Texas Neurorehab Center
1106 W DITTMAR RD, Austin, TX 78745 · Travis County
Program
- Type
- General residential operation
- Licensed capacity
- 36
- Ages
- 3-17
- Hours
- -
- Director / administrator
- Marsha Kay Reece
- Phone
- (512) 444-4835
- Regulated since
- Nov 12, 1986
- HHSC IDs
- Operation 94170 · number 6040
- Official record
- HHSC Child Care Search
Violations by category
Year by year
| Year | Violations | Serious | Main categories |
|---|---|---|---|
| 2026 | 6 | 4 | Cleanliness & sanitation (1), Illness & medication (1), Supervision & ratios (3), Other (1) |
| 2025 | 8 | 8 | Cleanliness & sanitation (1), Illness & medication (1), Supervision & ratios (2), Safety & premises (1), Staff background & training (3) |
| 2024 | 24 | 21 | Illness & medication (3), Supervision & ratios (1), Discipline & child guidance (3), Safety & premises (5), Food & allergies (1), Staff background & training (2), Records & paperwork (4), Other (5) |
| 2023 | 19 | 11 | Cleanliness & sanitation (3), Illness & medication (6), Supervision & ratios (2), Discipline & child guidance (3), Safety & premises (1), Records & paperwork (4) |
| 2022 | 5 | 5 | Safety & premises (2), Other (3) |
Inspections, investigations & assessments
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Aug 19, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 6, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 4, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 29, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Jul 25, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Jul 10, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 6, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Jun 26, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Jun 23, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Jun 16, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Jun 16, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Jun 15, 2026 Inspection · Deficiencies cited
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Supervision & ratios Serious
It was observed 2 Direct Care staff supervising 13 residents at lunch and were out of ratio while the other Direct Care staff took a lunch break.
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 2026-06-26. Correction verified 2026-06-26.
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Supervision & ratios Serious
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Jun 2, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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May 27, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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May 19, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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May 18, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Apr 8, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 30, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
-
Mar 27, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Mar 23, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 19, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 18, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Mar 14, 2026 Report · Deficiencies cited
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Supervision & ratios Serious
It was determined the unit was out of ratio.
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 2026-07-03. Correction verified 2026-07-01.
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Supervision & ratios Serious
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Mar 2, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 2, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Feb 21, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 18, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 18, 2026 Report · Deficiencies cited
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Supervision & ratios Serious
Through inspector eye witness and additional interviews with staff it was reported the nurses are being counted in ratio while completing nursing duties and administrative work.
HHSC 748.1005 — Child/caregiver ratio-Each group must have enough caregivers for that group who are not caring for other children or doing administrative work
HHSC risk weight: Medium High. Corrected 2026-03-30. Correction verified 2026-03-23.
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Illness & medication
During the course of the investigation, it was observed the master service plan, the initial nursing treatment plan, and the initial clinical review documents did not contain information regarding self-management of child's illness .
HHSC 748.1331(b)(2) — Preliminary Service Plan-For child receiving treatment services, include a description of child's immediate educational, medical, and dental needs
HHSC risk weight: Medium Low. Corrected 2026-03-30. Correction verified 2026-03-30.
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Cleanliness & sanitation
During the investigation the inspector observed a black substance on the caulking and grout in both shower areas which appeared to be consistent with mold. The inspector also observed black sticky substance emerging through cracks between the floor tiles in the bedrooms of the children. It was also observed a ceiling light fixture or camera is damaged. The hallway floor near the TV room contained visible dust and debris and required sweeping.
HHSC 748.3301(a)(2) — Physical Site- Buildings must be clean and in good repair.
HHSC risk weight: Medium. Corrected 2026-03-30. Correction verified 2026-03-23.
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Other Serious
During the investigation, dead insects were observed enclosed in a ceiling light fixture in the break room and nurse?s station. It was also observed a large spider web above the child?s bed. The inspector observed two small black specks in the cabinet with the children's cereal and on the floor by the TV room which appeared to be consistent with rat droppings.
