Rejo Helping Hands INC.
16673 INTERSTATE 45 N, Willis, TX 77318 · Montgomery County
Program
- Type
- General residential operation
- Licensed capacity
- 48
- Ages
- 7-17
- Hours
- -
- Director / administrator
- Latronda Karol Phanor
- Phone
- (936) 344-0244
- Regulated since
- Aug 23, 2023
- HHSC IDs
- Operation 1408212 · number 1744228
- Official record
- HHSC Child Care Search
Violations by category
Year by year
| Year | Violations | Serious | Main categories |
|---|---|---|---|
| 2026 | 8 | 2 | Supervision & ratios (4), Discipline & child guidance (2), Other (2) |
| 2025 | 84 | 18 | Cleanliness & sanitation (6), Illness & medication (12), Supervision & ratios (34), Safety & premises (4), Staff background & training (4), Records & paperwork (8), Other (16) |
| 2024 | 24 | 4 | Illness & medication (2), Supervision & ratios (2), Discipline & child guidance (2), Safety & premises (2), Staff background & training (8), Records & paperwork (4), Other (4) |
| 2023 | 38 | 2 | Illness & medication (8), Supervision & ratios (4), Discipline & child guidance (4), Safety & premises (2), Records & paperwork (4), Other (16) |
| 2022 | 32 | 10 | Cleanliness & sanitation (2), Supervision & ratios (6), Discipline & child guidance (4), Staff background & training (10), Records & paperwork (2), Other (8) |
Inspections, investigations & assessments
-
Sep 4, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 4, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Aug 31, 2026 Report
No violations cited on this visit.
-
Aug 31, 2026 Report
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Aug 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 3, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 3, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Jul 29, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 29, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jul 22, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jul 22, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 21, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 21, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jul 19, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Jul 19, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Jul 19, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 19, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 1, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Jul 1, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 30, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Jun 30, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 27, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jun 27, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 26, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Jun 26, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 23, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jun 23, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 3, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 3, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
May 14, 2026 Report · Deficiencies cited
-
Supervision & ratios
A caregiver did not follow operation policies for 24-hour awake staff as the staff was found asleep by DFPS contracts representative.
HHSC 748.126(b) — All employees and caregivers must be aware of and follow your policies and procedures
HHSC risk weight: Medium. Corrected 2026-06-22. Correction verified 2026-06-18.
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Supervision & ratios
-
May 14, 2026 Report · Deficiencies cited
-
Supervision & ratios
A caregiver did not follow operation policies for 24-hour awake staff as the staff was found asleep by DFPS contracts representative.
HHSC 748.126(b) — All employees and caregivers must be aware of and follow your policies and procedures
HHSC risk weight: Medium. Corrected 2026-06-22. Correction verified 2026-06-18.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
-
May 14, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 14, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
May 13, 2026 Report · Deficiencies cited (self-report)
-
Supervision & ratios
The operation did not report to licensing as soon as they were aware of the suicide attempt.
HHSC 748.303(a)(12)(A) — Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child
HHSC risk weight: Medium High. Corrected 2026-06-29.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
-
May 13, 2026 Report · Deficiencies cited (self-report)
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Supervision & ratios
The operation did not report to licensing as soon as they were aware of the suicide attempt.
HHSC 748.303(a)(12)(A) — Serious Incident-Report to Licensing as soon as aware of a suicide attempt by a child
HHSC risk weight: Medium High. Corrected 2026-06-29.
-
Supervision & ratios
-
May 10, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 10, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
May 6, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 6, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
May 4, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 4, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Apr 7, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Apr 7, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 26, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Mar 26, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 17, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 17, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Mar 17, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Mar 17, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 13, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Mar 13, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 4, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Mar 4, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 1, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 1, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Feb 28, 2026 Report · Deficiencies cited
-
Discipline & child guidance
A caregiver witnessed and recorded a physical altercation while on duty but did not report the serious incident to the Hotline when became aware.
HHSC 748.309 — Reporting Serious Incident - All serious incident reports to Licensing must be made to the Texas Abuse & Neglect Hotline
HHSC risk weight: Medium. Corrected 2026-04-27. Correction verified 2026-04-27.
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Other Serious
A caregiver was captured by video standing close by as physical altercation was occurring and did not intervene.
HHSC 748.685(a)(5) — Caregiver responsibility - being able to intervene when necessary to ensure child's safety
HHSC risk weight: High. Corrected 2026-04-27. Correction verified 2026-04-27.
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Discipline & child guidance
-
Feb 28, 2026 Report · Deficiencies cited
-
Discipline & child guidance
A caregiver witnessed and recorded a physical altercation while on duty but did not report the serious incident to the Hotline when became aware.
HHSC 748.309 — Reporting Serious Incident - All serious incident reports to Licensing must be made to the Texas Abuse & Neglect Hotline
HHSC risk weight: Medium. Corrected 2026-04-27. Correction verified 2026-04-27.
-
Other Serious
A caregiver was captured by video standing close by as physical altercation was occurring and did not intervene.
HHSC 748.685(a)(5) — Caregiver responsibility - being able to intervene when necessary to ensure child's safety
HHSC risk weight: High. Corrected 2026-04-27. Correction verified 2026-04-27.
HHSC inspection history · no longer published by HHSC; kept here
-
Discipline & child guidance
-
Feb 25, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 25, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Feb 24, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Feb 24, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 13, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 13, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Feb 12, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 12, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 9, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 9, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 9, 2026 Inspection
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 9, 2026 Inspection
No violations cited on this visit.
-
Feb 9, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 9, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Feb 9, 2026 Report · No deficiencies cited
No violations cited on this visit.
-
Feb 9, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 27, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 27, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Jan 15, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 15, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Jan 12, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 12, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Jan 5, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 5, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 22, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 22, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Dec 9, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 9, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 6, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Dec 6, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 4, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 4, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Dec 2, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 2, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 1, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 1, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 20, 2025 Inspection
No violations cited on this visit.
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Nov 20, 2025 Inspection
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 18, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Nov 18, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Nov 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Nov 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 18, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Nov 18, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 18, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 18, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Nov 17, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 17, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 16, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Nov 16, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Nov 13, 2025 Report · Deficiencies cited
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Other Serious
Staff admitted to placing the child's arms behind his back.
HHSC 748.2461(b)(6) — Short Personal Restraint-Caregiver may not use restraint that twists or places the child's limb(s) behind the child's back
HHSC risk weight: High. Corrected 2025-12-29. Correction verified 2026-01-05.
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Staff background & training
A staff member did not have training prior to being counted into ratio and conducting a restraint.
HHSC 748.863(a)(3) — Caregiver for child-care or prog. svcs only must have 8 hours EBI training, 4 before counted in ratio, rest in 90 days; 16hrs for treatment svcs
HHSC risk weight: Medium High. Corrected 2025-12-29. Correction verified 2026-01-05.
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Other Serious
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Nov 13, 2025 Report · Deficiencies cited
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Other Serious
Staff admitted to placing the child's arms behind his back.
HHSC 748.2461(b)(6) — Short Personal Restraint-Caregiver may not use restraint that twists or places the child's limb(s) behind the child's back
HHSC risk weight: High. Corrected 2025-12-29. Correction verified 2026-01-05.
-
Staff background & training
A staff member did not have training prior to being counted into ratio and conducting a restraint.
HHSC 748.863(a)(3) — Caregiver for child-care or prog. svcs only must have 8 hours EBI training, 4 before counted in ratio, rest in 90 days; 16hrs for treatment svcs
HHSC risk weight: Medium High. Corrected 2025-12-29. Correction verified 2026-01-05.
HHSC inspection history · no longer published by HHSC; kept here
-
Other Serious
-
Nov 5, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 5, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Nov 3, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Nov 3, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 3, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 3, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Oct 30, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 30, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Oct 29, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Oct 29, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 22, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Oct 22, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 13, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Oct 13, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 11, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 11, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Oct 10, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 10, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Oct 8, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 8, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Oct 8, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Oct 8, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 19, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Sep 19, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 19, 2025 Inspection · Deficiencies cited
-
Supervision & ratios
It was determined during this inspection that the operation's sanitation certification was expired.
HHSC 748.3001(a)(2) — Sanitation Inspection-Sanitation official must conduct sanitation inspection at least once every 12 months from date of last inspection
HHSC risk weight: Medium High. Corrected 2025-09-19. Correction verified 2025-10-08.
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Supervision & ratios
During the inspection it was determined that the operation's fire inspection certification was expired.
HHSC 748.3101(2) — Fire Inspection-Must have fire inspection at least once every 12 months from date of last fire inspection
HHSC risk weight: Medium High. Corrected 2025-09-26. Correction verified 2025-10-08.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
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Sep 19, 2025 Inspection · Deficiencies cited
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Supervision & ratios
It was determined during this inspection that the operation's sanitation certification was expired.
HHSC 748.3001(a)(2) — Sanitation Inspection-Sanitation official must conduct sanitation inspection at least once every 12 months from date of last inspection
HHSC risk weight: Medium High. Corrected 2025-09-19. Correction verified 2025-10-08.
-
Supervision & ratios
During the inspection it was determined that the operation's fire inspection certification was expired.
