 am. The medication record was not updated from the scheduled medication administration time of 8 am. The time was not documented with the correct time of administration.

    748.2151(c)(5)Corrected 2023-06-16
  • routine#862194544

    No violations found. All areas in compliance.

    No violations

  • self-report#862343733

    No violations found. All areas in compliance.

    No violations

  • routine#862194543

    No violations found. All areas in compliance.

    No violations

  • complaint#862343732

    No violations found. All areas in compliance.

    No violations

  • routine#862194542

    No violations found. All areas in compliance.

    No violations

  • routine#862194541

    No violations found. All areas in compliance.

    No violations

  • self-report#862343731

    No violations found. All areas in compliance.

    No violations

  • routine#862194540

    No violations found. All areas in compliance.

    No violations

  • complaint#862343730

    5 violations found (5 high severity).

    Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child

    High

    The incident was witnessed by two staff members and not reported by either. One staff interviewed states a supervisor and manager were also made aware of the incident on the day it occurred. An incident report was not completed at the time of the incident.

    748.303(a)(3)(A)Corrected 2023-07-03

    Emergency Behavior Intervention-Never used as a means to get a child to comply

    High

    A child was restrained by plugging of the nose by one staff while the nurse held the child in place in an attempt to have the child swallow their medication.

    748.2463(3)Corrected 2023-07-03

    Short Personal Restraint-Caregiver may not use restraint that obstructs child's airways or impairs child's breathing

    High

    A child's nose was plugged by staff which restricted the child's breathing.

    748.2461(b)(3)Corrected 2023-07-03

    Children's rights-The right to be free from being subjected to or threatened with corporal punishment, including spanking or hitting

    High

    In observing video footage, the staff slaps the child's hand.

    748.1101(b)(4)(A)(ii)Corrected 2023-07-03

    Other Prohibited Punishments-any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline/punishment

    High

    From witness interviews and video footage, a staff states, "it works on dogs to hold their nose closed." after plugging a child's nose.

    748.2307(1)Corrected 2023-07-03
  • routine#862194539

    No violations found. All areas in compliance.

    No violations

  • complaint#862343729

    No violations found. All areas in compliance.

    No violations

  • complaint#862343728

    2 violations found (1 high, 1 medium severity).

    Caregiver responsibility - ensure continuity of care by sharing information concerning each child with incoming caregivers

    High

    Caregivers and Medical staff were unaware of child's self-harming incident reported on 5/3/23 per interviews. Medical information was not shared from shift to shift according to interviews with nursing staff and caregivers. This information was also not documented in shift communication or progress notes observed.

    748.685(c)(5)Corrected 2023-07-17

    Implement and follow the children's service plans.

    Medium

    A child's service plan was not followed when the child self-harmed and a safety plan was not put in place. The child's service plan states due to the child's high risk of self-harming behaviors a safety plan should be implemented following this type of incident.

    748.685(c)(6)Corrected 2023-07-17
  • self-report#862343727

    No violations found. All areas in compliance.

    No violations

  • self-report#862343726

    No violations found. All areas in compliance.

    No violations

  • routine#862194538

    No violations found. All areas in compliance.

    No violations

  • self-report#862343725

    No violations found. All areas in compliance.

    No violations

  • routine#862194537

    No violations found. All areas in compliance.

    No violations

  • complaint#862343724

    1 violation found (1 medium severity).

    No later than 72 hours after the initiation of the intervention, you must provide written notice to the parent.

    Medium

    A child in care was restrained and caseworker was not notified in a timely manner.

    748.2857(a)Corrected 2023-06-23
  • routine#862194536

    No violations found. All areas in compliance.

    No violations

  • self-report#862343723

    No violations found. All areas in compliance.

    No violations

  • routine#862194535

    No violations found. All areas in compliance.

    No violations

  • routine#862194534

    No violations found. All areas in compliance.

    No violations

  • routine#862194532

    No violations found. All areas in compliance.