HHSC 748.3301(h) — Physical Site-The building must be free of rodents and insects
HHSC risk weight: Medium High. Corrected 2026-03-30. Correction verified 2026-03-23.
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Supervision & ratios Serious
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Feb 17, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Dec 15, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 11, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 26, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Nov 17, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Nov 8, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Nov 4, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 30, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Oct 28, 2025 Report · Deficiencies cited
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Supervision & ratios Serious
It was determined there were only 2 staff present for multiple hours with 18 children. 2 additional staff were present but were providing 1:1 care and unable to be counted in ratio.
HHSC 748.1005 — Child/caregiver ratio-Each group must have enough caregivers for that group who are not caring for other children or doing administrative work
HHSC risk weight: Medium High. Corrected 2025-12-12. Correction verified 2025-12-15.
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Supervision & ratios Serious
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Oct 28, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 28, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Oct 20, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Oct 2, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 27, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Jul 11, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 1, 2025 Inspection · Deficiencies cited
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Cleanliness & sanitation Serious
It was observed the unit's showers had mildew on the ceilings and grout, as well as two cockroaches in the shower.
HHSC 748.3391(a) — Bathrooms-Must be maintained in good repair & kept clean
HHSC risk weight: Medium High. Corrected 2025-07-09. Correction verified 2025-07-11.
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Staff background & training Serious
It was observed 2 out of 2 staff files reviewed did not have the required annual training hours or courses.
HHSC 748.930(a)(2) — Caregivers at operations with 25 or more children or 30% or more of their population receiving treatment services must have 50hrs annual training
HHSC risk weight: Medium High. Corrected 2025-07-09. Correction verified 2025-07-07.
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Staff background & training Serious
It was observed 2 out of 2 staff files reviewed did not contain the required 2 hours of Trauma Informed Care training.
HHSC 748.930(b)(2) — Annual Training- Caregivers must have 2 hrs trauma informed care.
HHSC risk weight: Medium High. Corrected 2025-07-09. Correction verified 2025-07-08.
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Staff background & training Serious
It was observed 2 out of 2 staff files reviewed did not contain the required 1 hour of Normalcy training.
HHSC 748.930(b)(3) — Annual Training- Caregivers must have 1 hour normalcy training.
HHSC risk weight: Medium High. Corrected 2025-07-09. Correction verified 2025-07-08.
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Cleanliness & sanitation Serious
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Jun 17, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 12, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Jun 8, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 6, 2025 Report · Deficiencies cited (self-report)
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Illness & medication Serious
A child was restrained for attempting to walk out of the cafeteria without permission which does not constitute an emergency situation where the child or others safety was at risk. The child was not on any safety plan or precautions at the time of the restraint.
HHSC 748.2455(a)(2) — Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
HHSC risk weight: Medium High. Corrected 2025-06-27. Correction verified 2025-07-01.
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Safety & premises Serious
A child was inappropriately restrained by a staff member who placed their arm around the child's neck.
HHSC 748.2551(b)(2) — EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
HHSC risk weight: Medium High. Corrected 2025-06-27. Correction verified 2025-07-01.
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Illness & medication Serious
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May 29, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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May 22, 2025 Report · No deficiencies cited
No violations cited on this visit.
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May 6, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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May 2, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Apr 16, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 13, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Apr 11, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 10, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Apr 9, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Mar 31, 2025 Report · Deficiencies cited
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Supervision & ratios Serious
It was determined staff were out of ratio when a physical altercation occurred between children in care. 2 children, 3 staff, and parent stated the ratio was 2:15 when the incident occurred.
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 2025-05-05. Correction verified 2025-05-06.
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Supervision & ratios Serious
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Mar 7, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 22, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Feb 7, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 23, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 7, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Dec 26, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 25, 2024 Report · Deficiencies cited
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Safety & premises Serious
During the investigation, a staff member reported that they used a threat of a personal restraint as tool for disciplining the child.
HHSC 748.2307(15) — Other Prohibited Punishments-using or threatening to use emergency behavior intervention as discipline or punishment
HHSC risk weight: High. Corrected 2025-01-31. Correction verified 2025-02-07.
