Noble Children's Services
11613 STATE HIGHWAY 64 W, Tyler, TX 75704 · Smith County
Program
- Type
- Child-placing agency
- Ages
- -
- Hours
- 08:30 AM-05:00 PM
- Director / administrator
- Elizabeth Andrusick
- Phone
- (936) 598-6468
- Regulated since
- Jan 6, 2011
- HHSC IDs
- Operation 591613 · number 1091989- 6611
- Official record
- HHSC Child Care Search
Violations by category
Year by year
| Year | Violations | Serious | Main categories |
|---|---|---|---|
| 2026 | 12 | 7 | Cleanliness & sanitation (2), Supervision & ratios (3), Discipline & child guidance (1), Staff background & training (1), Other (5) |
| 2025 | 10 | 5 | Cleanliness & sanitation (1), Illness & medication (1), Supervision & ratios (3), Safety & premises (1), Food & allergies (1), Staff background & training (1), Other (2) |
| 2024 | 12 | 4 | Illness & medication (5), Safety & premises (2), Staff background & training (2), Records & paperwork (1), Other (2) |
| 2023 | 14 | 5 | Cleanliness & sanitation (1), Illness & medication (4), Supervision & ratios (1), Safety & premises (2), Staff background & training (1), Records & paperwork (2), Other (3) |
| 2022 | 13 | 3 | Cleanliness & sanitation (1), Illness & medication (2), Discipline & child guidance (1), Safety & premises (2), Staff background & training (1), Records & paperwork (1), Other (5) |
| 2021 | 4 | 3 | Illness & medication (1), Supervision & ratios (1), Safety & premises (1), Other (1) |
Enforcement actions
- Seen Oct 1, 2026 — Conditions on permit (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 28, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 14, 2026 Assessment
No violations cited on this visit.
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Sep 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 4, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 31, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 28, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Aug 21, 2026 Inspection · Deficiencies cited
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Cleanliness & sanitation Serious
During the investigation inspection, the upstairs bathroom sink was clogged and full of water. The upstairs bathroom toilet was dirty.
HHSC 749.1001(a) — PHYSICAL ENVIRONMENT OF A FOSTER HOME
HHSC risk weight: High. Corrected 2026-08-31. Correction verified 2026-09-04.
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Other Serious
During the investigation inspection, it was found that a kinship child is sharing a bedroom with the foster parent's adult child and unrelated home member over the age of 18.
HHSC 749.4571(b) — Before sharing sleeping space with a kinship child, CPMS must ensure there's no harm risk in sharing, based on the child's service plan/assessment.
HHSC risk weight: High. Corrected 2026-08-21. Correction verified 2026-09-04.
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Cleanliness & sanitation Serious
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Aug 19, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 14, 2026 Report · 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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Aug 4, 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 31, 2026 Report · Deficiencies cited
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Other Serious
During an investigation, it was noted that a child in care stated that he was not allowed to talk about allegations being made when interviewed.
HHSC 745.8411(a) — Responsibilities - Not interfere with an inspection or investigation
HHSC risk weight: High. Corrected 2026-09-04. Correction verified 2026-09-14.
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Other Serious
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Jul 30, 2026 Inspection · Deficiencies cited
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Cleanliness & sanitation
During the walk-through, it was noticed that one of the bathrooms did not have running hot water.
HHSC 749.3035(b) — Bathrooms-All lavatories, tubs, and showers must have hot and cold running water
HHSC risk weight: Medium Low. Corrected 2026-08-07. Correction verified 2026-09-14.
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Cleanliness & sanitation
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Jul 22, 2026 Report
No violations cited on this visit.
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Jul 22, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 8, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 8, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 22, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 18, 2026 Report · Deficiencies cited
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Supervision & ratios
The foster parent was using video cameras in the children?s bedroom as a form of supervision without CPS?s consent.
HHSC 749.2595(b)(1) — Supervision-Video cameras may not be used with children other than infants and toddlers unless parent or person legally authorized gives consent
HHSC risk weight: Medium. Corrected 2026-07-24. Correction verified 2026-08-04.
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Other Serious
Foster parent failed to use prudent judgment by participating in an activity that was not approved on the child?s service plan.
