Special Parent Advocacy Group A Nj Nonprofit Corporation
13469 CHISUM RD, Sanger, TX 76266 · Denton County
Program
- Type
- General residential operation
- Licensed capacity
- 13
- Ages
- 5-17
- Hours
- -
- Director / administrator
- Samantha Maleika Lamb
- Phone
- (940) 248-9539
- Regulated since
- Mar 28, 2024
- HHSC IDs
- Operation 1441258 · number 1769797
- Official record
- HHSC Child Care Search
Violations by category
Year by year
| Year | Violations | Serious | Main categories |
|---|---|---|---|
| 2026 | 6 | 2 | Illness & medication (2), Supervision & ratios (2), Staff background & training (2) |
| 2025 | 60 | 14 | Cleanliness & sanitation (2), Illness & medication (22), Supervision & ratios (16), Safety & premises (2), Staff background & training (6), Records & paperwork (4), Other (8) |
| 2024 | 14 | 2 | Illness & medication (2), Discipline & child guidance (2), Staff background & training (2), Records & paperwork (6), Other (2) |
| 2023 | 12 | 4 | Illness & medication (6), Staff background & training (4), Other (2) |
Enforcement actions
- Seen Oct 1, 2026 — Corrective action in effect (HHSC operation record)
HHSC publishes these as current flags on the operation, not as dated actions. The date shown is when this site first saw the flag. The HHSC Child Care Search has the details.
Inspections, investigations & assessments
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Sep 24, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 24, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 18, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 18, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 20, 2026 Report
No violations cited on this visit.
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Jun 20, 2026 Report
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 18, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 18, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 9, 2026 Inspection
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 9, 2026 Inspection
No violations cited on this visit.
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Jun 8, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Jun 8, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 21, 2026 Report
No violations cited on this visit.
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May 21, 2026 Report
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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May 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 19, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Apr 19, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Apr 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 26, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 26, 2026 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 27, 2026 Inspection · Deficiencies cited
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Illness & medication
A child in care medication log was not signed by staff. The medication log was seen in the child's binder.
HHSC 748.2151(c)(6) — Medication record - must include name & signature of person who administered each medication
HHSC risk weight: Medium. Corrected 2026-03-06. Correction verified 2026-02-27.
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Illness & medication
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Feb 27, 2026 Inspection · Deficiencies cited
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Illness & medication
A child in care medication log was not signed by staff. The medication log was seen in the child's binder.
HHSC 748.2151(c)(6) — Medication record - must include name & signature of person who administered each medication
HHSC risk weight: Medium. Corrected 2026-03-06. Correction verified 2026-02-27.
HHSC inspection history · no longer published by HHSC; kept here
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Illness & medication
-
Jan 14, 2026 Inspection · Deficiencies cited
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Staff background & training Serious
Condition 1: Met Condition 2: No met. A training for a staff member expired in December and there was no documentation showing the staff was notified of her expired training or when they were due. Condition 3: Met Condition 4: Not due yet. Condition 5: Not met. There were two noted concerns by a youth with no plan to follow up on the concerns.
HHSC 745.8641 — Requirements during probation
HHSC risk weight: High. Corrected 2026-01-19. Correction verified 2026-01-26.
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Supervision & ratios
The written incident report still does not include the phone number for the operation.
HHSC 748.311 — Serious Incident Documentation-Documented in written report
HHSC risk weight: Medium. Corrected 2026-01-19. Correction verified 2026-01-26.
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Staff background & training Serious
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Jan 14, 2026 Inspection · Deficiencies cited
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Staff background & training Serious
Condition 1: Met Condition 2: No met. A training for a staff member expired in December and there was no documentation showing the staff was notified of her expired training or when they were due. Condition 3: Met Condition 4: Not due yet. Condition 5: Not met. There were two noted concerns by a youth with no plan to follow up on the concerns.
HHSC 745.8641 — Requirements during probation
HHSC risk weight: High. Corrected 2026-01-19. Correction verified 2026-01-26.
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Supervision & ratios
The written incident report still does not include the phone number for the operation.
HHSC 748.311 — Serious Incident Documentation-Documented in written report
HHSC risk weight: Medium. Corrected 2026-01-19. Correction verified 2026-01-26.
HHSC inspection history · no longer published by HHSC; kept here
-
Staff background & training Serious
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Jan 10, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Jan 10, 2026 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 8, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 8, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jan 7, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Jan 7, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Dec 20, 2025 Report · Deficiencies cited
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Supervision & ratios Serious
A child that was required 1:1 supervision was left unsupervised with another child resulting in inappropriate contact between the children. The children were also allowed to be on the couch together under blankets.