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Safety & premises Serious
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Dec 11, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Nov 16, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Nov 16, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 8, 2024 Report · Deficiencies cited (self-report)
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Illness & medication Serious
It was reported that on 11/5/24, a child in care punched a wall at school and this required medical attention. The same child was found to be punching a window at the gym later that same day. It was found this child sustained two finger fractures to the right hand with callous formation and didn?t receive a cast/splint until 11/8/24.
HHSC 748.1531(a)(2) — Medical care-A child in care must receive medical care as needed for injury, illness, and pain
HHSC risk weight: High. Corrected 2025-01-17. Correction verified 2025-01-23.
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Illness & medication Serious
It was found that the incident occurred on 11/5/24 and staff were aware of the child?s right-hand injury on this day, however the incident wasn?t reported to the A/N Hotline until 11/8/24.
HHSC 748.303(a)(2)(A) — AP Serious Incdt-Report to Licensing no later than 24 hours after injury/illness that warrants treatment by a medical professional or hospitalization
HHSC risk weight: Medium High. Corrected 2025-01-17. Correction verified 2025-01-23.
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Records & paperwork
It was found that sections [748.311(2), (4), (5), (7), and (8)] of the incident report documentation were missing required information.
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 2025-01-17. Correction verified 2025-01-23.
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Illness & medication Serious
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Oct 25, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Oct 14, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Oct 14, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Oct 10, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 25, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 24, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Sep 18, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Sep 18, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Sep 17, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 16, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Sep 13, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 11, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Sep 5, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 3, 2024 Report · Deficiencies cited
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Records & paperwork Serious
During the course of the investigation, a staff member and a child reported that the child was restrained briefly on their back (in a supine position).
HHSC 748.2461(b)(1) — Short Personal Restraint-Caregiver may not use a prone or supine restraint
HHSC risk weight: High. Corrected 2024-11-05. Correction verified 2024-11-16.
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Records & paperwork Serious
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Aug 29, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 29, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Aug 29, 2024 Report · Deficiencies cited
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Records & paperwork Serious
Several people interviewed reported a staff member used profane language following a personal restraint in front of a children in care.
HHSC 748.2307(9) — Other Prohibited Punishments-subjecting a child to abusive or profane language
HHSC risk weight: Medium High. Corrected 2024-11-01. Correction verified 2024-11-01.
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Records & paperwork Serious
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Aug 8, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 7, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Jun 24, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 21, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 19, 2024 Report · Deficiencies cited
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Discipline & child guidance Serious
2 children interviewed mentioned a staff threatened at least 1 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 2024-09-09. Correction verified 2024-09-17.
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Food & allergies Serious
A staff threw away a child's food in response to the child spitting at their feet.
HHSC 748.2307(14) — Other Prohibited Punishments-withholding food that meets the child's nutritional requirements
HHSC risk weight: High. Corrected 2024-09-09. Correction verified 2024-09-17.
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Safety & premises Serious
Instead of permitting other staff to manage and defuse the situation, a staff member exacerbated the situation by intervening even though they were aware the child was upset with them.
HHSC 748.2455(a)(1) — Emergency Behavior Intervention-Before using EBI, the caregiver must attempt less restrictive interventions that prove to be ineffective
HHSC risk weight: Medium High. Corrected 2024-09-09. Correction verified 2024-09-17.
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Other Serious
A child received a bloody, swollen nose during a restraint due to a staff member banging their head on the ground.
HHSC 748.2461(a)(2) — Short Personal Restraint-Caregiver must use minimal amount of reasonable and necessary physical force
HHSC risk weight: High. Corrected 2024-09-09. Correction verified 2024-09-17.
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Other Serious
While a child was being restrained by staff, another staff choked the child.
HHSC 748.2461(b)(3) — Short Personal Restraint-Caregiver may not use restraint that obstructs child's airways or impairs child's breathing
HHSC risk weight: High. Corrected 2024-09-09. Correction verified 2024-09-17.
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Discipline & child guidance Serious
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Jun 17, 2024 Report · Deficiencies cited
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Records & paperwork
During an interviews staff stated that a child was escorted from the school building back to the Sierra Unit. This walk would take over 1 minute making it a personal restraint which is required to be documented.