    No violations

  • routine#862194533

    No violations found. All areas in compliance.

    No violations

  • routine#862194531

    No violations found. All areas in compliance.

    No violations

  • complaint#862343722

    No violations found. All areas in compliance.

    No violations

  • complaint#862343721

    No violations found. All areas in compliance.

    No violations

  • complaint#862343720

    1 violation found (1 high severity).

    Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being

    High

    One staff member fell asleep while counted in ratio. Video footage shows the staff's alarm sounding and children waking her. The incident was confirmed in child interviews.

    748.685(a)(4)Corrected 2023-04-12
  • complaint#862343719

    No violations found. All areas in compliance.

    No violations

  • routine#862194530

    No violations found. All areas in compliance.

    No violations

  • routine#862194529

    No violations found. All areas in compliance.

    No violations

  • routine#862194528

    No violations found. All areas in compliance.

    No violations

  • routine#862194527

    No violations found. All areas in compliance.

    No violations

  • complaint#862343718

    No violations found. All areas in compliance.

    No violations

  • complaint#862343717

    No violations found. All areas in compliance.

    No violations

  • assessment#862394207

    No violations found. All areas in compliance.

    No violations

  • self-report#862343716

    No violations found. All areas in compliance.

    No violations

  • routine#862194526

    No violations found. All areas in compliance.

    No violations

  • routine#862194525

    No violations found. All areas in compliance.

    No violations

  • self-report#862343715

    2 violations found (2 high severity).

    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

    High

    Two staff interviewed made statements that the staff to child ratio exceeded 1:5 during the incident. One staff said there were eight children. Another said there were at least six children. Interviews confirm two staff were present, however, one staff was in observations and not counted into ratio on the day of the incident. Management confirms the staff was not counted into ratio during their interview.

    748.1003(a)Corrected 2023-03-15

    Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being

    High

    The child was not supervised in the staff only area allowing access to a craft knife which was later used for self-harming.

    748.685(a)(4)Corrected 2023-03-15
  • self-report#862343714

    No violations found. All areas in compliance.

    No violations

  • self-report#862343713

    No violations found. All areas in compliance.

    No violations

  • routine#862194524

    1 violation found (1 medium severity).

    Administration of prescription medication-Administer each child's medication within one hour of preparation

    Medium

    Medication was prepared four hours before time of administration.

    748.2003(b)(4)Corrected 2023-01-24
  • complaint#862343712

    No violations found. All areas in compliance.

    No violations

  • complaint#862343711

    No violations found. All areas in compliance.

    No violations

  • routine#862194523

    No violations found. All areas in compliance.

    No violations

  • routine#862194522

    No violations found. All areas in compliance.

    No violations

  • routine#862194521

    No violations found. All areas in compliance.

    No violations

  • complaint#862343710

    2 violations found (2 high severity).

    Caregiver responsibility - being able to intervene when necessary to ensure child's safety

    High

    In video footage reviewed, the caregiver exhibits a lack of urgency and fails to protect the child from harm. Body positioning was not positioned to protect the child from injury. The aggressive child was not restrained, and the targeted child was not removed.

    748.685(a)(5)Corrected 2023-02-03

    Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks

    High

    After reviewing video footage, EBI curriculum, and staff statements, Emergency Behavioral Intervention training was not utilized on the aggressive child as required by the extent of possible physical injury. The child's hair was pulled twice, and she was kicked four times prior to the caregiver pulling out phone to call for assistance. The decision was made not to restrain the aggressive child without assistance despite the behaviors needing further management.

    748.507(1)Corrected 2023-02-03
  • routine#862194520

    1 violation found (1 high severity).

    Bathrooms-Must be maintained in good repair & kept clean

    High

    Shower was dirty and coming apart from wall.

    748.3391(a)Corrected 2022-12-30
  • routine#862194519

    No violations found. All areas in compliance.

    No violations

  • self-report#862343709

    No violations found. All areas in compliance.