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 2026-02-04. Correction verified 2026-02-12.
HHSC inspection history · no longer published by HHSC; kept here
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Supervision & ratios Serious
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Dec 20, 2025 Report · Deficiencies cited
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Supervision & ratios Serious
A child that was required 1:1 supervision was left unsupervised with another child resulting in inappropriate contact between the children. The children were also allowed to be on the couch together under blankets.
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 2026-02-04. Correction verified 2026-02-12.
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Supervision & ratios Serious
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Dec 16, 2025 Inspection · Deficiencies cited
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Records & paperwork Serious
One restraint report reviewed documented that a child was held in a personal restraint for an hour and 45 minutes.
HHSC 748.2801(2)(A) — EBI Time Limits-Maximum length of time for personal restraint for a child of any age is 30 minutes.
HHSC risk weight: High. Corrected 2025-12-19. Correction verified 2026-01-14.
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Records & paperwork
One report reviewed indicated two restraints were used on a child and both restraints did not have a time documented for how long the restraints lasted.
HHSC 748.2855(a)(6) — EBI Documentation-Must include the length of time the child was restrained or secluded
HHSC risk weight: Medium. Corrected 2025-12-23. Correction verified 2025-12-18.
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Supervision & ratios
EBI Quarterly reports were not submitted for the 1st, 2nd and 3rd quarters.
HHSC 748.2953(a) — Evaluation-Quarterly, operation must collect, document, & review aggregate numbers of emergency behavior interventions by type of intervention
HHSC risk weight: Medium. Corrected 2025-12-23. Correction verified 2025-12-18.
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Records & paperwork Serious
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Dec 16, 2025 Inspection · Deficiencies cited
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Records & paperwork Serious
One restraint report reviewed documented that a child was held in a personal restraint for an hour and 45 minutes.
HHSC 748.2801(2)(A) — EBI Time Limits-Maximum length of time for personal restraint for a child of any age is 30 minutes.
HHSC risk weight: High. Corrected 2025-12-19. Correction verified 2026-01-14.
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Records & paperwork
One report reviewed indicated two restraints were used on a child and both restraints did not have a time documented for how long the restraints lasted.
HHSC 748.2855(a)(6) — EBI Documentation-Must include the length of time the child was restrained or secluded
HHSC risk weight: Medium. Corrected 2025-12-23. Correction verified 2025-12-18.
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Supervision & ratios
EBI Quarterly reports were not submitted for the 1st, 2nd and 3rd quarters.
HHSC 748.2953(a) — Evaluation-Quarterly, operation must collect, document, & review aggregate numbers of emergency behavior interventions by type of intervention
HHSC risk weight: Medium. Corrected 2025-12-23. Correction verified 2025-12-18.
HHSC inspection history · no longer published by HHSC; kept here
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Records & paperwork Serious
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Dec 1, 2025 Report · Deficiencies cited
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Other
A child in care that is receiving treatment services for autism spectrum disorder has not had the service plan reviewed since May 2025. This exceeds the 90-day requirement by 140 days.
HHSC 748.1381(2) — Service Plan Review-If child receiving treatment services for ED, ASD, or PMN, review at least 90 days from date of last service plan
HHSC risk weight: Medium Low. Corrected 2026-01-05. Correction verified 2026-01-14.
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Supervision & ratios
The incident report reviewed had incorrect documentation on whether the child loss consciousness or not. Also, the EBI reports did not document the restraints as separate documents.
HHSC 748.151(3) — Operational responsibilities - Maintain current, true, accurate, and complete records
HHSC risk weight: Medium. Corrected 2026-01-23. Correction verified 2026-02-03.
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Illness & medication
The operation is using PRN medications as emergency medication. The operation is not permitted for emergency medications.
HHSC 748.2451(a)(3) — Emergency Behavior Intervention-Use emergency medication only if policies permit and requirements of this subchapter are met
HHSC risk weight: Medium High. Corrected 2026-01-05. Correction verified 2026-01-14.
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Safety & premises
A caregiver grabbed and held the shirt collar of a child in care rather than conducting an appropriate restraint.
HHSC 748.2463(4) — Emergency Behavior Intervention-Never used as a convenience for caregivers or other persons
HHSC risk weight: Medium High. Corrected 2026-01-05. Correction verified 2026-01-14.
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Illness & medication Serious
The operation did not have written orders to administer emergency medication to a youth in care.