HHSC 748.3101(2) — Fire Inspection-Must have fire inspection at least once every 12 months from date of last fire inspection
HHSC risk weight: Medium High. Corrected 2025-09-26. Correction verified 2025-10-08.
-
Supervision & ratios
-
Sep 18, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 18, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Sep 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Sep 18, 2025 Report · Deficiencies cited (self-report)
-
Supervision & ratios
The operation created an incident with an incorrect child in care's name on it.
HHSC 748.311(3) — Serious Incident Documentation-Includes name, age, gender, and date of admission of the child or children involved
HHSC risk weight: Medium. Corrected 2025-11-28. Correction verified 2025-12-22.
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Supervision & ratios
-
Sep 18, 2025 Report · Deficiencies cited (self-report)
-
Supervision & ratios
The operation created an incident with an incorrect child in care's name on it.
HHSC 748.311(3) — Serious Incident Documentation-Includes name, age, gender, and date of admission of the child or children involved
HHSC risk weight: Medium. Corrected 2025-11-28. Correction verified 2025-12-22.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
-
Sep 17, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 17, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Sep 8, 2025 Report · Deficiencies cited
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Other Serious
A caregiver restrained a child in care with force, leaving a hand print. on the child's arm.
HHSC 748.2461(a)(1) — Short Personal Restraint-Caregiver must minimize risk of physical discomfort, harm, or pain to child
HHSC risk weight: High. Corrected 2025-10-01. Correction verified 2025-11-03.
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Other Serious
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Sep 8, 2025 Report · Deficiencies cited
-
Other Serious
A caregiver restrained a child in care with force, leaving a hand print. on the child's arm.
HHSC 748.2461(a)(1) — Short Personal Restraint-Caregiver must minimize risk of physical discomfort, harm, or pain to child
HHSC risk weight: High. Corrected 2025-10-01. Correction verified 2025-11-03.
HHSC inspection history · no longer published by HHSC; kept here
-
Other Serious
-
Aug 7, 2025 Report · Deficiencies cited
-
Supervision & ratios
A child visiting the operation threatened to discipline a child in care.
HHSC 748.2301(a) — Disciplinary Measures-only a caregiver known to and knowledgeable of the child may discipline the child
HHSC risk weight: Medium. Corrected 2025-10-10. Correction verified 2025-10-09.
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Records & paperwork
Incident report was missing required information such as time, child's date of birth, date of admission...
HHSC 748.311 — Serious Incident Documentation-Documented in written report
HHSC risk weight: Medium. Corrected 2025-10-10. Correction verified 2025-10-09.
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Supervision & ratios
-
Aug 7, 2025 Report · Deficiencies cited
-
Supervision & ratios
A child visiting the operation threatened to discipline a child in care.
HHSC 748.2301(a) — Disciplinary Measures-only a caregiver known to and knowledgeable of the child may discipline the child
HHSC risk weight: Medium. Corrected 2025-10-10. Correction verified 2025-10-09.
-
Records & paperwork
Incident report was missing required information such as time, child's date of birth, date of admission...
HHSC 748.311 — Serious Incident Documentation-Documented in written report
HHSC risk weight: Medium. Corrected 2025-10-10. Correction verified 2025-10-09.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
-
Jul 16, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jul 16, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 14, 2025 Report · Deficiencies cited (self-report)
-
Records & paperwork
Names of staff involved and witnesses not listed on serious incident report. Report mentioned staff intervened but staff was not listed.
HHSC 748.311(4) — Serious Incident Documentation-Includes names of all adults involved and their role in relation to the child(ren)
HHSC risk weight: Medium. Corrected 2025-08-06. Correction verified 2025-08-18.
-
Records & paperwork
-
Jul 14, 2025 Report · Deficiencies cited (self-report)
-
Records & paperwork
Names of staff involved and witnesses not listed on serious incident report. Report mentioned staff intervened but staff was not listed.
HHSC 748.311(4) — Serious Incident Documentation-Includes names of all adults involved and their role in relation to the child(ren)
HHSC risk weight: Medium. Corrected 2025-08-06. Correction verified 2025-08-18.
HHSC inspection history · no longer published by HHSC; kept here
-
Records & paperwork
-
Jul 11, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 11, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jul 7, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 7, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jul 3, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 3, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Jun 27, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 27, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jun 26, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 26, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Jun 20, 2025 Report · Deficiencies cited
-
Other Serious
Staff placed youth in cares arms behind their back and during a short personal restraint.
HHSC 748.2461(b)(6) — Short Personal Restraint-Caregiver may not use restraint that twists or places the child's limb(s) behind the child's back
HHSC risk weight: High. Corrected 2025-08-21. Correction verified 2025-11-18.
HHSC inspection history · no longer published by HHSC; kept here
-
Other Serious
-
Jun 20, 2025 Report · Deficiencies cited
-
Other Serious
Staff placed youth in cares arms behind their back and during a short personal restraint.
HHSC 748.2461(b)(6) — Short Personal Restraint-Caregiver may not use restraint that twists or places the child's limb(s) behind the child's back
HHSC risk weight: High. Corrected 2025-08-21. Correction verified 2025-11-18.
-
Other Serious
-
Jun 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jun 11, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 11, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jun 10, 2025 Inspection · Deficiencies cited
-
Illness & medication
Three out of three medications were observed to be stored in disposable cups - outside of their original packaging.
HHSC 748.2003(b)(2) — Administration of Medication-Store medication in the original container unless there is an additional container with the same label & instructions
HHSC risk weight: Medium High. Corrected 2025-06-17. Correction verified 2025-06-19.
-
Illness & medication
Three of the boys' medications are being prepared between 12 to 24 hours in advance.
HHSC 748.2003(b)(4) — Administration of prescription medication-Administer each child's medication within one hour of preparation
HHSC risk weight: Medium. Corrected 2025-06-17. Correction verified 2025-06-19.
-
Illness & medication
One of the three children's medication records reviewed was missing the times medications were administered.
HHSC 748.2151(c)(5) — Medication record - must include date (day/month/year) & time each medication was administered
HHSC risk weight: Medium High. Corrected 2025-06-17. Correction verified 2025-06-19.
-
Illness & medication
Medication counts were inaccurate for all three boys' medicaition records.
HHSC 748.2151(d) — Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
HHSC risk weight: Medium High. Corrected 2025-06-17. Correction verified 2025-06-19.
-
Supervision & ratios
The operation's fire extinguisher in the rec area was due to be serviced by the end of May 2025.
HHSC 748.3115(3) — Fire Extinguisher-Must ensure fire extinguishers are serviced as required by manufacturer's instructions, or as required by fire inspector
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2025-06-17.
-
Cleanliness & sanitation
Cleaning supplies and chemicals were on the table and under an unlocked cabinet in the rec room. This was corrected by staff at inspection.
HHSC 748.3421(3) — Poisons-Ensure poisonous/flammable material is stored in an area that is inaccessible to children unless child is capable to use responsibly.
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2025-06-10.
-
Cleanliness & sanitation
Butter was not covered in the freezer, staff threw uncovered food.
HHSC 748.3441(a) — Food Preparation-Food & drinks must be of safe quality, stored, prepared, distributed, & served under sanitary & safe conditions
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2025-06-10.
-
Supervision & ratios
Two of the three chest freezers did not contain thermometers
HHSC 748.3443(b)(2) — Food Preparation-Must have a thermometer in freezers & store frozen food at 0 degrees Fahrenheit or below
HHSC risk weight: Medium. Corrected 2025-06-17. Correction verified 2025-06-19.
-
Illness & medication
-
Jun 10, 2025 Inspection · Deficiencies cited
-
Illness & medication
Three out of three medications were observed to be stored in disposable cups - outside of their original packaging.
HHSC 748.2003(b)(2) — Administration of Medication-Store medication in the original container unless there is an additional container with the same label & instructions
HHSC risk weight: Medium High. Corrected 2025-06-17. Correction verified 2025-06-19.
-
Illness & medication
Three of the boys' medications are being prepared between 12 to 24 hours in advance.
HHSC 748.2003(b)(4) — Administration of prescription medication-Administer each child's medication within one hour of preparation
HHSC risk weight: Medium. Corrected 2025-06-17. Correction verified 2025-06-19.
-
Illness & medication
One of the three children's medication records reviewed was missing the times medications were administered.
HHSC 748.2151(c)(5) — Medication record - must include date (day/month/year) & time each medication was administered
HHSC risk weight: Medium High. Corrected 2025-06-17. Correction verified 2025-06-19.
-
Illness & medication
Medication counts were inaccurate for all three boys' medicaition records.
HHSC 748.2151(d) — Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model
HHSC risk weight: Medium High. Corrected 2025-06-17. Correction verified 2025-06-19.
-
Supervision & ratios
The operation's fire extinguisher in the rec area was due to be serviced by the end of May 2025.
HHSC 748.3115(3) — Fire Extinguisher-Must ensure fire extinguishers are serviced as required by manufacturer's instructions, or as required by fire inspector
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2025-06-17.
-
Cleanliness & sanitation
Cleaning supplies and chemicals were on the table and under an unlocked cabinet in the rec room. This was corrected by staff at inspection.
HHSC 748.3421(3) — Poisons-Ensure poisonous/flammable material is stored in an area that is inaccessible to children unless child is capable to use responsibly.