HHSC 748.2855(a) — EBI Documentation-Caregiver must document EBI in child's record as soon as possible, but no later than 24 hours after initiation of the intervention
HHSC risk weight: Medium. Corrected 2024-07-23. Correction verified 2024-07-23.
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Records & paperwork
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Jun 17, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Jun 17, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Jun 12, 2024 Report · Deficiencies cited
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Staff background & training
The facility was unable to provide documentation to show which trainings the staff took with the required information.
HHSC 748.949(a) — Annual Training Documentation-Keep documentation verifying completion of training in the personnel record
HHSC risk weight: Medium Low. Corrected 2024-07-26. Correction verified 2024-07-15.
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Staff background & training
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Jun 12, 2024 Report · Deficiencies cited
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Other Serious
During a restraint, a staff used excessive force to take a child to the ground, causing the child to chip a tooth upon impact.
HHSC 748.2551(c)(2) — EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
HHSC risk weight: High. Corrected 2024-08-02. Correction verified 2024-08-08.
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Other Serious
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Jun 10, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 4, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 3, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Jun 1, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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May 31, 2024 Report · No deficiencies cited
No violations cited on this visit.
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May 30, 2024 Report · No deficiencies cited
No violations cited on this visit.
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May 29, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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May 27, 2024 Report · No deficiencies cited
No violations cited on this visit.
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May 26, 2024 Report · No deficiencies cited
No violations cited on this visit.
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May 25, 2024 Inspection · Deficiencies cited
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Supervision & ratios Serious
During the inspection, it was observed two caregivers were left with fifteen children for approximately ten minutes. This was corrected when the third caregiver returned to the unit.
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 at inspection. Corrected 2024-05-25.
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Supervision & ratios Serious
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May 23, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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May 21, 2024 Report · No deficiencies cited
No violations cited on this visit.
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May 15, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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May 15, 2024 Report · No deficiencies cited
No violations cited on this visit.
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May 14, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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May 13, 2024 Assessment · Deficiencies cited
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Staff background & training Serious
A staff member has been working at the operation since 12.26.23 with an inactive background check.
HHSC 745.641 — AP Background check results - Must receive notification prior to allowing subject to be present at your operation
HHSC risk weight: High. Corrected 2024-05-15. Correction verified 2024-05-15.
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Staff background & training Serious
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May 11, 2024 Report · No deficiencies cited
No violations cited on this visit.
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May 10, 2024 Report · No deficiencies cited
No violations cited on this visit.
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May 9, 2024 Report · No deficiencies cited
No violations cited on this visit.
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May 8, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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May 2, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 24, 2024 Report · Deficiencies cited
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Safety & premises Serious
A child was placed in seclusion before staff utilized less restrictive techniques.
HHSC 748.2455(a)(1) — Emergency Behavior Intervention-Before using EBI, the caregiver must attempt less restrictive interventions that prove to be ineffective
HHSC risk weight: Medium High. Corrected 2024-06-21. Correction verified 2024-06-24.
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Illness & medication Serious
A child was placed in the seclusion room for a non-emergency situation.
HHSC 748.2455(a)(2) — Emergency Behavior Intervention-Basis for EBI is an emergency situation or to administer medication
HHSC risk weight: Medium High. Corrected 2024-06-21. Correction verified 2024-06-24.
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Safety & premises Serious
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Apr 22, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 19, 2024 Report · Deficiencies cited
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Other Serious
During interviews 3 out of 3 children stated staff use profane language around them. 2 staff memebers also admitted to using profane language.
HHSC 748.2307(9) — Other Prohibited Punishments-subjecting a child to abusive or profane language
HHSC risk weight: Medium High. Corrected 2024-05-10. Correction verified 2024-05-14.
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Other Serious
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Apr 18, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Mar 25, 2024 Report · Deficiencies cited
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Discipline & child guidance Serious
This standards was found deficient as part of a DFPS investigation.
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 2024-05-17. Correction verified 2024-05-29.