HHSC 748.2501(3)(A) — Emergency Behavior Intervention Orders-Required for emergency medication
HHSC risk weight: High. Corrected 2026-01-05. Correction verified 2026-01-14.
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Other Serious
A caregiver sat on a child's torso during a supine restraint putting pressure on the child's torso.
HHSC 748.2605(a)(1) — Personal Restraints Prohibited-Restraints that impair child's breathing by putting pressure on child's torso
HHSC risk weight: High. Corrected 2026-01-05. Correction verified 2026-01-14.
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Illness & medication
The documentation reviewed for a restraint did not include the following: #10 - attempts to explain to the child what behaviors were necessary for release #11 - The child's condition following the use of the medication. #12 - The actions the caregivers took the return the child to normal activities.
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 2026-01-05. Correction verified 2026-01-14.
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Other
The supine restraint used was not documented.
HHSC 748.2855(c) — EBI Documentation-If personal restraint, must include specific restraint techniques used, including prone/supine restraint used as transitional hold
HHSC risk weight: Medium. Corrected 2026-01-05. Correction verified 2026-01-14.
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Supervision & ratios
The written incident report did not include the following: Phone number for the operation The gender of the child in care is incorrect.
HHSC 748.311 — Serious Incident Documentation-Documented in written report
HHSC risk weight: Medium. Corrected 2026-01-05. Correction verified 2026-03-26.
HHSC inspection history · no longer published by HHSC; kept here
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Other
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Dec 1, 2025 Report · Deficiencies cited
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Other
A child in care that is receiving treatment services for autism spectrum disorder has not had the service plan reviewed since May 2025. This exceeds the 90-day requirement by 140 days.
HHSC 748.1381(2) — Service Plan Review-If child receiving treatment services for ED, ASD, or PMN, review at least 90 days from date of last service plan
HHSC risk weight: Medium Low. Corrected 2026-01-05. Correction verified 2026-01-14.
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Supervision & ratios
The incident report reviewed had incorrect documentation on whether the child loss consciousness or not. Also, the EBI reports did not document the restraints as separate documents.
HHSC 748.151(3) — Operational responsibilities - Maintain current, true, accurate, and complete records
HHSC risk weight: Medium. Corrected 2026-01-23. Correction verified 2026-02-03.
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Illness & medication
The operation is using PRN medications as emergency medication. The operation is not permitted for emergency medications.
HHSC 748.2451(a)(3) — Emergency Behavior Intervention-Use emergency medication only if policies permit and requirements of this subchapter are met
HHSC risk weight: Medium High. Corrected 2026-01-05. Correction verified 2026-01-14.
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Safety & premises
A caregiver grabbed and held the shirt collar of a child in care rather than conducting an appropriate restraint.
HHSC 748.2463(4) — Emergency Behavior Intervention-Never used as a convenience for caregivers or other persons
HHSC risk weight: Medium High. Corrected 2026-01-05. Correction verified 2026-01-14.
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Illness & medication Serious
The operation did not have written orders to administer emergency medication to a youth in care.
HHSC 748.2501(3)(A) — Emergency Behavior Intervention Orders-Required for emergency medication
HHSC risk weight: High. Corrected 2026-01-05. Correction verified 2026-01-14.
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Other Serious
A caregiver sat on a child's torso during a supine restraint putting pressure on the child's torso.
HHSC 748.2605(a)(1) — Personal Restraints Prohibited-Restraints that impair child's breathing by putting pressure on child's torso
HHSC risk weight: High. Corrected 2026-01-05. Correction verified 2026-01-14.
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Illness & medication
The documentation reviewed for a restraint did not include the following: #10 - attempts to explain to the child what behaviors were necessary for release #11 - The child's condition following the use of the medication. #12 - The actions the caregivers took the return the child to normal activities.
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 2026-01-05. Correction verified 2026-01-14.
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Other
The supine restraint used was not documented.
HHSC 748.2855(c) — EBI Documentation-If personal restraint, must include specific restraint techniques used, including prone/supine restraint used as transitional hold
HHSC risk weight: Medium. Corrected 2026-01-05. Correction verified 2026-01-14.
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Supervision & ratios
The written incident report did not include the following: Phone number for the operation The gender of the child in care is incorrect.
HHSC 748.311 — Serious Incident Documentation-Documented in written report
HHSC risk weight: Medium. Corrected 2026-01-05. Correction verified 2026-03-26.
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Other
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Dec 1, 2025 Inspection
No violations cited on this visit.