    No violations

  • routine#862194518

    No violations found. All areas in compliance.

    No violations

  • routine#862194517

    No violations found. All areas in compliance.

    No violations

  • self-report#862343708

    1 violation found (1 high severity).

    Other Prohibited Punishments-humiliating, shaming, ridiculing, rejecting, or yelling at a child

    High

    Staff member used profanity and yelled at children in care.

    748.2307(8)Corrected 2023-01-13
  • routine#862194516

    No violations found. All areas in compliance.

    No violations

  • routine#862194515

    No violations found. All areas in compliance.

    No violations

  • routine#862194514

    No violations found. All areas in compliance.

    No violations

  • self-report#862343707

    No violations found. All areas in compliance.

    No violations

  • routine#862194513

    No violations found. All areas in compliance.

    No violations

  • routine#862194512

    No violations found. All areas in compliance.

    No violations

  • self-report#862343706

    No violations found. All areas in compliance.

    No violations

  • routine#862194511

    No violations found. All areas in compliance.

    No violations

  • routine#862194510

    No violations found. All areas in compliance.

    No violations

  • self-report#862343705

    No violations found. All areas in compliance.

    No violations

  • routine#862194509

    No violations found. All areas in compliance.

    No violations

  • self-report#862343704

    No violations found. All areas in compliance.

    No violations

  • routine#862194508

    No violations found. All areas in compliance.

    No violations

  • routine#862194507

    1 violation found (1 high severity).

    Evacuation-Emergency evacuation & relocation diagram includes at least 2 exit routes that are not blocked in any way

    High

    During the walk through a wooden picnic table was seen blocking the side door.

    748.3233(b)(4)(B)Corrected 2022-09-12
  • complaint#862343703

    No violations found. All areas in compliance.

    No violations

  • routine#862194506

    No violations found. All areas in compliance.

    No violations

  • routine#862194505

    No violations found. All areas in compliance.

    No violations

  • routine#862194504

    No violations found. All areas in compliance.

    No violations

  • complaint#862343702

    No violations found. All areas in compliance.

    No violations

  • routine#862194503

    No violations found. All areas in compliance.

    No violations

  • complaint#862343701

    No violations found. All areas in compliance.

    No violations

  • routine#862194502

    No violations found. All areas in compliance.

    No violations

  • routine#862194501

    No violations found. All areas in compliance.

    No violations

  • routine#862194500

    No violations found. All areas in compliance.

    No violations

  • routine#862194499

    No violations found. All areas in compliance.

    No violations

  • self-report#862343700

    No violations found. All areas in compliance.

    No violations

  • assessment#862394206

    1 violation found (1 high severity).

    Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.

    High

    During a review conducted on August 5, 2022, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the original 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on July 20, 2022, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: The operation received a medium and medium-high weighted citation in a pattern/trend category on July 20, 2022. Specifically, the operation was cited for 748.2151(c)(6) and 748.2151(d) related to medication documentation. The operation met compliance on July 25, 2022. - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring; and - Operation was unable to meet compliance with Medium-High or High weighted licensing citations. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans.

    748.535(2)Corrected 2022-08-06
  • routine#862194498

    No violations found. All areas in compliance.

    No violations

  • routine#862194497

    No violations found. All areas in compliance.

    No violations

  • routine#862194496

    2 violations found (1 high, 1 medium severity).

    Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model

    High

    1 out of 3 child s medication record reviewed it was discovered that a psychotropic medication count was documented incorrectly on the medication log.

    748.2151(d)Corrected 2022-07-27

    Medication record - must include name & signature of person who administered each medication

    Medium

    During the review of three child medication records if was noticed that two staff who administered medication to a child in care had not written their name and/or signature in the section provided on the bottom of the medication log to identify their initials.

    748.2151(c)(6)Corrected 2022-07-27
  • complaint#862343699

    No violations found. All areas in compliance.

    No violations

  • routine#862194495

    No violations found. All areas in compliance.