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Safety & premises Serious
During the course of the investigation, it was determined that the caregiver used a type of restraint that was not allowed.
HHSC 748.2551(b)(2) — EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention
HHSC risk weight: Medium High. Corrected 2024-06-11. Correction verified 2024-05-29.
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Other Serious
During the course of the investigation, it was determined that the caregiver used more force causing injury to a child.
HHSC 748.2551(c)(2) — EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force
HHSC risk weight: High. Corrected 2024-06-11. Correction verified 2024-05-29.
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Safety & premises Serious
During the course of the investigation, it was determined that a child in care had their arm held behind their back during an emergency behavior intervention.
HHSC 748.2605(a)(5) — Personal Restraints Prohibited-Restraints that twist or place the child's limb(s) behind the child's back
HHSC risk weight: High. Corrected 2024-06-11. Correction verified 2024-05-29.
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Discipline & child guidance Serious
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Mar 16, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Mar 12, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 8, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Mar 7, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 4, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Mar 1, 2024 Report · Deficiencies cited
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Discipline & child guidance Serious
The incident occurred on 1.23.24 and the child made the allegations the same day during the debriefing. However, the incident was not reported to Licensing until 2.29.24.
HHSC 748.303(a)(3)(A) — Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child
HHSC risk weight: Medium High. Corrected 2024-06-03. Correction verified 2024-06-06.
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Discipline & child guidance Serious
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Feb 28, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Feb 6, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 17, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 12, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Dec 28, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 27, 2023 Report · Deficiencies cited
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Discipline & child guidance Serious
An internal investigation was completed on 12.19.24 for an incident that occurred on 12.17.24. This incident should have been reported to statewide intake for an abuse investigation.
HHSC 745.8411(a) — Responsibilities - Not interfere with an inspection or investigation
HHSC risk weight: High. Corrected 2024-03-01. Correction verified 2024-03-07.
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Discipline & child guidance Serious
The incident took place on 12.17.24 but was not reported to licensing until 12.27.24.
HHSC 748.303(a)(3)(A) — Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child
HHSC risk weight: Medium High. Corrected 2024-03-01. Correction verified 2024-03-07.
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Discipline & child guidance Serious
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Dec 26, 2023 Report · Deficiencies cited (self-report)
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Illness & medication Serious
During the investigation, it was determined that the operation failed to submit the serious incident report within the required timeframe. The incident occurred on 12/22/23 and was reported to Licensing on 12/26/23.
HHSC 748.303(a)(2)(A) — AP Serious Incdt-Report to Licensing no later than 24 hours after injury/illness that warrants treatment by a medical professional or hospitalization
HHSC risk weight: Medium High. Corrected 2024-01-26. Correction verified 2024-01-25.
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Illness & medication Serious
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Dec 21, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Dec 20, 2023 Report · Deficiencies cited
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Discipline & child guidance Serious
A child in care was hit and choked by a staff member. This incident meets Texas Family Code and Texas Administrative Code definition of abuse.
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 2024-03-12. Correction verified 2024-03-12.
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Discipline & child guidance Serious
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Dec 19, 2023 Inspection · Deficiencies cited
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Cleanliness & sanitation Serious
Mold was observed in the Sierra unit showers.
HHSC 748.3351(1) — Interior Space-Provide living space, appropriate furnishings, & bathroom facilities that are safe, clean and maintained in good repair
HHSC risk weight: Medium High. Corrected 2024-01-02. Correction verified 2024-01-17.
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Cleanliness & sanitation Serious
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Nov 15, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Nov 9, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Nov 3, 2023 Report · Deficiencies cited
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Illness & medication Serious
It was discovered the child was administered the wrong medication accidently, one they were documented to be allergic to. The child did not have a reaction to the medication, so it was added to their daily medication regimen.
HHSC 748.2203(c) — Medication Error-Operation must meet documentation requirements within 24 hrs
HHSC risk weight: Medium High. Corrected 2023-12-22. Correction verified 2023-12-21.