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Dec 1, 2025 Inspection
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Nov 24, 2025 Inspection · Deficiencies cited
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Illness & medication Serious
Condition 1 - Met; Condition 2 - Met; Condition 3 - Not Met - Two children had errors on their medication audits that were not reviewed by the LCCA or contained a compliance plan; Condition 4 - Met; Condition 5 - Not Met - Observation reports were not signed by all three governing body members.
HHSC 745.8641 — Requirements during probation
HHSC risk weight: High. Corrected 2025-12-05. Correction verified 2026-01-14.
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Illness & medication
Two Medication logs reviewed were missing the time each medication was provided.
HHSC 748.2151(c)(5) — Medication record - must include date (day/month/year) & time each medication was administered
HHSC risk weight: Medium High. Corrected 2025-12-05. Correction verified 2026-01-14.
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Staff background & training
One employee's file reviewed had an affidavit that was not notarized.
HHSC 748.505(b)(4) — Minimum qualifications for employees-Complete notarized Licensing Affidavit for Applicants for Employment form
HHSC risk weight: Medium. Corrected 2025-12-01. Correction verified 2026-01-14.
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Staff background & training
One employee's file reviewed did not have a completed pre-employment screening.
HHSC 748.505(b)(6) — Minimum qualifications for employees- Must have cleared pre-employment screening assessment.
HHSC risk weight: Medium High. Corrected 2025-12-05. Correction verified 2026-01-14.
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Illness & medication Serious
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Nov 24, 2025 Inspection · Deficiencies cited
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Illness & medication Serious
Condition 1 - Met; Condition 2 - Met; Condition 3 - Not Met - Two children had errors on their medication audits that were not reviewed by the LCCA or contained a compliance plan; Condition 4 - Met; Condition 5 - Not Met - Observation reports were not signed by all three governing body members.
HHSC 745.8641 — Requirements during probation
HHSC risk weight: High. Corrected 2025-12-05. Correction verified 2026-01-14.
-
Illness & medication
Two Medication logs reviewed were missing the time each medication was provided.
HHSC 748.2151(c)(5) — Medication record - must include date (day/month/year) & time each medication was administered
HHSC risk weight: Medium High. Corrected 2025-12-05. Correction verified 2026-01-14.
-
Staff background & training
One employee's file reviewed had an affidavit that was not notarized.
HHSC 748.505(b)(4) — Minimum qualifications for employees-Complete notarized Licensing Affidavit for Applicants for Employment form
HHSC risk weight: Medium. Corrected 2025-12-01. Correction verified 2026-01-14.
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Staff background & training
One employee's file reviewed did not have a completed pre-employment screening.
HHSC 748.505(b)(6) — Minimum qualifications for employees- Must have cleared pre-employment screening assessment.
HHSC risk weight: Medium High. Corrected 2025-12-05. Correction verified 2026-01-14.
HHSC inspection history · no longer published by HHSC; kept here
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Illness & medication Serious
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Nov 19, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Nov 19, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Oct 15, 2025 Inspection · Deficiencies cited
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Supervision & ratios Serious
Condition 1- Compliant Condition 2- The operation's timeframe to implement this condition has not expired. Pending Review. Condition 3- Compliant Condition 4-The operation's timeframe to implement this condition has not expired. Pending Review. Condition 5- Deficient-. The observation forms did not include the signature of the Governing Body within 48 hours of the observation. The observation log did ensure that all observations were conducted by the Administrator, Designee on record, or Designated person in Management (not to include Direct Staff or Direct Care Supervisors). The observation did not evaluate the interactions of the Direct Care Supervisors, Caregivers, and Children in Care
HHSC 745.8641 — Requirements during probation
HHSC risk weight: High. Corrected 2025-10-22. Correction verified 2025-10-24.
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Supervision & ratios Serious
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Oct 15, 2025 Inspection · Deficiencies cited
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Supervision & ratios Serious
Condition 1- Compliant Condition 2- The operation's timeframe to implement this condition has not expired. Pending Review. Condition 3- Compliant Condition 4-The operation's timeframe to implement this condition has not expired. Pending Review. Condition 5- Deficient-. The observation forms did not include the signature of the Governing Body within 48 hours of the observation. The observation log did ensure that all observations were conducted by the Administrator, Designee on record, or Designated person in Management (not to include Direct Staff or Direct Care Supervisors). The observation did not evaluate the interactions of the Direct Care Supervisors, Caregivers, and Children in Care
HHSC 745.8641 — Requirements during probation
HHSC risk weight: High. Corrected 2025-10-22. Correction verified 2025-10-24.