    No violations

  • routine#862194494

    No violations found. All areas in compliance.

    No violations

  • routine#862194493

    No violations found. All areas in compliance.

    No violations

  • routine#862194492

    2 violations found (2 medium severity).

    TB exam-Documentation of baseline test or chest xray results in person's record w/in 40 days of beginning to live, work, volunteer at facility

    Medium

    Two of the three child records reviewed did not have the child s TB test results located in the child s records. However the operation was able to request one child's TB test results and placed it in the child's file.

    748.1583(b)Corrected 2022-06-23

    TB exam-Persons over 1 yr old who live, work, volunteer at facility have exam w/in 30 days, unless person had previous exam that meets requirements

    Medium

    One of the three child records reviewed did not have an up to date TB test.

    748.1583(a)Corrected 2022-07-08
  • complaint#862343698

    No violations found. All areas in compliance.

    No violations

  • self-report#862343697

    No violations found. All areas in compliance.

    No violations

  • routine#862194491

    No violations found. All areas in compliance.

    No violations

  • routine#862194490

    No violations found. All areas in compliance.

    No violations

  • routine#862194489

    No violations found. All areas in compliance.

    No violations

  • routine#862194488

    No violations found. All areas in compliance.

    No violations

  • complaint#862343696

    No violations found. All areas in compliance.

    No violations

  • complaint#862343695

    No violations found. All areas in compliance.

    No violations

  • self-report#862343694

    No violations found. All areas in compliance.

    No violations

  • routine#862194487

    No violations found. All areas in compliance.

    No violations

  • complaint#862343693

    No violations found. All areas in compliance.

    No violations

  • routine#862194486

    No violations found. All areas in compliance.

    No violations

  • routine#862194485

    No violations found. All areas in compliance.

    No violations

  • routine#862194484

    1 violation found (1 medium severity).

    Annual Training Timeline-Each person must complete the required annual training within 12 months from the date of hire

    Medium

    During the review of employee records, it was discovered that two direct care staff had not completed their required annual trainings.

    748.935(a)(1)Corrected 2022-05-25
  • routine#862194483

    No violations found. All areas in compliance.

    No violations

  • routine#862194482

    No violations found. All areas in compliance.

    No violations

  • self-report#862343692

    No violations found. All areas in compliance.

    No violations

  • complaint#862343691

    No violations found. All areas in compliance.

    No violations

  • self-report#862343690

    No violations found. All areas in compliance.

    No violations

  • routine#862194481

    No violations found. All areas in compliance.

    No violations

  • routine#862194480

    No violations found. All areas in compliance.

    No violations

  • complaint#862343689

    No violations found. All areas in compliance.

    No violations

  • complaint#862343688

    No violations found. All areas in compliance.

    No violations

  • self-report#862343687

    No violations found. All areas in compliance.

    No violations

  • routine#862194479

    1 violation found (1 high severity).

    Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model

    High

    During the review of a child's medication record it was discovered that a psychotropic medication count was documented incorrectly on the medication log.

    748.2151(d)Corrected 2022-04-11
  • routine#862194478

    No violations found. All areas in compliance.

    No violations

  • routine#862194477

    No violations found. All areas in compliance.

    No violations

  • routine#862194476

    No violations found. All areas in compliance.

    No violations

  • routine#862194475

    1 violation found (1 high severity).

    Medication record - update cumulative record within 2 hours of administering medication

    High

    One prescription medication was not documented as administered within the two hour timeframe.

    748.2151(b)(1)Corrected 2022-03-28
  • self-report#862343686

    No violations found. All areas in compliance.

    No violations

  • routine#862194474

    No violations found. All areas in compliance.

    No violations

  • self-report#862343685

    No violations found. All areas in compliance.

    No violations

  • complaint#862343684

    No violations found. All areas in compliance.

    No violations

  • routine#862194473

    No violations found. All areas in compliance.