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Illness & medication Serious
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Nov 2, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Oct 13, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Sep 15, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 4, 2023 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Aug 24, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Aug 17, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Aug 17, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Aug 11, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Aug 10, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Aug 9, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Aug 7, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 27, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 24, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Jul 6, 2023 Inspection · Deficiencies cited
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Safety & premises
It was observed in the gym that there was no fire extinguisher found in the vicinity. This was corrected during the inspection when the maintenance worker sent a picture to the administrator of the fire extinguisher being posted in the gym.
HHSC 748.3115(2) — Fire Extinguisher-Must ensure fire extinguishers are accessible for immediate use by employees, caregivers, & volunteers
HHSC risk weight: Medium. Corrected at inspection. Corrected 2023-07-06.
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Cleanliness & sanitation
It was observed on the sidewalk outside of the gym there were animal feces in dog bags.
HHSC 748.3301(a)(2) — Physical Site- Buildings must be clean and in good repair.
HHSC risk weight: Medium. Corrected 2023-07-21. Correction verified 2023-08-07.
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Cleanliness & sanitation Serious
It was observed in the gym that three window panels were missing/broken, It was also found that one of the closets in the gym was unlocked and a hole in the ceiling along with the light fixture was not turning on properly was observed.
HHSC 748.3301(c) — Physical Site-Windows & doors must be in good repair & free of broken glass or hazards
HHSC risk weight: Medium High. Corrected 2023-08-07. Correction verified 2023-08-07.
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Safety & premises
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Jun 30, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Jun 28, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 23, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Jun 11, 2023 Report · Deficiencies cited (self-report)
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Records & paperwork
The incident was reported to the hotline sixteen hours after the children in care were noticed missing and not reported within six hours. During the course of the investigation, it was noticed that only one victim was reported missing when two children in care eloped from the facility.
HHSC 748.303(a)(10)(A) — Serious Incident-Report to Licensing no later than 6 hours after determining unauthorized absence of a child 13 yrs old or older.
HHSC risk weight: Medium. Corrected 2023-08-14. Correction verified 2023-08-14.
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Records & paperwork
The facility failed to provide RCCL Inspectors with a serious incident report or formal facility report for the incident. Requests for an incident report were made on 06/15/2023, 06/28/2023, and 07/19/2023, requests were made in person and through email.
HHSC 748.311(8) — Serious Incident Documentation-Includes interventions made during and after the incident, i.e. medical interventions, contacts made, other actions
HHSC risk weight: Medium. Corrected 2023-08-14. Correction verified 2023-08-14.
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Supervision & ratios Serious
Two children in care spent several days creating a hole big enough to escape unnoticed. During the time the children in care eloped, caretakers conducted routine 15-minute checks and marked them in their rooms.
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 2023-08-14. Correction verified 2023-08-14.
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Records & paperwork
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Apr 5, 2023 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Feb 27, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 18, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Feb 13, 2023 Inspection · Deficiencies cited
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Illness & medication
It was determined that a nurse had multiple medications ready to disburse hours prior to the time the medication is labeled to be administered.
HHSC 748.2003(b)(4) — Administration of prescription medication-Administer each child's medication within one hour of preparation
HHSC risk weight: Medium. Corrected 2023-02-27. Correction verified 2023-02-27.
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Illness & medication Serious
It was found that three future time and signature were documented in a medication record prior to administering the medication. One medication record had the incorrect count documented. It was also found that one medication record was missing information on who disbursed the medication.
HHSC 748.2151(b)(1) — Medication record - update cumulative record within 2 hours of administering medication
HHSC risk weight: Medium High. Corrected 2023-02-27. Correction verified 2023-02-27.
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Illness & medication
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Jan 26, 2023 Inspection · Deficiencies cited
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Illness & medication Serious
There were two staff members 13 resident in the Sierra Unit. As per staff the nurse was counted in ration. There were 14 residents to 2 staff members in the Chaparral Unit. Both nurses were seen in the locked nurse s station administering medication.
HHSC 748.1005 — Child/caregiver ratio-Each group must have enough caregivers for that group who are not caring for other children or doing administrative work
HHSC risk weight: Medium High. Corrected 2023-02-08. Correction verified 2023-02-13.