HHSC inspection history · no longer published by HHSC; kept here
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Supervision & ratios Serious
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Sep 12, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Sep 12, 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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Sep 3, 2025 Inspection · Deficiencies cited
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Supervision & ratios
The grass in the backyard needed to be mowed and there was a tree in the middle of the property that had fallen.
HHSC 748.3301(f) — Physical Site-The grounds of the operation must be well maintained and free of hazards
HHSC risk weight: Medium High. Corrected 2026-05-03. Correction verified 2026-02-27.
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Cleanliness & sanitation
There were two bedrooms that are designated for male children that is not near a restroom. The children have to walk through the case manager's office, living room, two hallways and the master bedroom to reach the restroom that is designated for them.
HHSC 748.3391(c) — Bathrooms-Child must not have to cross a common use room to access a bathroom from the child's bedroom
HHSC risk weight: Low. Corrected 2026-05-03. Correction verified 2026-02-27.
HHSC inspection history · no longer published by HHSC; kept here
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Supervision & ratios
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Sep 3, 2025 Inspection · Deficiencies cited
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Supervision & ratios
The grass in the backyard needed to be mowed and there was a tree in the middle of the property that had fallen.
HHSC 748.3301(f) — Physical Site-The grounds of the operation must be well maintained and free of hazards
HHSC risk weight: Medium High. Corrected 2026-05-03. Correction verified 2026-02-27.
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Cleanliness & sanitation
There were two bedrooms that are designated for male children that is not near a restroom. The children have to walk through the case manager's office, living room, two hallways and the master bedroom to reach the restroom that is designated for them.
HHSC 748.3391(c) — Bathrooms-Child must not have to cross a common use room to access a bathroom from the child's bedroom
HHSC risk weight: Low. Corrected 2026-05-03. Correction verified 2026-02-27.
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Supervision & ratios
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Sep 2, 2025 Report
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Sep 2, 2025 Report
No violations cited on this visit.
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Jul 8, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jul 8, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 26, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Jun 26, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Jun 20, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 20, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 30, 2025 Report · No deficiencies cited
No violations cited on this visit.
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May 30, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 6, 2025 Inspection · 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.
HHSC inspection history · no longer published by HHSC; kept here
-
May 6, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
May 6, 2025 Inspection · 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 11, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Apr 2, 2025 Report · Deficiencies cited
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Other Serious
A caregiver restrained a child by placing both arms behind the 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 2025-05-06. Correction verified 2025-05-06.
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Supervision & ratios
The entry/exit doors to a room have child locking devices on the doorknobs. This room was used to isolate a child while escalated. The child was left alone in the room without a method to supervise. The operation is not permitted to provide seclusion services as a behavior intervention.
HHSC 748.2651(a) — Seclusion-Caregivers must continuously observe the child; use of window or one-way mirror allowed; use of video camera not permitted
HHSC risk weight: Medium High. Corrected 2025-05-06. Correction verified 2025-05-06.
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Other Serious
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Apr 2, 2025 Report · Deficiencies cited
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Other Serious
A caregiver restrained a child by placing both arms behind the 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 2025-05-06. Correction verified 2025-05-06.
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Supervision & ratios
The entry/exit doors to a room have child locking devices on the doorknobs. This room was used to isolate a child while escalated. The child was left alone in the room without a method to supervise. The operation is not permitted to provide seclusion services as a behavior intervention.
HHSC 748.2651(a) — Seclusion-Caregivers must continuously observe the child; use of window or one-way mirror allowed; use of video camera not permitted
HHSC risk weight: Medium High. Corrected 2025-05-06. Correction verified 2025-05-06.
HHSC inspection history · no longer published by HHSC; kept here
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Other Serious
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Mar 30, 2025 Report · Recorded (self-report)
No violations cited on this visit.
-
Mar 30, 2025 Report · Recorded (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 25, 2025 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 25, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Mar 16, 2025 Inspection · Deficiencies cited
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Illness & medication
A child in care was not given his prescription eye drops as instructed by the doctor.
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 2025-03-21. Correction verified 2025-05-06.
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Illness & medication
The medication log did not have a specific time as to when the medication was given.
HHSC 748.2151(c)(5) — Medication record - must include date (day/month/year) & time each medication was administered
HHSC risk weight: Medium High. Corrected 2025-03-21. Correction verified 2025-05-06.
HHSC inspection history · no longer published by HHSC; kept here
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Illness & medication
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Mar 16, 2025 Inspection · Deficiencies cited
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Illness & medication
A child in care was not given his prescription eye drops as instructed by the doctor.