    No violations

  • routine#862194472

    No violations found. All areas in compliance.

    No violations

  • self-report#862343683

    No violations found. All areas in compliance.

    No violations

  • routine#862194471

    No violations found. All areas in compliance.

    No violations

  • self-report#862343682

    No violations found. All areas in compliance.

    No violations

  • self-report#862343681

    No violations found. All areas in compliance.

    No violations

  • self-report#862343680

    No violations found. All areas in compliance.

    No violations

  • complaint#862343679

    No violations found. All areas in compliance.

    No violations

  • routine#862194470

    No violations found. All areas in compliance.

    No violations

  • routine#862194469

    No violations found. All areas in compliance.

    No violations

  • routine#862194468

    No violations found. All areas in compliance.

    No violations

  • self-report#862343678

    No violations found. All areas in compliance.

    No violations

  • routine#862194467

    No violations found. All areas in compliance.

    No violations

  • routine#862194466

    No violations found. All areas in compliance.

    No violations

  • routine#862194465

    No violations found. All areas in compliance.

    No violations

  • routine#862194464

    No violations found. All areas in compliance.

    No violations

  • routine#862194463

    No violations found. All areas in compliance.

    No violations

  • routine#862194462

    No violations found. All areas in compliance.

    No violations

  • self-report#862343677

    No violations found. All areas in compliance.

    No violations

  • routine#862194461

    No violations found. All areas in compliance.

    No violations

  • complaint#862343676

    No violations found. All areas in compliance.

    No violations

  • routine#862194460

    No violations found. All areas in compliance.

    No violations

  • complaint#862343675

    No violations found. All areas in compliance.

    No violations

  • routine#862194459

    No violations found. All areas in compliance.

    No violations

  • routine#862194458

    No violations found. All areas in compliance.

    No violations

  • routine#862194457

    No violations found. All areas in compliance.

    No violations

  • complaint#862343674

    No violations found. All areas in compliance.

    No violations

  • routine#862194456

    No violations found. All areas in compliance.

    No violations

  • routine#862194455

    No violations found. All areas in compliance.

    No violations

  • complaint#862343673

    No violations found. All areas in compliance.

    No violations

  • routine#862194454

    No violations found. All areas in compliance.

    No violations

  • self-report#862343672

    No violations found. All areas in compliance.

    No violations

  • routine#862194453

    No violations found. All areas in compliance.

    No violations

  • routine#862194452

    No violations found. All areas in compliance.

    No violations

  • complaint#862343671

    No violations found. All areas in compliance.

    No violations

  • self-report#862343670

    No violations found. All areas in compliance.

    No violations

  • complaint#862343669

    No violations found. All areas in compliance.

    No violations

  • routine#862194451

    No violations found. All areas in compliance.

    No violations

  • routine#862194450

    No violations found. All areas in compliance.

    No violations

  • routine#862194449

    No violations found. All areas in compliance.

    No violations

  • routine#862194448

    No violations found. All areas in compliance.

    No violations

  • self-report#862343668

    No violations found. All areas in compliance.

    No violations

  • self-report#862343667

    1 violation found (1 high severity).

    Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being

    High

    A youth in care was left alone in the unit unsupervised.

    748.685(a)(4)Corrected 2022-01-11
  • routine#862194447

    No violations found. All areas in compliance.

    No violations

  • routine#862194446

    No violations found. All areas in compliance.

    No violations

  • routine#862194445

    No violations found. All areas in compliance.

    No violations

  • self-report#862343666

    No violations found. All areas in compliance.

    No violations

  • complaint#862343665

    No violations found. All areas in compliance.

    No violations

  • routine#862194444

    No violations found. All areas in compliance.

    No violations

  • routine#862194443

    No violations found. All areas in compliance.

    No violations

  • routine#862194442

    No violations found. All areas in compliance.

    No violations

  • routine#862194441

    No violations found. All areas in compliance.

    No violations

  • complaint#862343664

    No violations found. All areas in compliance.