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2025-06-10.
-
Cleanliness & sanitation
Butter was not covered in the freezer, staff threw uncovered food.
HHSC 748.3441(a) — Food Preparation-Food & drinks must be of safe quality, stored, prepared, distributed, & served under sanitary & safe conditions
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2025-06-10.
-
Supervision & ratios
Two of the three chest freezers did not contain thermometers
HHSC 748.3443(b)(2) — Food Preparation-Must have a thermometer in freezers & store frozen food at 0 degrees Fahrenheit or below
HHSC risk weight: Medium. Corrected 2025-06-17. Correction verified 2025-06-19.
HHSC inspection history · no longer published by HHSC; kept here
-
Illness & medication
-
May 30, 2025 Report · Deficiencies cited (self-report)
-
Other
Unauthorized Absent Log is missing the age and gender of the victim.
HHSC 748.453(a)(1) — Unauthorized Absence - Annual summary log must include name, age, gender, date of admission
HHSC risk weight: Medium. Corrected 2025-07-29. Correction verified 2025-07-25.
-
Other
-
May 30, 2025 Report · Deficiencies cited (self-report)
-
Other
Unauthorized Absent Log is missing the age and gender of the victim.
HHSC 748.453(a)(1) — Unauthorized Absence - Annual summary log must include name, age, gender, date of admission
HHSC risk weight: Medium. Corrected 2025-07-29. Correction verified 2025-07-25.
HHSC inspection history · no longer published by HHSC; kept here
-
Other
-
May 29, 2025 Assessment · Deficiencies cited
-
Supervision & ratios Serious
The operation has been operating without an Administrator for more than 60 days.
HHSC 748.151(1) — Operational responsibilities - Designate a qualified full-time child-care administrator
HHSC risk weight: High. Corrected 2025-06-29. Correction verified 2025-06-11.
-
Supervision & ratios Serious
-
May 29, 2025 Assessment · Deficiencies cited
-
Supervision & ratios Serious
The operation has been operating without an Administrator for more than 60 days.
HHSC 748.151(1) — Operational responsibilities - Designate a qualified full-time child-care administrator
HHSC risk weight: High. Corrected 2025-06-29. Correction verified 2025-06-11.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios Serious
-
May 27, 2025 Report · Deficiencies cited
-
Safety & premises
Staff used restraint in an effort to have child comply with taking a shower.
HHSC 748.2463(3) — Emergency Behavior Intervention-Never used as a means to get a child to comply
HHSC risk weight: Medium High. Corrected 2025-07-10. Correction verified 2025-07-25.
-
Other
Staff removed a child's shirt from their body in front of other children in care while attempting to get the child to shower.
HHSC 748.2551(d)(2) — EBI Implementation-Caregiver must make every effort to protect child's dignity and well-being, including ensuring that child's body is covered
HHSC risk weight: Medium. Corrected 2025-07-10. Correction verified 2025-07-25.
HHSC inspection history · no longer published by HHSC; kept here
-
Safety & premises
-
May 27, 2025 Report · Deficiencies cited
-
Safety & premises
Staff used restraint in an effort to have child comply with taking a shower.
HHSC 748.2463(3) — Emergency Behavior Intervention-Never used as a means to get a child to comply
HHSC risk weight: Medium High. Corrected 2025-07-10. Correction verified 2025-07-25.
-
Other
Staff removed a child's shirt from their body in front of other children in care while attempting to get the child to shower.
HHSC 748.2551(d)(2) — EBI Implementation-Caregiver must make every effort to protect child's dignity and well-being, including ensuring that child's body is covered
HHSC risk weight: Medium. Corrected 2025-07-10. Correction verified 2025-07-25.
-
Safety & premises
-
May 18, 2025 Report · Deficiencies cited
-
Staff background & training Serious
The operation failed to ensure a caregiver had a completed background check prior to being hired.
HHSC 745.621(a)(2) — AP Initial background checks submitted - At the time you hire someone
HHSC risk weight: High. Corrected 2025-07-11. Correction verified 2025-07-14.
-
Staff background & training Serious
-
May 18, 2025 Report · Deficiencies cited
-
Staff background & training Serious
The operation failed to ensure a caregiver had a completed background check prior to being hired.
HHSC 745.621(a)(2) — AP Initial background checks submitted - At the time you hire someone
HHSC risk weight: High. Corrected 2025-07-11. Correction verified 2025-07-14.
HHSC inspection history · no longer published by HHSC; kept here
-
Staff background & training Serious
-
May 16, 2025 Report · Deficiencies cited (self-report)
-
Supervision & ratios
One of two child case workers indicated they had not been notified by the operation within six hours of determining their child was on unauthorized absence. The worker reported the unauthorized absence occurred on June 6, 2025, and the worker was notified by a Probation Officer on June 9, 2025, of the unauthorized absence.
HHSC 748.303(a)(10)(B) — Serious Incident-Report to parents no later than 6 hours after determining unauthorized absence of a child 13 years old or older.
HHSC risk weight: Medium. Corrected 2025-07-15. Correction verified 2025-07-15.
-
Supervision & ratios
One of the two child case workers indicated they were not notified by the operation of the child arrest. The worker reported being notified by a Probation Officer on Monday on the incident that took place over the weekend. The worker denied missing a call over the weekend from the operation.
HHSC 748.303(a)(6)(B) — Serious Incident-Report to parents as soon as facility aware that child is indicted, charged, or arrested
HHSC risk weight: Medium. Corrected 2025-07-15. Correction verified 2025-07-15.
-
Supervision & ratios Serious
One of the two children Plan of Services was reviewed indicating the child is on 1:1 supervision. Two of the three staff indicated the child had 1:1 supervision; although they were not present when the child went on unauthorized absence. One of the three staff, that was present during the incident, indicated neither of the two children were on 1:1 supervision, which is contradictory to one child's plan of service.
HHSC 748.685(a)(4) — Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
HHSC risk weight: High. Corrected 2025-07-15. Correction verified 2025-07-15.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
-
May 16, 2025 Report · Deficiencies cited (self-report)
-
Supervision & ratios
One of two child case workers indicated they had not been notified by the operation within six hours of determining their child was on unauthorized absence. The worker reported the unauthorized absence occurred on June 6, 2025, and the worker was notified by a Probation Officer on June 9, 2025, of the unauthorized absence.
HHSC 748.303(a)(10)(B) — Serious Incident-Report to parents no later than 6 hours after determining unauthorized absence of a child 13 years old or older.
HHSC risk weight: Medium. Corrected 2025-07-15. Correction verified 2025-07-15.
-
Supervision & ratios
One of the two child case workers indicated they were not notified by the operation of the child arrest. The worker reported being notified by a Probation Officer on Monday on the incident that took place over the weekend. The worker denied missing a call over the weekend from the operation.
HHSC 748.303(a)(6)(B) — Serious Incident-Report to parents as soon as facility aware that child is indicted, charged, or arrested
HHSC risk weight: Medium. Corrected 2025-07-15. Correction verified 2025-07-15.
-
Supervision & ratios Serious
One of the two children Plan of Services was reviewed indicating the child is on 1:1 supervision. Two of the three staff indicated the child had 1:1 supervision; although they were not present when the child went on unauthorized absence. One of the three staff, that was present during the incident, indicated neither of the two children were on 1:1 supervision, which is contradictory to one child's plan of service.
HHSC 748.685(a)(4) — Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being
HHSC risk weight: High. Corrected 2025-07-15. Correction verified 2025-07-15.
-
Supervision & ratios
-
May 7, 2025 Report · Deficiencies cited
-
Supervision & ratios
The documented report of the use of an EBI intervention indicates multiple staff restrained a child in care but does not identify which staff were involved, what EBI techniques were used, or the duration of each restraint used during the intervention.
HHSC 748.2855(a)(7) — EBI Documentation-Must include the name of the caregiver(s) involved in the EBI and in the circumstances that led to the EBI
HHSC risk weight: Medium. Corrected 2025-07-07. Correction verified 2025-06-30.
-
Supervision & ratios
-
May 7, 2025 Report · Deficiencies cited
-
Supervision & ratios
The documented report of the use of an EBI intervention indicates multiple staff restrained a child in care but does not identify which staff were involved, what EBI techniques were used, or the duration of each restraint used during the intervention.
HHSC 748.2855(a)(7) — EBI Documentation-Must include the name of the caregiver(s) involved in the EBI and in the circumstances that led to the EBI
HHSC risk weight: Medium. Corrected 2025-07-07. Correction verified 2025-06-30.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
-
May 6, 2025 Report · Deficiencies cited (self-report)
-
Supervision & ratios
The operation did not document the serious incident.
HHSC 748.311 — Serious Incident Documentation-Documented in written report
HHSC risk weight: Medium. Corrected 2025-06-16. Correction verified 2025-06-16.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
-
May 6, 2025 Report · Deficiencies cited (self-report)
-
Supervision & ratios
The operation did not document the serious incident.
HHSC 748.311 — Serious Incident Documentation-Documented in written report
HHSC risk weight: Medium. Corrected 2025-06-16. Correction verified 2025-06-16.
-
Supervision & ratios
-
May 4, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 4, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Apr 29, 2025 Assessment · No deficiencies cited
No violations cited on this visit.