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 2025-03-21. Correction verified 2025-05-06.
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Illness & medication
The medication log did not have a specific time as to when the medication was given.
HHSC 748.2151(c)(5) — Medication record - must include date (day/month/year) & time each medication was administered
HHSC risk weight: Medium High. Corrected 2025-03-21. Correction verified 2025-05-06.
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Illness & medication
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Mar 15, 2025 Report · Deficiencies cited
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Staff background & training
A staff member did not complete annual trainings in a timely manner nor by the required time frame.
HHSC 748.935(a)(2) — Annual Training Timeline-Each person must complete the required annual training during each subsequent 12-month period
HHSC risk weight: Medium. Corrected 2025-05-02. Correction verified 2025-05-06.
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Staff background & training
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Mar 15, 2025 Report · Deficiencies cited
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Staff background & training
A staff member did not complete annual trainings in a timely manner nor by the required time frame.
HHSC 748.935(a)(2) — Annual Training Timeline-Each person must complete the required annual training during each subsequent 12-month period
HHSC risk weight: Medium. Corrected 2025-05-02. Correction verified 2025-05-06.
HHSC inspection history · no longer published by HHSC; kept here
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Staff background & training
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Mar 14, 2025 Report · Deficiencies cited
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Illness & medication
The child in care did not receive his insulin according to the management plan.
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 2025-04-18. Correction verified 2025-05-06.
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Illness & medication
Multiple medication logs reviewed did not have the reason medication was prescribed.
HHSC 748.2151(c)(3) — Medication record - must include reason medication was prescribed, for prescription medication
HHSC risk weight: Medium. Corrected 2025-04-18. Correction verified 2025-05-06.
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Illness & medication
A child did not receive their medication for 03/13/25 and there was not a documentation addressing the error completed.
HHSC 748.2203(a) — Medication Error-If prescription medication, contact a health-care professional immediately & follow health-care professional's recommendations
HHSC risk weight: Medium High. Corrected 2025-04-18. Correction verified 2025-05-06.
HHSC inspection history · no longer published by HHSC; kept here
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Illness & medication
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Mar 14, 2025 Report · Deficiencies cited
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Illness & medication
The child in care did not receive his insulin according to the management plan.
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 2025-04-18. Correction verified 2025-05-06.
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Illness & medication
Multiple medication logs reviewed did not have the reason medication was prescribed.
HHSC 748.2151(c)(3) — Medication record - must include reason medication was prescribed, for prescription medication
HHSC risk weight: Medium. Corrected 2025-04-18. Correction verified 2025-05-06.
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Illness & medication
A child did not receive their medication for 03/13/25 and there was not a documentation addressing the error completed.
HHSC 748.2203(a) — Medication Error-If prescription medication, contact a health-care professional immediately & follow health-care professional's recommendations
HHSC risk weight: Medium High. Corrected 2025-04-18. Correction verified 2025-05-06.
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Illness & medication
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Mar 12, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 12, 2025 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 25, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 25, 2025 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 5, 2025 Report · Deficiencies cited
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Illness & medication
A staff member provided medications to a child in care without being trained.
HHSC 748.2003(b)(6) — Administration of prescription medication-ensure a person trained in & authorized to administer prescription medication administers the medication
HHSC risk weight: Medium High. Corrected 2025-02-24. Correction verified 2025-02-20.
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Supervision & ratios
A child in care requires 1:1 supervision. The child is being provided line of sight supervision.
HHSC 748.685(c)(6) — Implement and follow the children's service plans.
HHSC risk weight: Medium. Corrected 2025-03-19. Correction verified 2025-03-19.
HHSC inspection history · no longer published by HHSC; kept here
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Illness & medication
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Feb 5, 2025 Report · Deficiencies cited
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Illness & medication
A staff member provided medications to a child in care without being trained.
HHSC 748.2003(b)(6) — Administration of prescription medication-ensure a person trained in & authorized to administer prescription medication administers the medication
HHSC risk weight: Medium High. Corrected 2025-02-24. Correction verified 2025-02-20.
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Supervision & ratios
A child in care requires 1:1 supervision. The child is being provided line of sight supervision.
HHSC 748.685(c)(6) — Implement and follow the children's service plans.
HHSC risk weight: Medium. Corrected 2025-03-19. Correction verified 2025-03-19.