    No violations

  • routine#862194440

    No violations found. All areas in compliance.

    No violations

  • routine#862194439

    No violations found. All areas in compliance.

    No violations

  • routine#862194438

    No violations found. All areas in compliance.

    No violations

  • self-report#862343663

    No violations found. All areas in compliance.

    No violations

  • routine#862194437

    No violations found. All areas in compliance.

    No violations

  • routine#862194436

    No violations found. All areas in compliance.

    No violations

  • complaint#862343662

    No violations found. All areas in compliance.

    No violations

  • complaint#862343661

    No violations found. All areas in compliance.

    No violations

  • routine#862194435

    No violations found. All areas in compliance.

    No violations

  • routine#862194434

    No violations found. All areas in compliance.

    No violations

  • complaint#862343660

    1 violation found (1 high severity).

    Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being

    High

    A resident was on a safety plan and staff did not check on resident while showering. Resident got ahold of her hygiene and ingested her bottle of shampoo.

    748.685(a)(4)Corrected 2021-10-20
  • routine#862194433

    No violations found. All areas in compliance.

    No violations

  • routine#862194432

    1 violation found (1 high severity).

    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

    High

    There was only one caregiver for 9 children for 30 minutes during the morning shift. The other staff memeber that was supposed to be on the unit had called in, and a replacement for the staff was not sent to the unit.

    748.1003(a)Corrected 2021-08-24
  • routine#862194431

    No violations found. All areas in compliance.

    No violations

  • complaint#862343659

    1 violation found (1 high severity).

    Children's rights- Free from demeaning behavior to embarrass/control/harm/intimidate/isolate the child

    High

    The operation staff discouraged children in care from writing grievances.

    748.1101(b)(4)(A)(vii)Corrected 2021-10-22
  • complaint#862343658

    No violations found. All areas in compliance.

    No violations

  • routine#862194430

    No violations found. All areas in compliance.

    No violations

  • routine#862194429

    No violations found. All areas in compliance.

    No violations

  • routine#862194428

    No violations found. All areas in compliance.

    No violations

  • routine#862194427

    No violations found. All areas in compliance.

    No violations

  • complaint#862343657

    No violations found. All areas in compliance.

    No violations

  • routine#862194426

    No violations found. All areas in compliance.

    No violations

  • routine#862194425

    1 violation found (1 high severity).

    Sanitation Inspection-Sanitation official must conduct sanitation inspection at least once every 12 months from date of last inspection

    High

    Last health inspection was completed on 4/30/2019. Therefore, operation did not complete the annual required health inspection.

    748.3001(a)(2)Corrected 2021-07-29
  • self-report#862343656

    No violations found. All areas in compliance.

    No violations

  • routine#862194424

    1 violation found (1 medium severity).

    Medication record - must include name & signature of person who administered each medication

    Medium

    The med log in the Olsen unit did not have staff's initials who administered meds for the PM shift on 7/6/21.

    748.2151(c)(6)Corrected 2021-07-12
  • complaint#862343655

    No violations found. All areas in compliance.

    No violations

  • complaint#862343654

    2 violations found (2 high severity).

    Physical Site-Buildings must be structurally sound, clean, and in good repair. Paints must be lead-free

    High

    A light fixture wires were hanging down where residents could reach and pull down and a light bulb was broken.

    748.3301(a)Corrected 2021-09-07

    Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation

    High

    Resident was standing on a table and staff moved the table causing resident to fall onto the ground, resulting in a fractured shoulder.

    748.1101(b)(1)(B)Corrected 2021-09-07
  • self-report#862343653

    No violations found. All areas in compliance.

    No violations

  • routine#862194423

    No violations found. All areas in compliance.

    No violations

  • routine#862194422

    No violations found. All areas in compliance.

    No violations

  • complaint#862343652

    No violations found. All areas in compliance.

    No violations

  • complaint#862343651

    No violations found. All areas in compliance.