-
Apr 29, 2025 Assessment · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 26, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Apr 26, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 16, 2025 Inspection
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 16, 2025 Inspection
No violations cited on this visit.
-
Apr 12, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Apr 12, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 12, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Apr 12, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 8, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Apr 8, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 6, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Apr 6, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 5, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Apr 5, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 4, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Apr 4, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 4, 2025 Report · Deficiencies cited (self-report)
-
Illness & medication
According to documentation and interviews, the child injured their hand on 4/3/2025 but refused medical care until 4/4/2025. Staff made a report to SWI, however, the CVS parent did not receive the I&R until 3 days later on 4/7/2025. Thus, the CVS parent was not immediately notified of the critical injury immediately after ensuring the child's safety.
HHSC 748.303(a)(2)(B) — AP Serious Incdt- Report to parents any injury/illness that warrants treatment from a medical prof. directly after ensuring the safety of the child.
HHSC risk weight: Medium High. Corrected 2025-04-25. Correction verified 2025-05-05.
HHSC inspection history · no longer published by HHSC; kept here
-
Illness & medication
-
Apr 4, 2025 Report · Deficiencies cited (self-report)
-
Illness & medication
According to documentation and interviews, the child injured their hand on 4/3/2025 but refused medical care until 4/4/2025. Staff made a report to SWI, however, the CVS parent did not receive the I&R until 3 days later on 4/7/2025. Thus, the CVS parent was not immediately notified of the critical injury immediately after ensuring the child's safety.
HHSC 748.303(a)(2)(B) — AP Serious Incdt- Report to parents any injury/illness that warrants treatment from a medical prof. directly after ensuring the safety of the child.
HHSC risk weight: Medium High. Corrected 2025-04-25. Correction verified 2025-05-05.
-
Illness & medication
-
Apr 3, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 3, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Apr 2, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Apr 2, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 25, 2025 Assessment · No deficiencies cited
No violations cited on this visit.
-
Mar 25, 2025 Assessment · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 21, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Mar 21, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Mar 10, 2025 Inspection · Deficiencies cited
-
Supervision & ratios
During a walkthrough of the facility it was observed that there was one caregiver to 9 children in the recreational area.
HHSC 748.1003(a) — Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
HHSC risk weight: Medium High. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Illness & medication
Two of four children's records reviewed did not have an immunization record in the file.
HHSC 748.1205(a)(7) — Admission Documentation-Includes child's immunization record
HHSC risk weight: Medium High. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Records & paperwork
One of four children's records reviewed did not have an initial service plan in the file.
HHSC 748.1335 — Initial Service Plan-Complete the initial service plan within 45 days after admission
HHSC risk weight: Medium Low. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Supervision & ratios
During the inspection, the children's records reviewed did not include a copy of the service plan invitation in the file. Additionally, two of the employee records reviewed lacked documentation of the drug tests taken.
HHSC 748.151(3) — Operational responsibilities - Maintain current, true, accurate, and complete records
HHSC risk weight: Medium. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Cleanliness & sanitation
During a walk-through of the operation, cottage three had mold in the shower handel.
HHSC 748.3301(a)(2) — Physical Site- Buildings must be clean and in good repair.
HHSC risk weight: Medium. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Records & paperwork
Personnel records were not available for review when requested, records were locked up and staff did not have a key to access records.
HHSC 748.399(a) — Records Available for Licensing-all active records immediately available for review and reproduction
HHSC risk weight: Medium. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Supervision & ratios
-
Mar 10, 2025 Inspection · Deficiencies cited
-
Supervision & ratios
During a walkthrough of the facility it was observed that there was one caregiver to 9 children in the recreational area.
HHSC 748.1003(a) — Child/caregiver ratio-Caregiver may care for 5 children if any require tx svcs, 8 children if not; children under 5 yrs old count as 2 children
HHSC risk weight: Medium High. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Illness & medication
Two of four children's records reviewed did not have an immunization record in the file.
HHSC 748.1205(a)(7) — Admission Documentation-Includes child's immunization record
HHSC risk weight: Medium High. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Records & paperwork
One of four children's records reviewed did not have an initial service plan in the file.
HHSC 748.1335 — Initial Service Plan-Complete the initial service plan within 45 days after admission
HHSC risk weight: Medium Low. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Supervision & ratios
During the inspection, the children's records reviewed did not include a copy of the service plan invitation in the file. Additionally, two of the employee records reviewed lacked documentation of the drug tests taken.
HHSC 748.151(3) — Operational responsibilities - Maintain current, true, accurate, and complete records
HHSC risk weight: Medium. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Cleanliness & sanitation
During a walk-through of the operation, cottage three had mold in the shower handel.
HHSC 748.3301(a)(2) — Physical Site- Buildings must be clean and in good repair.
HHSC risk weight: Medium. Corrected 2025-03-17. Correction verified 2025-03-25.
-
Records & paperwork
Personnel records were not available for review when requested, records were locked up and staff did not have a key to access records.
HHSC 748.399(a) — Records Available for Licensing-all active records immediately available for review and reproduction
HHSC risk weight: Medium. Corrected 2025-03-17. Correction verified 2025-03-25.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
-
Mar 6, 2025 Report · Deficiencies cited
-
Supervision & ratios Serious
Employee was observed to be asleep during night shift.
HHSC 748.1013(a) — Child/caregiver ratio-A caregiver must be awake when caring for a child needing constant supervision
HHSC risk weight: High. Corrected 2025-04-15. Correction verified 2025-04-12.
-
Other
One child initial service plan was not completed within 45 days after admission.
HHSC 748.1335 — Initial Service Plan-Complete the initial service plan within 45 days after admission
HHSC risk weight: Medium Low. Corrected 2025-04-15. Correction verified 2025-04-12.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios Serious
-
Mar 6, 2025 Report · Deficiencies cited
-
Supervision & ratios Serious
Employee was observed to be asleep during night shift.
HHSC 748.1013(a) — Child/caregiver ratio-A caregiver must be awake when caring for a child needing constant supervision
HHSC risk weight: High. Corrected 2025-04-15. Correction verified 2025-04-12.
-
Other
One child initial service plan was not completed within 45 days after admission.
HHSC 748.1335 — Initial Service Plan-Complete the initial service plan within 45 days after admission
HHSC risk weight: Medium Low. Corrected 2025-04-15. Correction verified 2025-04-12.
-
Supervision & ratios Serious
-
Feb 24, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Feb 24, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 20, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Feb 20, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 20, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Feb 20, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Feb 17, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Feb 17, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 11, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Feb 11, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 10, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Feb 10, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Feb 8, 2025 Report · Deficiencies cited
-
Other Serious
Staff failed to appropriately intervene during a serious incident involving a child in care exhibiting self-harm and making threats of harm to others, as well as engaging in self-injurious behavior.
HHSC 748.685(a)(5) — Caregiver responsibility - being able to intervene when necessary to ensure child's safety
HHSC risk weight: High. Corrected 2025-04-18. Correction verified 2025-04-12.
-
Other Serious
-
Feb 8, 2025 Report · Deficiencies cited
-
Other Serious
Staff failed to appropriately intervene during a serious incident involving a child in care exhibiting self-harm and making threats of harm to others, as well as engaging in self-injurious behavior.
HHSC 748.685(a)(5) — Caregiver responsibility - being able to intervene when necessary to ensure child's safety
HHSC risk weight: High. Corrected 2025-04-18. Correction verified 2025-04-12.
HHSC inspection history · no longer published by HHSC; kept here
-
Other Serious
-
Jan 31, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 31, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Jan 31, 2025 Report · Deficiencies cited
-
Safety & premises Serious
The top bunk bed was observed to have no safety bedrails.
HHSC 748.3369(e) — Bedding-Bunk bed must have attached bedrails; bedrails & the mattress supports must not be an entrapment hazard
HHSC risk weight: High. Corrected 2025-03-28. Correction verified 2025-04-12.
-
Supervision & ratios
The administrator failed to communicate with all caregivers a children's risk behaviors.
HHSC 748.535(1) — Child-care administrator responsibilities-Daily supervision and on-site administrative responsibility for the overall operation
HHSC risk weight: Medium. Corrected 2025-03-28. Correction verified 2025-04-12.
-
Safety & premises Serious
-
Jan 31, 2025 Report · Deficiencies cited
-
Safety & premises Serious
The top bunk bed was observed to have no safety bedrails.
HHSC 748.3369(e) — Bedding-Bunk bed must have attached bedrails; bedrails & the mattress supports must not be an entrapment hazard
HHSC risk weight: High. Corrected 2025-03-28. Correction verified 2025-04-12.
-
Supervision & ratios
The administrator failed to communicate with all caregivers a children's risk behaviors.
HHSC 748.535(1) — Child-care administrator responsibilities-Daily supervision and on-site administrative responsibility for the overall operation
HHSC risk weight: Medium. Corrected 2025-03-28. Correction verified 2025-04-12.
HHSC inspection history · no longer published by HHSC; kept here
-
Safety & premises Serious
-
Jan 30, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 30, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Jan 29, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 29, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Jan 28, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 28, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jan 19, 2025 Report · No deficiencies cited
No violations cited on this visit.