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Illness & medication
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Jan 31, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Jan 31, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 24, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Jan 24, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 23, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Jan 23, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Nov 15, 2024 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 15, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Oct 30, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Oct 30, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Oct 20, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 20, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Sep 10, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Sep 10, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Sep 10, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 10, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Aug 30, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Aug 30, 2024 Report · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Jul 11, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 11, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Jun 29, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Jun 29, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Apr 23, 2024 Inspection · Deficiencies cited
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Records & paperwork
The three children files reviewed did not have vision or hearing exams.
HHSC 748.1545(b) — Vision and hearing screening - Results on file for child, or parental statement that school has records or screening should not be done
HHSC risk weight: Medium Low. Corrected at inspection. Corrected 2024-05-07.
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Records & paperwork
Two children files did not have TB Test results
HHSC 748.1583(b) — TB exam-Documentation of baseline test or chest xray results in person's record w/in 40 days of beginning to live, work, volunteer at facility
HHSC risk weight: Medium Low. Corrected at inspection. Corrected 2024-04-26.
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Illness & medication
On January 12, 2024 medical documentation indicates that a child should take Ondansetron and fluocinolone to manage their medical condition. These prescriptions were not filled by the operation.
HHSC 748.2005(b) — Medication Orders-A verbal order must be documented in the record, including the health care professional's name, date and time of call
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2024-04-26.
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Records & paperwork
The Treatment Director's case file does not support a hire date. The case file also is missing numbers 3, 4, 6-9, and 11-14 of this rule.
HHSC 748.363(1) — Personnel records-Include date of employment
HHSC risk weight: Medium. Corrected at inspection. Corrected 2024-04-26.
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Staff background & training
Personnel file support that trainings were completed online through DFPS. The instructor lead portion is not being completed by a medical professional.
HHSC 748.869(c) — Training on administering psych. medication must be instructor-led. The instructor must be a health-care professional or pharmacist.
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2024-04-26.
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Other
1 out 3 staffs files didnt have thier First Aid completed.
HHSC 748.911(c)(1) — Each caregiver must be certified in first aid within 90 days of employment.
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2024-04-26.
HHSC inspection history · no longer published by HHSC; kept here
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Records & paperwork
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Apr 23, 2024 Inspection · Deficiencies cited
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Records & paperwork
The three children files reviewed did not have vision or hearing exams.
HHSC 748.1545(b) — Vision and hearing screening - Results on file for child, or parental statement that school has records or screening should not be done
HHSC risk weight: Medium Low. Corrected at inspection. Corrected 2024-05-07.
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Records & paperwork
Two children files did not have TB Test results
HHSC 748.1583(b) — TB exam-Documentation of baseline test or chest xray results in person's record w/in 40 days of beginning to live, work, volunteer at facility
HHSC risk weight: Medium Low. Corrected at inspection. Corrected 2024-04-26.
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Illness & medication
On January 12, 2024 medical documentation indicates that a child should take Ondansetron and fluocinolone to manage their medical condition. These prescriptions were not filled by the operation.
HHSC 748.2005(b) — Medication Orders-A verbal order must be documented in the record, including the health care professional's name, date and time of call
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2024-04-26.
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Records & paperwork
The Treatment Director's case file does not support a hire date. The case file also is missing numbers 3, 4, 6-9, and 11-14 of this rule.
HHSC 748.363(1) — Personnel records-Include date of employment
HHSC risk weight: Medium. Corrected at inspection. Corrected 2024-04-26.
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Staff background & training
Personnel file support that trainings were completed online through DFPS. The instructor lead portion is not being completed by a medical professional.
HHSC 748.869(c) — Training on administering psych. medication must be instructor-led. The instructor must be a health-care professional or pharmacist.
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2024-04-26.
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Other
1 out 3 staffs files didnt have thier First Aid completed.
HHSC 748.911(c)(1) — Each caregiver must be certified in first aid within 90 days of employment.
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2024-04-26.
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Records & paperwork
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Mar 5, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Mar 5, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 5, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 5, 2024 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 9, 2024 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 9, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Jan 4, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 4, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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Jan 1, 2024 Report · Deficiencies cited
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Discipline & child guidance Serious
Child in care was hit by a staff member.
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 2024-02-19. Correction verified 2024-03-05.
HHSC inspection history · no longer published by HHSC; kept here
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Discipline & child guidance Serious
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Jan 1, 2024 Report · Deficiencies cited
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Discipline & child guidance Serious
Child in care was hit by a staff member.
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 2024-02-19. Correction verified 2024-03-05.