    No violations

  • routine#862194421

    No violations found. All areas in compliance.

    No violations

  • routine#862194420

    No violations found. All areas in compliance.

    No violations

  • routine#862194419

    No violations found. All areas in compliance.

    No violations

  • self-report#862343650

    No violations found. All areas in compliance.

    No violations

  • self-report#862343649

    1 violation found (1 high severity).

    Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being

    High

    Operation staff left a resident at the cottage by herself when staff and residents went on outing. Resident was by herself for two hours.

    748.685(a)(4)Corrected 2021-07-30
  • routine#862194418

    No violations found. All areas in compliance.

    No violations

  • routine#862194417

    No violations found. All areas in compliance.

    No violations

  • routine#862194416

    No violations found. All areas in compliance.

    No violations

  • routine#862194415

    No violations found. All areas in compliance.

    No violations

  • routine#862194414

    No violations found. All areas in compliance.

    No violations

  • complaint#862343648

    No violations found. All areas in compliance.

    No violations

  • self-report#862343647

    No violations found. All areas in compliance.

    No violations

  • routine#862194413

    No violations found. All areas in compliance.

    No violations

  • self-report#862343646

    No violations found. All areas in compliance.

    No violations

  • complaint#862343645

    No violations found. All areas in compliance.

    No violations

  • complaint#862343644

    No violations found. All areas in compliance.

    No violations

  • complaint#862343643

    2 violations found (2 high severity).

    Emergency Behavior Intervention-Before using EBI, the caregiver must attempt less restrictive interventions that prove to be ineffective

    High

    Staff did not give resident appropriate space and resident became more dysregulated. Verbal de-escalation techniques were also not used.

    748.2455(a)(1)Corrected 2021-07-17

    Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation

    High

    Staff threw a water bottle and struck resident in the face.

    748.1101(b)(1)(B)Corrected 2021-07-17
  • complaint#862343642

    No violations found. All areas in compliance.

    No violations

  • complaint#862343641

    No violations found. All areas in compliance.

    No violations

  • routine#862194412

    No violations found. All areas in compliance.

    No violations

  • complaint#862343640

    1 violation found (1 high severity).

    Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child

    High

    Investigation documentation reveals operation staff had a note from a child in care expressing intention to commit suicide and shortly after the child in care was seen with a jacket around their neck and would not remove the jacket until staff threatened to cut the jacket off with scissors. The operation admits they did not count this as a suicide attempt and didn't report it.

    748.303(a)(11)(A)Corrected 2021-06-18
  • complaint#862343639

    No violations found. All areas in compliance.

    No violations

  • complaint#862343638

    1 violation found (1 high severity).

    Children's rights-The right to be free from being subjected to or threatened with corporal punishment, including spanking or hitting

    High

    A staff member shoved a resident in between restraints.

    748.1101(b)(4)(A)(ii)Corrected 2021-06-29
  • complaint#862343637

    No violations found. All areas in compliance.

    No violations

  • routine#862194411

    No violations found. All areas in compliance.

    No violations

  • routine#862194410

    No violations found. All areas in compliance.

    No violations

  • routine#862194409

    No violations found. All areas in compliance.

    No violations

  • complaint#862343636

    1 violation found (1 high severity).

    Child's rights-Make complaints/calls/reports w/o interference,coercion,punishment,retaliation,threats.Right to make them anonymously

    High

    Staff supervise all children in care when calls are made, resulting in calls not remaining private.

    748.1101(b)(7)Corrected 2021-07-01
  • complaint#862343635

    No violations found. All areas in compliance.

    No violations

  • routine#862194408

    No violations found. All areas in compliance.

    No violations

  • complaint#862343634

    No violations found. All areas in compliance.

    No violations

  • complaint#862343633

    No violations found. All areas in compliance.

    No violations

  • complaint#862343632

    2 violations found (2 high severity).

    Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation

    High

    Staff pushed resident down on the ground, causing bruising.