-
Jan 19, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 17, 2025 Report · Deficiencies cited (self-report)
-
Supervision & ratios
The required PLSP debriefing wasn't conducted with a child post hospitalization.
HHSC 748.125(f)(1) — A PLSP must meet with a child within 24 hours of their return to an operation post hospitalization.
HHSC risk weight: Medium High. Corrected 2025-03-19. Correction verified 2025-04-04.
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Other
There wasn't a post hospitalization safety plan created/updated after a child's hospitalization stay.
HHSC 748.125(f)(2)(B) — Post hospitalization protocols must include creating or reviewing and updating the child?s safety plan.
HHSC risk weight: Medium High. Corrected 2025-03-19. Correction verified 2025-04-04.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
-
Jan 17, 2025 Report · Deficiencies cited (self-report)
-
Supervision & ratios
The required PLSP debriefing wasn't conducted with a child post hospitalization.
HHSC 748.125(f)(1) — A PLSP must meet with a child within 24 hours of their return to an operation post hospitalization.
HHSC risk weight: Medium High. Corrected 2025-03-19. Correction verified 2025-04-04.
-
Other
There wasn't a post hospitalization safety plan created/updated after a child's hospitalization stay.
HHSC 748.125(f)(2)(B) — Post hospitalization protocols must include creating or reviewing and updating the child?s safety plan.
HHSC risk weight: Medium High. Corrected 2025-03-19. Correction verified 2025-04-04.
-
Supervision & ratios
-
Dec 27, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 27, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Dec 22, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
-
Dec 22, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 12, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Dec 12, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 12, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Dec 12, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 11, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 11, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
-
Dec 10, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Dec 10, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 30, 2024 Report · Deficiencies cited
-
Discipline & child guidance Serious
A child in care reported being attacked by other children in care by the direction of a staff member. The victim sustained injuries that required medical attention.
HHSC 748.1101(b)(1)(B) — Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
HHSC risk weight: High. Corrected 2025-01-24. Correction verified 2025-01-28.
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Other
A staff member involved other children when attempting to de-escalate a situation with one child in care.
HHSC 748.507(1) — Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
HHSC risk weight: Medium High. Corrected 2025-01-24. Correction verified 2025-01-28.
HHSC inspection history · no longer published by HHSC; kept here
-
Discipline & child guidance Serious
-
Nov 30, 2024 Report · Deficiencies cited
-
Discipline & child guidance Serious
A child in care reported being attacked by other children in care by the direction of a staff member. The victim sustained injuries that required medical attention.
HHSC 748.1101(b)(1)(B) — Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation
HHSC risk weight: High. Corrected 2025-01-24. Correction verified 2025-01-28.
-
Other
A staff member involved other children when attempting to de-escalate a situation with one child in care.
HHSC 748.507(1) — Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks
HHSC risk weight: Medium High. Corrected 2025-01-24. Correction verified 2025-01-28.
-
Discipline & child guidance Serious
-
Nov 27, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Nov 27, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 26, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 26, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
-
Nov 15, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 15, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Sep 26, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 26, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Sep 23, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Sep 23, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 19, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 19, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Sep 19, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
-
Sep 19, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Sep 17, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Sep 17, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 30, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 30, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
-
Aug 28, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 28, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Aug 24, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 24, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Aug 19, 2024 Inspection · Deficiencies cited
-
Records & paperwork
One of four Child Right's documents reviewed for a child admitted on 07/29/2024 was observed to be missing the child's signature.
HHSC 748.1103(d) — Informing child of rights-Person being informed must sign statement indicating he read and understands the rights-signed copy filed in child's record
HHSC risk weight: Medium. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Illness & medication
Three of the four records reviewed was observed to have immunization records in the admission documentation.
HHSC 748.1205(a)(7) — Admission Documentation-Includes child's immunization record
HHSC risk weight: Medium High. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Records & paperwork
Two of four Admission Assessments reviewed was observed to not be signed or dated from the Professional Level Service Provider.
HHSC 748.1215(b) — Admission Assessment-Professional level service provider must sign & date assessment, which must be in child's record
HHSC risk weight: Low. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Staff background & training Serious
Neither of the four staff files reviewed was observed to be current in Suicide Training.
HHSC 748.125(c)(1) — Suicide Training-All caregivers and employees must complete at least one hour of annual suicide prevention training.
HHSC risk weight: High. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Other
One of four Preliminary Service Plans reviewed was observed to be missing a signature from Treatment Director or Professional Level Service Provider.
HHSC 748.1333 — Preliminary Service Plan-Treatment director or PLSP must develop, sign, and date the plan for children receiving treatment services
HHSC risk weight: Medium. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Supervision & ratios
Case manager reported that some staff files could not be reviewed due to them being forgotten at her personal residence.
HHSC 748.361(a) — Personnel records - All active records maintained at the operation
HHSC risk weight: Medium Low. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Staff background & training
One of the four staff files reviewed was observed to be delinquent in annual Emergency Behavior Intervention Training.
HHSC 748.930(b)(1)(A) — Annual Training-Caregivers in operations other than cottage homes must have 4 hrs of EBI every 6 months.
HHSC risk weight: Medium High. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Staff background & training
Two of the four staff members records involved was observed to be delinquent on Normalcy Training.
HHSC 748.930(b)(3) — Annual Training- Caregivers must have 1 hour normalcy training.
HHSC risk weight: Medium High. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Staff background & training
One of four staff members was observed to have an expired CPR Certification.
HHSC 748.981(a)(1) — First-aid-CPR training-Each caregiver must have current certification in first-aid
HHSC risk weight: Medium High. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Records & paperwork
-
Aug 19, 2024 Inspection · Deficiencies cited
-
Records & paperwork
One of four Child Right's documents reviewed for a child admitted on 07/29/2024 was observed to be missing the child's signature.
HHSC 748.1103(d) — Informing child of rights-Person being informed must sign statement indicating he read and understands the rights-signed copy filed in child's record
HHSC risk weight: Medium. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Illness & medication
Three of the four records reviewed was observed to have immunization records in the admission documentation.
HHSC 748.1205(a)(7) — Admission Documentation-Includes child's immunization record
HHSC risk weight: Medium High. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Records & paperwork
Two of four Admission Assessments reviewed was observed to not be signed or dated from the Professional Level Service Provider.
HHSC 748.1215(b) — Admission Assessment-Professional level service provider must sign & date assessment, which must be in child's record
HHSC risk weight: Low. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Staff background & training Serious
Neither of the four staff files reviewed was observed to be current in Suicide Training.
HHSC 748.125(c)(1) — Suicide Training-All caregivers and employees must complete at least one hour of annual suicide prevention training.
HHSC risk weight: High. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Other
One of four Preliminary Service Plans reviewed was observed to be missing a signature from Treatment Director or Professional Level Service Provider.
HHSC 748.1333 — Preliminary Service Plan-Treatment director or PLSP must develop, sign, and date the plan for children receiving treatment services
HHSC risk weight: Medium. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Supervision & ratios
Case manager reported that some staff files could not be reviewed due to them being forgotten at her personal residence.
HHSC 748.361(a) — Personnel records - All active records maintained at the operation
HHSC risk weight: Medium Low. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Staff background & training
One of the four staff files reviewed was observed to be delinquent in annual Emergency Behavior Intervention Training.
HHSC 748.930(b)(1)(A) — Annual Training-Caregivers in operations other than cottage homes must have 4 hrs of EBI every 6 months.
HHSC risk weight: Medium High. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Staff background & training
Two of the four staff members records involved was observed to be delinquent on Normalcy Training.
HHSC 748.930(b)(3) — Annual Training- Caregivers must have 1 hour normalcy training.
HHSC risk weight: Medium High. Corrected 2024-08-23. Correction verified 2024-08-23.
-
Staff background & training
One of four staff members was observed to have an expired CPR Certification.
HHSC 748.981(a)(1) — First-aid-CPR training-Each caregiver must have current certification in first-aid
HHSC risk weight: Medium High. Corrected 2024-08-23. Correction verified 2024-08-23.
HHSC inspection history · no longer published by HHSC; kept here
-
Records & paperwork
-
Aug 16, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Aug 16, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 30, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Jul 30, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 5, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Jul 5, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 10, 2024 Assessment · Deficiencies cited
-
Safety & premises
The annual fire inspection was not completed timely.
HHSC 748.3101(2) — Fire Inspection-Must have fire inspection at least once every 12 months from date of last fire inspection
HHSC risk weight: Medium High. Corrected 2024-06-14. Correction verified 2024-06-10.
HHSC inspection history · no longer published by HHSC; kept here
-
Safety & premises
-
Jun 10, 2024 Assessment · Deficiencies cited
-
Safety & premises
The annual fire inspection was not completed timely.
HHSC 748.3101(2) — Fire Inspection-Must have fire inspection at least once every 12 months from date of last fire inspection
HHSC risk weight: Medium High. Corrected 2024-06-14. Correction verified 2024-06-10.
-
Safety & premises
-
Jun 6, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 6, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
-
May 17, 2024 Assessment · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 17, 2024 Assessment · No deficiencies cited
No violations cited on this visit.
-
May 2, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 2, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Apr 10, 2024 Inspection
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 10, 2024 Inspection
No violations cited on this visit.