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Records & paperwork
There was no Keeping Children Safe poster located anywhere in the Chaparral Unit.
HHSC 748.191(2) — Required Postings-Post Licensing notice Keeping Children Safe in prominent and publicly accessible place where others may easily view it at all times
HHSC risk weight: Medium Low. Corrected 2023-02-08. Correction verified 2023-02-13.
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Illness & medication Serious
8 noted times on 6 medication records/logs did not document administered medication.
HHSC 748.2151(b)(1) — Medication record - update cumulative record within 2 hours of administering medication
HHSC risk weight: Medium High. Corrected 2023-02-08. Correction verified 2023-02-13.
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Records & paperwork
It was reported that all showers in the Chaparral and Sierra Unit were not in working condition as of three week prior to this date. Children in care take turns every other day to take showers in another building not subject to regulation.
HHSC 748.3397(d)(2) — Bathing-Provide sufficient hot water to meet the demands of the children
HHSC risk weight: Medium Low. Corrected 2023-02-08. Correction verified 2023-02-13.
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Supervision & ratios
During the walk-through of the cafeteria, it was noted that pork was kept uncovered in the freezer, a stainless-steel container of peaches in juice were kept uncovered on a cart located in a hallway in the cafeteria and a bowl of food was uncovered in the refrigerator located in the cafeteria entrance.
HHSC 748.3443(a)(1) — Food Preparation-Food items must be covered & stored off the floor
HHSC risk weight: Medium. Corrected 2023-02-08. Correction verified 2023-02-13.
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Illness & medication Serious
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Jan 14, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Dec 29, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Dec 5, 2022 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 26, 2022 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Nov 7, 2022 Report · Deficiencies cited
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Safety & premises Serious
It was determined that a child was restrained by staff in a wooded area in an attempt to stop them from elopement. This area was reported to be an open field with extensive brush, trees, frontage including thorns. After multiple attempts to restrain the child, there were four reported physical altercations between staff and child in where they fell on to the described brush. As such, the staff sustained several injuries.
HHSC 748.2551(b)(1) — EBI Implementation-The caregiver must consider the characteristics of the immediate physical environment
HHSC risk weight: High. Corrected 2022-12-22. Correction verified 2022-12-22.
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Safety & premises Serious
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Nov 1, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Jul 22, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Jul 18, 2022 Report · Deficiencies cited (self-report)
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Safety & premises Serious
It was concluded that a staff member subjected a child to an unnecessary EBI as a means to comply.
HHSC 748.2455(a)(1) — Emergency Behavior Intervention-Before using EBI, the caregiver must attempt less restrictive interventions that prove to be ineffective
HHSC risk weight: Medium High. Corrected 2022-12-01. Correction verified 2022-11-30.
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Other Serious
During the course of this investigation, it was determined that a staff member conducted an unnecessary EBI and used unnecessary strength forcing a child in care to the ground causing a bruise on their face. It was determined that the child was not a danger to self and/or others.
HHSC 748.2551(c)(1) — EBI Implementation-Caregiver must minimize risk of physical discomfort, harm, or pain to the child
HHSC risk weight: High. Corrected 2022-12-01. Correction verified 2022-11-30.
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Safety & premises Serious
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Jul 15, 2022 Inspection · Deficiencies cited
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Other Serious
Both Chaparral and Sierra Unit walls had extensive peeling.
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 2022-07-29. Correction verified 2022-07-29.
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Other Serious
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Jun 28, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Jun 17, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Apr 18, 2022 Report · Deficiencies cited
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Other Serious
During the course of this investigation, it was determined that a child in care was improperly restrained and not documented.
HHSC 748.2551(c)(1) — EBI Implementation-Caregiver must minimize risk of physical discomfort, harm, or pain to the child
HHSC risk weight: High. Corrected 2022-06-22. Correction verified 2022-06-22.
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Other Serious
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Mar 7, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Jan 29, 2022 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 21, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Oct 8, 2021 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 8, 2021 Report · No deficiencies cited
No violations cited on this visit.
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, via 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.