    748.1101(b)(1)(B)Corrected 2021-07-22

    Children's rights- Free from demeaning behavior to embarrass/control/harm/intimidate/isolate the child

    High

    Staff pushed resident with both hands with force back into her room, isolating her in her room with the door closed.

    748.1101(b)(4)(A)(vii)Corrected 2021-07-22
  • routine#862194407

    No violations found. All areas in compliance.

    No violations

  • complaint#862343631

    1 violation found (1 high severity).

    Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation

    High

    Staff failed to properly maintain control of resident while attempting to de-escalate a situation. Staff struck child in the face with her fist.

    748.1101(b)(1)(B)Corrected 2021-06-01
  • complaint#862343630

    No violations found. All areas in compliance.

    No violations

  • routine#862194406

    No violations found. All areas in compliance.

    No violations

  • complaint#862343629

    No violations found. All areas in compliance.

    No violations

  • routine#862194405

    No violations found. All areas in compliance.

    No violations

  • routine#862194404

    No violations found. All areas in compliance.

    No violations

  • complaint#862343628

    No violations found. All areas in compliance.

    No violations

  • self-report#862343627

    No violations found. All areas in compliance.

    No violations

  • routine#862194403

    1 violation found (1 medium severity).

    Operational responsibilities - Maintain current, true, accurate, and complete records

    Medium

    True and accurrate information was not reported in a complete timely manner.

    748.151(3)Corrected 2021-03-23
  • self-report#862343626

    No violations found. All areas in compliance.

    No violations

  • complaint#862343625

    1 violation found (1 high severity).

    Administration of prescription medication-Ensure the child has taken the medication as prescribed

    High

    Medication records, a professional medical collateral, medical care staff, direct care staff and child in care interviews together confirm a child in care missed one dose on one evening of a medication causing the child in care to feel upset and tired.

    748.2003(b)(5)Corrected 2021-05-21
  • complaint#862343624

    No violations found. All areas in compliance.

    No violations

  • routine#862194402

    No violations found. All areas in compliance.

    No violations

  • routine#862194401

    No violations found. All areas in compliance.

    No violations

  • routine#862194400

    No violations found. All areas in compliance.

    No violations

  • routine#862194399

    No violations found. All areas in compliance.

    No violations

  • complaint#862343623

    No violations found. All areas in compliance.

    No violations

  • complaint#862343622

    No violations found. All areas in compliance.

    No violations

  • routine#862194398

    No violations found. All areas in compliance.

    No violations

  • routine#862194397

    No violations found. All areas in compliance.

    No violations

  • self-report#862343621

    No violations found. All areas in compliance.

    No violations

  • complaint#862343620

    1 violation found (1 high severity).

    Triggered Reviews-Must occur as soon as possible, but no later than 30 days after the review is triggered

    High

    Child in care was restrained multiple times during on week.

    748.2903(a)Corrected 2021-04-10
  • complaint#862343619

    No violations found. All areas in compliance.

    No violations

  • complaint#862343618

    No violations found. All areas in compliance.

    No violations

  • complaint#862343617

    No violations found. All areas in compliance.

    No violations

  • complaint#862343616

    No violations found. All areas in compliance.

    No violations

  • complaint#862343615

    1 violation found (1 high severity).

    Administration of prescription medication-Ensure the child has taken the medication as prescribed

    High

    Three residents were "cheeking" their medication and storing them in their room.

    748.2003(b)(5)Corrected 2021-03-24
  • complaint#862343614

    No violations found. All areas in compliance.

    No violations

  • complaint#862343613

    No violations found. All areas in compliance.

    No violations

  • self-report#862343612

    No violations found. All areas in compliance.

    No violations

Availability

60 children capacity

Estimated Tuition

$750$1,100/mo

By age group

Infant$950$1,400
Toddler$850$1,250
Preschool$750$1,100
School-age$450$750

Estimated from regional averages. Actual rates may vary.

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