-
Apr 8, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 8, 2024 Report · No deficiencies cited
No violations cited on this visit.
-
Apr 4, 2024 Assessment · No deficiencies cited
No violations cited on this visit.
-
Apr 4, 2024 Assessment · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 13, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
-
Mar 13, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 27, 2023 Report · No deficiencies cited
No violations cited on this visit.
-
Dec 27, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 5, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Dec 5, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
-
Nov 22, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Nov 22, 2023 Report · No deficiencies cited
No violations cited on this visit.
-
Nov 14, 2023 Report · No deficiencies cited
No violations cited on this visit.
-
Nov 14, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 12, 2023 Report · No deficiencies cited
No violations cited on this visit.
-
Oct 12, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 11, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
-
Oct 11, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 9, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Oct 9, 2023 Report · No deficiencies cited
No violations cited on this visit.
-
Sep 27, 2023 Report · Deficiencies cited (self-report)
-
Other
The annual summary log does not have how long the child was gone for. The log has a designated area for time and date of return however only the date is being entered.
HHSC 748.453(a)(3) — Unauthorized Absence ? Annual summary log must include how long the child was gone or if the child did not return
HHSC risk weight: Medium. Corrected 2023-11-28. Correction verified 2023-11-29.
HHSC inspection history · no longer published by HHSC; kept here
-
Other
-
Sep 27, 2023 Report · Deficiencies cited (self-report)
-
Other
The annual summary log does not have how long the child was gone for. The log has a designated area for time and date of return however only the date is being entered.
HHSC 748.453(a)(3) — Unauthorized Absence ? Annual summary log must include how long the child was gone or if the child did not return
HHSC risk weight: Medium. Corrected 2023-11-28. Correction verified 2023-11-29.
-
Other
-
Aug 17, 2023 Inspection · Deficiencies cited
-
Supervision & ratios
An incident report was observed with additional information that was not reported to SWI.
HHSC 748.151(3) — Operational responsibilities - Maintain current, true, accurate, and complete records
HHSC risk weight: Medium. Corrected 2023-08-24. Correction verified 2023-08-22.
-
Records & paperwork
1 of 3 records was observed without a TB exam. Staff was hired 6/9/23.
HHSC 748.1583(a) — 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
HHSC risk weight: Medium. Corrected 2023-08-24. Correction verified 2023-08-22.
HHSC inspection history · no longer published by HHSC; kept here
-
Supervision & ratios
-
Aug 17, 2023 Inspection · Deficiencies cited
-
Supervision & ratios
An incident report was observed with additional information that was not reported to SWI.
HHSC 748.151(3) — Operational responsibilities - Maintain current, true, accurate, and complete records
HHSC risk weight: Medium. Corrected 2023-08-24. Correction verified 2023-08-22.
-
Records & paperwork
1 of 3 records was observed without a TB exam. Staff was hired 6/9/23.
HHSC 748.1583(a) — 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
HHSC risk weight: Medium. Corrected 2023-08-24. Correction verified 2023-08-22.
-
Supervision & ratios
-
Aug 12, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 12, 2023 Report · No deficiencies cited
No violations cited on this visit.
-
Aug 9, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 9, 2023 Report · No deficiencies cited
No violations cited on this visit.
-
Aug 7, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 7, 2023 Report · No deficiencies cited
No violations cited on this visit.
-
Jul 25, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 25, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
-
Jul 14, 2023 Inspection · Deficiencies cited
-
Illness & medication
One medication, Guanfacine 2MG, was supposed to be administered daily at 4pm, was administered after 4pm on 7/5-7/13.
HHSC 748.2003(b)(3) — AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
HHSC risk weight: Medium High. Corrected 2023-07-17. Correction verified 2023-09-11.
HHSC inspection history · no longer published by HHSC; kept here
-
Illness & medication
-
Jul 14, 2023 Inspection · Deficiencies cited
-
Illness & medication
One medication, Guanfacine 2MG, was supposed to be administered daily at 4pm, was administered after 4pm on 7/5-7/13.
HHSC 748.2003(b)(3) — AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
HHSC risk weight: Medium High. Corrected 2023-07-17. Correction verified 2023-09-11.
-
Illness & medication
-
May 17, 2023 Inspection · Deficiencies cited
-
Records & paperwork
4 of 4 records reviewed did not include the results of the child's suicide risk screening.
HHSC 748.1205(a)(14) — Admission Documentation- Includes the results of the suicide screening at admission, if required.
HHSC risk weight: Low. Corrected 2023-05-24. Correction verified 2023-05-25.
-
Other
3 of 4 placement agreements did not include the reason for placement and the anticipated length of time in care.
HHSC 748.1207(a)(3) — Placement agreement-Must include the reason for placement & anticipated length of time in care
HHSC risk weight: Low. Corrected 2023-05-24. Correction verified 2023-05-25.
-
Other
4 of 4 admissions assessments did not include the child's birth and neonatal history; (c)(6) child?s school history, including the names and dates of previous schools attended, grades earned, and special achievements; (c)(7) the reason for the previous placements.
HHSC 748.1217(c)(3) — Admission Assessment-Prior to initial service plan, add child's birth and neonatal history
HHSC risk weight: Low. Corrected 2023-05-24. Correction verified 2023-05-25.
-
Other
3 of 4 initial and review service plans did not include the date of participation for the PLSP. 1 service plan did not include the signature of the PLSP.
HHSC 748.1347(a)(2) — Initial Service Plan-Document PLSP's date of participation
HHSC risk weight: Low. Corrected 2023-05-24. Correction verified 2023-05-25.
-
Other
The evaluation of the child's progress was not thoroughly documented on 2 of 4 service plan reviews.
HHSC 748.1385(1) — Service Plan Review-Must include evaluation of child's progress and effectiveness of strategies and techniques used to meet identified needs
HHSC risk weight: Medium Low. Corrected 2023-05-24. Correction verified 2023-05-25.
-
Other
1 of 1 service plan reviews were missing all signatures.
HHSC 748.1387 — Service Plan Review-Must comply with notification, participation, implementation, and documentation requirements for an initial service plan
HHSC risk weight: Medium Low. Corrected 2023-05-24. Correction verified 2023-05-25.
-
Supervision & ratios
Service plans reviewed noted the effective date of the plans to be before the completion dates of the plan; the supervision and ratio requirements are inconsistent between the preliminary, initial, and review service plans; admission's assessments, preliminary, initial, and review service plans were not individualized and detailed for each child in care; dates did not accompany all signatures on documents, for example initial and review service plans, to show when the document was signed and to ensure compliance with minimum standards timeframes; information from the application for placement, psychological assessment, and admission's assessment were not thoroughly included in the goals and needs documented for children in care in their initial and review service plans
HHSC 748.151(3) — Operational responsibilities - Maintain current, true, accurate, and complete records
HHSC risk weight: Medium. Corrected 2023-05-24. Correction verified 2023-05-25.
-
Records & paperwork
-
May 17, 2023 Inspection · Deficiencies cited
-
Records & paperwork
4 of 4 records reviewed did not include the results of the child's suicide risk screening.
HHSC 748.1205(a)(14) — Admission Documentation- Includes the results of the suicide screening at admission, if required.
HHSC risk weight: Low. Corrected 2023-05-24. Correction verified 2023-05-25.
-
Other
3 of 4 placement agreements did not include the reason for placement and the anticipated length of time in care.
HHSC 748.1207(a)(3) — Placement agreement-Must include the reason for placement & anticipated length of time in care
HHSC risk weight: Low. Corrected 2023-05-24. Correction verified 2023-05-25.
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Other
4 of 4 admissions assessments did not include the child's birth and neonatal history; (c)(6) child?s school history, including the names and dates of previous schools attended, grades earned, and special achievements; (c)(7) the reason for the previous placements.
HHSC 748.1217(c)(3) — Admission Assessment-Prior to initial service plan, add child's birth and neonatal history
HHSC risk weight: Low. Corrected 2023-05-24. Correction verified 2023-05-25.
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Other
3 of 4 initial and review service plans did not include the date of participation for the PLSP. 1 service plan did not include the signature of the PLSP.
HHSC 748.1347(a)(2) — Initial Service Plan-Document PLSP's date of participation
HHSC risk weight: Low. Corrected 2023-05-24. Correction verified 2023-05-25.
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Other
The evaluation of the child's progress was not thoroughly documented on 2 of 4 service plan reviews.
HHSC 748.1385(1) — Service Plan Review-Must include evaluation of child's progress and effectiveness of strategies and techniques used to meet identified needs
HHSC risk weight: Medium Low. Corrected 2023-05-24. Correction verified 2023-05-25.
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Other
1 of 1 service plan reviews were missing all signatures.
HHSC 748.1387 — Service Plan Review-Must comply with notification, participation, implementation, and documentation requirements for an initial service plan
HHSC risk weight: Medium Low. Corrected 2023-05-24. Correction verified 2023-05-25.