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Discipline & child guidance Serious
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Nov 28, 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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Nov 28, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 13, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 13, 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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Oct 19, 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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Oct 19, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 17, 2023 Report · Deficiencies cited (self-report)
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Illness & medication
Prescription medication for two siblings was administered incorrectly which resulted in one sibling being given the other siblings medication.
HHSC 748.2003(b)(10) — Administration of prescription medication-must not borrow or administer prescription medication to a child that is prescribed to another person
HHSC risk weight: Medium High. Corrected 2023-11-29. Correction verified 2023-11-27.
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Illness & medication
The caregiver did not use prudent judgement when distributing medication to two non-verbal children in care, resulting in the children receiving the wrong medication.
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 2023-11-29. Correction verified 2023-11-27.
HHSC inspection history · no longer published by HHSC; kept here
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Illness & medication
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Oct 17, 2023 Report · Deficiencies cited (self-report)
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Illness & medication
Prescription medication for two siblings was administered incorrectly which resulted in one sibling being given the other siblings medication.
HHSC 748.2003(b)(10) — Administration of prescription medication-must not borrow or administer prescription medication to a child that is prescribed to another person
HHSC risk weight: Medium High. Corrected 2023-11-29. Correction verified 2023-11-27.
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Illness & medication
The caregiver did not use prudent judgement when distributing medication to two non-verbal children in care, resulting in the children receiving the wrong medication.
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 2023-11-29. Correction verified 2023-11-27.
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Illness & medication
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Oct 10, 2023 Inspection · Deficiencies cited
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Illness & medication Serious
A staff member with a provisional status is not following all the conditions of the restrictions by administering medication to children.
HHSC 745.635(3) — AP Background ck determination - If provisionally eligible w/conditions or eligible w/conditions you must restrict duties per conditions/restrictions
HHSC risk weight: High. Corrected 2023-10-13. Correction verified 2023-10-23.
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Illness & medication Serious
-
Oct 10, 2023 Inspection · Deficiencies cited
-
Illness & medication Serious
A staff member with a provisional status is not following all the conditions of the restrictions by administering medication to children.
HHSC 745.635(3) — AP Background ck determination - If provisionally eligible w/conditions or eligible w/conditions you must restrict duties per conditions/restrictions
HHSC risk weight: High. Corrected 2023-10-13. Correction verified 2023-10-23.
HHSC inspection history · no longer published by HHSC; kept here
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Illness & medication Serious
-
Oct 6, 2023 Report · Deficiencies cited (self-report)
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Other Serious
Two staff members were not properly supervising a child who was attempting to cause harm to own wrist and was able to gain access to an item and place around the neck.
HHSC 748.685(a)(5) — Caregiver responsibility - being able to intervene when necessary to ensure child's safety
HHSC risk weight: High. Corrected 2023-11-09. Correction verified 2023-11-13.
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Staff background & training
A staff member who was using EBI on a child in care was assisted by a staff member who was not trained in EBI.
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 2023-11-09. Correction verified 2023-11-13.
HHSC inspection history · no longer published by HHSC; kept here
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Other Serious
-
Oct 6, 2023 Report · Deficiencies cited (self-report)
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Other Serious
Two staff members were not properly supervising a child who was attempting to cause harm to own wrist and was able to gain access to an item and place around the neck.
HHSC 748.685(a)(5) — Caregiver responsibility - being able to intervene when necessary to ensure child's safety
HHSC risk weight: High. Corrected 2023-11-09. Correction verified 2023-11-13.
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Staff background & training
A staff member who was using EBI on a child in care was assisted by a staff member who was not trained in EBI.
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 2023-11-09. Correction verified 2023-11-13.
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Other Serious
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Sep 27, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 27, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
-
Aug 7, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
-
Aug 7, 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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Jul 6, 2023 Inspection · Deficiencies cited
-
Staff background & training
Employee records missing ceritifcations or memorandum of training completed per minimum standard requirement.
HHSC 748.363(11) — Personnel records-Include record of training and training hours
HHSC risk weight: Medium. Corrected 2023-07-21. Correction verified 2023-07-28.
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Staff background & training
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Jul 6, 2023 Inspection · Deficiencies cited
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Staff background & training
Employee records missing ceritifcations or memorandum of training completed per minimum standard requirement.
HHSC 748.363(11) — Personnel records-Include record of training and training hours
HHSC risk weight: Medium. Corrected 2023-07-21. Correction verified 2023-07-28.
HHSC inspection history · no longer published by HHSC; kept here
-
Staff background & training
-
May 2, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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May 2, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
HHSC inspection history · no longer published by HHSC; kept here
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.