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Supervision & ratios
Service plans reviewed noted the effective date of the plans to be before the completion dates of the plan; the supervision and ratio requirements are inconsistent between the preliminary, initial, and review service plans; admission's assessments, preliminary, initial, and review service plans were not individualized and detailed for each child in care; dates did not accompany all signatures on documents, for example initial and review service plans, to show when the document was signed and to ensure compliance with minimum standards timeframes; information from the application for placement, psychological assessment, and admission's assessment were not thoroughly included in the goals and needs documented for children in care in their initial and review service plans
HHSC 748.151(3) — Operational responsibilities - Maintain current, true, accurate, and complete records
HHSC risk weight: Medium. Corrected 2023-05-24. Correction verified 2023-05-25.
HHSC inspection history · no longer published by HHSC; kept here
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Records & paperwork
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May 7, 2023 Report · Deficiencies cited
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Discipline & child guidance Serious
During interview, staff admitted to threatening a child with corporal punishment.
HHSC 748.2303(a) — Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
HHSC risk weight: High. Corrected 2023-07-19. Correction verified 2023-07-25.
HHSC inspection history · no longer published by HHSC; kept here
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Discipline & child guidance Serious
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May 7, 2023 Report · Deficiencies cited
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Discipline & child guidance Serious
During interview, staff admitted to threatening a child with corporal punishment.
HHSC 748.2303(a) — Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.
HHSC risk weight: High. Corrected 2023-07-19. Correction verified 2023-07-25.
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Discipline & child guidance Serious
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Apr 17, 2023 Inspection · Deficiencies cited
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Safety & premises
The annual fire inspection was due on 4/1/23.
HHSC 748.3101(2) — Fire Inspection-Must have fire inspection at least once every 12 months from date of last fire inspection
HHSC risk weight: Medium High. Corrected 2023-04-24. Correction verified 2023-04-28.
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Safety & premises
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Apr 17, 2023 Inspection · Deficiencies cited
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Safety & premises
The annual fire inspection was due on 4/1/23.
HHSC 748.3101(2) — Fire Inspection-Must have fire inspection at least once every 12 months from date of last fire inspection
HHSC risk weight: Medium High. Corrected 2023-04-24. Correction verified 2023-04-28.
HHSC inspection history · no longer published by HHSC; kept here
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Safety & premises
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Apr 11, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 11, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Mar 28, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Mar 28, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Feb 20, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Feb 20, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 11, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Feb 11, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Feb 2, 2023 Inspection
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Feb 2, 2023 Inspection
No violations cited on this visit.
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Jan 22, 2023 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Jan 22, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Jan 18, 2023 Inspection · Deficiencies cited
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Discipline & child guidance
4 of 4 admissions' assessments did not include the services the operation would provide to children in care, and the child's substance abuse history, and the child's understanding of placement.
HHSC 748.1217(b)(12) — Admission Assessment-At admission, must include services the operation plans to provide to the child
HHSC risk weight: Medium Low. Corrected 2023-01-25. Correction verified 2023-01-19.
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Other
4 preliminary service plans did not document who would be responsible for meeting each of the child's needs.
HHSC 748.1331(b)(5) — Preliminary Service Plan-For child receiving treatment services, designate who will be responsible for meeting each of the child's needs
HHSC risk weight: Medium Low. Corrected 2023-01-25. Correction verified 2023-01-19.
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Other
One preliminary service plan was missing the signature from the PLSP/Treatment Director.
HHSC 748.1333 — Preliminary Service Plan-Treatment director or PLSP must develop, sign, and date the plan for children receiving treatment services
HHSC risk weight: Medium. Corrected 2023-01-25. Correction verified 2023-01-19.
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Illness & medication
One medication record reviewed showed a child received Lovastatin on 10 days, in the morning, when the instructions stated it should have been given with an evening meal. The same record showed the child was given Omega 3 Acid once a day on 1/12/23 and 1/17/23 when it was prescribed to be given twice a day. The child also received Aripiprazole only once on 1/17/23, when it was prescribed to be given twice daily.
HHSC 748.2003(b)(3) — AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
HHSC risk weight: Medium High. Corrected 2023-01-20. Correction verified 2023-01-19.
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Illness & medication
4 of 4 records reviewed had medication logs with the reason for the medications not listed.
HHSC 748.2151(c)(3) — Medication record - must include reason medication was prescribed, for prescription medication
HHSC risk weight: Medium. Corrected 2023-01-25. Correction verified 2023-01-19.
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Illness & medication
One file did not include the child's immunization record.
HHSC 748.399(a) — Records Available for Licensing-all active records immediately available for review and reproduction
HHSC risk weight: Medium. Corrected 2023-01-25. Correction verified 2023-09-11.
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Discipline & child guidance
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Jan 18, 2023 Inspection · Deficiencies cited
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Discipline & child guidance
4 of 4 admissions' assessments did not include the services the operation would provide to children in care, and the child's substance abuse history, and the child's understanding of placement.
HHSC 748.1217(b)(12) — Admission Assessment-At admission, must include services the operation plans to provide to the child
HHSC risk weight: Medium Low. Corrected 2023-01-25. Correction verified 2023-01-19.
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Other
4 preliminary service plans did not document who would be responsible for meeting each of the child's needs.
HHSC 748.1331(b)(5) — Preliminary Service Plan-For child receiving treatment services, designate who will be responsible for meeting each of the child's needs
HHSC risk weight: Medium Low. Corrected 2023-01-25. Correction verified 2023-01-19.
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Other
One preliminary service plan was missing the signature from the PLSP/Treatment Director.
HHSC 748.1333 — Preliminary Service Plan-Treatment director or PLSP must develop, sign, and date the plan for children receiving treatment services
HHSC risk weight: Medium. Corrected 2023-01-25. Correction verified 2023-01-19.
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Illness & medication
One medication record reviewed showed a child received Lovastatin on 10 days, in the morning, when the instructions stated it should have been given with an evening meal. The same record showed the child was given Omega 3 Acid once a day on 1/12/23 and 1/17/23 when it was prescribed to be given twice a day. The child also received Aripiprazole only once on 1/17/23, when it was prescribed to be given twice daily.
HHSC 748.2003(b)(3) — AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders
HHSC risk weight: Medium High. Corrected 2023-01-20. Correction verified 2023-01-19.
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Illness & medication
4 of 4 records reviewed had medication logs with the reason for the medications not listed.
HHSC 748.2151(c)(3) — Medication record - must include reason medication was prescribed, for prescription medication
HHSC risk weight: Medium. Corrected 2023-01-25. Correction verified 2023-01-19.
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Illness & medication
One file did not include the child's immunization record.
HHSC 748.399(a) — Records Available for Licensing-all active records immediately available for review and reproduction
HHSC risk weight: Medium. Corrected 2023-01-25. Correction verified 2023-09-11.
HHSC inspection history · no longer published by HHSC; kept here
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Discipline & child guidance
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Nov 30, 2022 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Nov 30, 2022 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 17, 2022 Inspection · Deficiencies cited
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Discipline & child guidance
Of the two files reviewed, neither employee had a signed statement of reporting abuse or neglect.
HHSC 748.363(8) — Personnel records - Include signed dated statement by the employee that he must immediately report suspected child abuse, neglect, or exploitation.
HHSC risk weight: Medium. Corrected 2022-10-31. Correction verified 2022-11-07.
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Staff background & training
The administrator personnel file did not contain any of the trainings documents.
HHSC 748.864(d) — Pre-Service Training-Document the completion of each training requirement in the appropriate personnel record.
HHSC risk weight: Medium Low. Corrected 2022-10-31. Correction verified 2022-11-07.
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Discipline & child guidance
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Oct 17, 2022 Inspection · Deficiencies cited
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Discipline & child guidance
Of the two files reviewed, neither employee had a signed statement of reporting abuse or neglect.
HHSC 748.363(8) — Personnel records - Include signed dated statement by the employee that he must immediately report suspected child abuse, neglect, or exploitation.
HHSC risk weight: Medium. Corrected 2022-10-31. Correction verified 2022-11-07.
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Staff background & training
The administrator personnel file did not contain any of the trainings documents.
HHSC 748.864(d) — Pre-Service Training-Document the completion of each training requirement in the appropriate personnel record.
HHSC risk weight: Medium Low. Corrected 2022-10-31. Correction verified 2022-11-07.
HHSC inspection history · no longer published by HHSC; kept here
-
Discipline & child guidance
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Aug 25, 2022 Assessment · No deficiencies cited
No violations cited on this visit.
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Aug 25, 2022 Assessment · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Aug 18, 2022 Inspection · Deficiencies cited
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Other Serious
During this application review, it was found that the drug test for the staff C.R. was invalid. C.R. has not had drug test.
HHSC 745.4151(c)(4)(A) — Mandatory drug testing-all applicants intended to be hired are subject to pre-employment testing, must have results prior to child access
HHSC risk weight: High. Corrected 2022-08-19. Correction verified 2022-08-19.
HHSC inspection history · no longer published by HHSC; kept here
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Other Serious
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Aug 18, 2022 Inspection · Deficiencies cited
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Other Serious
During this application review, it was found that the drug test for the staff C.R. was invalid. C.R. has not had drug test.
HHSC 745.4151(c)(4)(A) — Mandatory drug testing-all applicants intended to be hired are subject to pre-employment testing, must have results prior to child access
HHSC risk weight: High. Corrected 2022-08-19. Correction verified 2022-08-19.
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Other Serious
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Jul 19, 2022 Inspection · Deficiencies cited
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Other Serious
During this application review, it was found that the drug test for the staff C.R. was invalid. C.R. has not had drug test.
HHSC 745.4151(c)(4)(A) — Mandatory drug testing-all applicants intended to be hired are subject to pre-employment testing, must have results prior to child access
HHSC risk weight: High. Corrected 2022-08-02. Correction verified 2022-08-18.
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Supervision & ratios Serious
The weapons, firearms, explosive materials and projectiles policy is missing from the operational policies.
HHSC 748.103(b)(12) — Policies and procedures to submit - Weapons, firearms, explosive materials and projectiles
HHSC risk weight: High. Corrected 2022-08-02. Correction verified 2022-07-29.
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Staff background & training
The personnel policies do not include all required information for the professional positions. The personnel policies were missing a professional staffing plan with required information.
HHSC 748.105(3)(B) — Personnel policies-develop professional staffing plan that describes qualifications/duties/responsibilities/authority of professional positions
HHSC risk weight: Medium. Corrected 2022-08-02. Correction verified 2022-07-29.
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Other
The child care policy is missing information including education, child's rights and religion.
HHSC 748.111 — Child-care policy required
HHSC risk weight: Medium. Corrected 2022-08-02. Correction verified 2022-07-29.
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Supervision & ratios
The EBI policy is missing information, such as what restraints are acceptable.
HHSC 748.113 — EBI policy - develop EBI policies if my operation is permitted to use EBI
HHSC risk weight: Medium High. Corrected 2022-08-02. Correction verified 2022-07-29.
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Discipline & child guidance
During the inspection, the abuse and neglect policies are missing from the operational policies.
HHSC 748.121 — Abuse and neglect policy - You must develop policies on preventing, recognizing, and responding to abuse and neglect of children
HHSC risk weight: Medium High. Corrected 2022-08-02. Correction verified 2022-07-29.
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Records & paperwork
During the inspection, the staff did not have a record of a TB in their file.
HHSC 748.1583(a) — 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
HHSC risk weight: Medium. Corrected 2022-08-02. Correction verified 2022-08-18.
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Supervision & ratios Serious
The tobacco and e-cigarette policy is missing from operational policies. This policy should be address both staff and children in care.
HHSC 748.1661(a) — Tobacco Products and E-Cigarettes -Children may not use or possess tobacco products, e-cigarettes or any type of vaporizers
HHSC risk weight: High. Corrected 2022-08-02. Correction verified 2022-07-29.
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Other
The sanitation inspection was not present and needs to be sent in writing.
HHSC 748.3001(a)(1) — Sanitation Inspection-Sanitation official must conduct a sanitation inspection before initial permit issued
HHSC risk weight: Medium High. Corrected 2022-07-26. Correction verified 2022-07-21.
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Cleanliness & sanitation Serious
During the walk through there were several physical site issues such as a hole in the ceiling on the corner of bedroom 4, a broken drape handle, a hole in the wall with chipped paint in bedroom 3. Additionally, the air ducts needed to cleaned. Work orders were provided.
HHSC 748.3301(a)(1) — Physical Site- Buildings must be structurally sound and not pose a risk to the health and safety of children.
HHSC risk weight: High. Corrected at inspection. Corrected 2022-07-19.
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Staff background & training
During the application review, staff files did not have an adequate amount of required training and the file was missing training hours.
HHSC 748.363(11) — Personnel records-Include record of training and training hours
HHSC risk weight: Medium. Corrected 2022-08-02. Correction verified 2022-08-18.
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Staff background & training
During the application review, C.R. as the PLSP job description is missing the 2 years of experience, education requirement and training does not meet the minimum standards for this position.
HHSC 748.563(c) — Professional level service provider-must meet specific educational and professional qualifications
HHSC risk weight: Medium. Corrected 2022-08-02. Correction verified 2022-07-21.
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Staff background & training
During the application review, the staff did not have valid First Aid and CPR Training in their file.
HHSC 748.981(a)(1) — First-aid-CPR training-Each caregiver must have current certification in first-aid
HHSC risk weight: Medium High. Corrected 2022-08-02. Correction verified 2022-08-18.
HHSC inspection history · no longer published by HHSC; kept here
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Other Serious
-
Jul 19, 2022 Inspection · Deficiencies cited
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Other Serious
During this application review, it was found that the drug test for the staff C.R. was invalid. C.R. has not had drug test.
HHSC 745.4151(c)(4)(A) — Mandatory drug testing-all applicants intended to be hired are subject to pre-employment testing, must have results prior to child access
HHSC risk weight: High. Corrected 2022-08-02. Correction verified 2022-08-18.
-
Supervision & ratios Serious
The weapons, firearms, explosive materials and projectiles policy is missing from the operational policies.
HHSC 748.103(b)(12) — Policies and procedures to submit - Weapons, firearms, explosive materials and projectiles
HHSC risk weight: High. Corrected 2022-08-02. Correction verified 2022-07-29.
-
Staff background & training
The personnel policies do not include all required information for the professional positions. The personnel policies were missing a professional staffing plan with required information.
HHSC 748.105(3)(B) — Personnel policies-develop professional staffing plan that describes qualifications/duties/responsibilities/authority of professional positions
HHSC risk weight: Medium. Corrected 2022-08-02. Correction verified 2022-07-29.
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Other
The child care policy is missing information including education, child's rights and religion.
HHSC 748.111 — Child-care policy required
HHSC risk weight: Medium. Corrected 2022-08-02. Correction verified 2022-07-29.
-
Supervision & ratios
The EBI policy is missing information, such as what restraints are acceptable.
HHSC 748.113 — EBI policy - develop EBI policies if my operation is permitted to use EBI
HHSC risk weight: Medium High. Corrected 2022-08-02. Correction verified 2022-07-29.
-
Discipline & child guidance
During the inspection, the abuse and neglect policies are missing from the operational policies.
HHSC 748.121 — Abuse and neglect policy - You must develop policies on preventing, recognizing, and responding to abuse and neglect of children
HHSC risk weight: Medium High. Corrected 2022-08-02. Correction verified 2022-07-29.
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Records & paperwork
During the inspection, the staff did not have a record of a TB in their file.
HHSC 748.1583(a) — 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
HHSC risk weight: Medium. Corrected 2022-08-02. Correction verified 2022-08-18.
-
Supervision & ratios Serious
The tobacco and e-cigarette policy is missing from operational policies. This policy should be address both staff and children in care.
HHSC 748.1661(a) — Tobacco Products and E-Cigarettes -Children may not use or possess tobacco products, e-cigarettes or any type of vaporizers
HHSC risk weight: High. Corrected 2022-08-02. Correction verified 2022-07-29.
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Other
The sanitation inspection was not present and needs to be sent in writing.
HHSC 748.3001(a)(1) — Sanitation Inspection-Sanitation official must conduct a sanitation inspection before initial permit issued
HHSC risk weight: Medium High. Corrected 2022-07-26. Correction verified 2022-07-21.
-
Cleanliness & sanitation Serious
During the walk through there were several physical site issues such as a hole in the ceiling on the corner of bedroom 4, a broken drape handle, a hole in the wall with chipped paint in bedroom 3. Additionally, the air ducts needed to cleaned. Work orders were provided.
HHSC 748.3301(a)(1) — Physical Site- Buildings must be structurally sound and not pose a risk to the health and safety of children.
HHSC risk weight: High. Corrected at inspection. Corrected 2022-07-19.
-
Staff background & training
During the application review, staff files did not have an adequate amount of required training and the file was missing training hours.
HHSC 748.363(11) — Personnel records-Include record of training and training hours
HHSC risk weight: Medium. Corrected 2022-08-02. Correction verified 2022-08-18.
-
Staff background & training
During the application review, C.R. as the PLSP job description is missing the 2 years of experience, education requirement and training does not meet the minimum standards for this position.
HHSC 748.563(c) — Professional level service provider-must meet specific educational and professional qualifications
HHSC risk weight: Medium. Corrected 2022-08-02. Correction verified 2022-07-21.
-
Staff background & training
During the application review, the staff did not have valid First Aid and CPR Training in their file.
HHSC 748.981(a)(1) — First-aid-CPR training-Each caregiver must have current certification in first-aid
HHSC risk weight: Medium High. Corrected 2022-08-02. Correction verified 2022-08-18.
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Other Serious
Get the full file
HHSC publishes inspections, investigations and assessments from October 2017 onward, with each cited deficiency and its risk weight. Investigation narratives, complaint files and older history require a public information request. The Texas Public Information Act (Texas Government Code Chapter 552) gives anyone the right to ask. You don't have to say why.
Email the request Printable letter (fax or mail)
- Send to
- HHSC Open Records Coordinator, MC-1070 · OpenRecordsRequest@hhs.texas.gov · fax 512-424-6586 · 4601 W. Guadalupe Street, Austin, Texas 78751-3146 · agency instructions
Show the letter text
If something is happening now, report a concern to HHSC Child Care Regulation. For suspected abuse, contact your county child protective services or law enforcement.
Source: Texas Health and Human Services Commission, Child Care Regulation datasets on data.texas.gov. Last read Oct 1, 2026. Violation text is HHSC's own wording. The categories are ours, added to help you scan. About this data.