HHSC 749.607(1) — Employee and caregiver responsibilities-Competency, prudent judgment, self-control in presence of children and when performing assigned tasks
HHSC risk weight: High. Corrected 2026-07-24. Correction verified 2026-08-04.
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Supervision & ratios
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Jun 9, 2026 Inspection
No violations cited on this visit.
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May 29, 2026 Assessment · Deficiencies cited
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Other Serious
During a Monitoring Agency Home Inspection, a swimming pool was noted to have green algae, and the bottom of the pool could not be seen.
HHSC 749.3133(k) — Swimming Pools-bottom of the pool must be visible at all times.
HHSC risk weight: High. Corrected 2026-06-08. Correction verified 2026-06-17.
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Other Serious
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May 27, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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May 21, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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May 21, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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May 11, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 28, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 16, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 14, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Apr 14, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Apr 13, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 1, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 1, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 17, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 12, 2026 Assessment · Deficiencies cited
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Supervision & ratios
During a review conducted on 3/10/2026 it was determined that: (1) the Administrator failed to ensure compliance with the current HM Plan; and (2) 12 months had elapsed since the effective date of the plan. The heightened monitoring plan for this operation included a specific ?planned end date? at the 12-month mark by which the operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with the heightened monitoring plan, this operation is now unable to successfully move to post-plan monitoring. Furthermore, the operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended. Further details of the administrator?s failure to ensure compliance include the following: Operation failed to satisfy the conditions of the plan Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring; and Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation.
HHSC 749.635(2) — AP CPA administrator responsibilities- Ensure that the operation complies with current heightened monitoring plans.
HHSC risk weight: Medium High. Corrected 2026-03-13. Correction verified 2026-03-13.
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Supervision & ratios
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Mar 10, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 9, 2026 Inspection · Deficiencies cited
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Other
During the inspection, I observed the foster mother did not have the verification certificate posted, and she confirmed the agency did not provide her with a copy of the certificate despite multiple requests.
HHSC 749.2481(a)(1) — Verification Certificate-Agency must give the home a verification certificate after verifying the home
HHSC risk weight: Low. Corrected 2026-03-18. Correction verified 2026-04-01.
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Other
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Mar 7, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Mar 3, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 3, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 17, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 3, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 3, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 23, 2026 Report · Deficiencies cited
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Staff background & training Serious
The agency did not complete a background check on an individual before the individual became a household member.
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 2026-02-26. Correction verified 2026-03-03.
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Discipline & child guidance Serious
During an investigation, 2 out of 2 children indicated they were being spanked in the foster home.
HHSC 749.1953(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 2026-02-26. Correction verified 2026-03-03.
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Supervision & ratios
During an investigation, a foster parent was not within hearing distance of the children in care as required by the service plan. The foster parent noted the children were outside playing at one point and a camera was used.
HHSC 749.2593(c)(6) — Supervision-Caregivers counted in child/caregiver ratio must implement and follow the children's service plans
HHSC risk weight: Medium High. Corrected 2026-02-26. Correction verified 2026-03-03.
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Staff background & training Serious
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Jan 21, 2026 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Jan 20, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 14, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 14, 2026 Report · No deficiencies cited
No violations cited on this visit.
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Jan 12, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 8, 2026 Assessment · No deficiencies cited
No violations cited on this visit.
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Jan 5, 2026 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 22, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 9, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 9, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 24, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 10, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 10, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 27, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 21, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Oct 13, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 30, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 25, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 25, 2025 Report · Deficiencies cited
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Staff background & training Serious
It was found that a caregiver, and a nurse did not have an approved background check.
HHSC 745.621(a)(7) — AP Initial background checks submitted - At the time you become aware of anyone requiring a background check under 745.605
HHSC risk weight: High. Corrected 2025-10-27. Correction verified 2025-11-10.
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Supervision & ratios Serious
Foster parent left a child unattended with a person who was not an approved caregiver.
HHSC 749.2593(a)(5) — Supervision-The caregiver is responsible for not performing tasks that clearly impede the caregiver's ability to supervise and interact with children
HHSC risk weight: High. Corrected 2025-10-28. Correction verified 2025-11-10.
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Staff background & training Serious
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Sep 17, 2025 Inspection
No violations cited on this visit.
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Sep 11, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 6, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Sep 3, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 3, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 19, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 19, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 11, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Aug 8, 2025 Report
No violations cited on this visit.
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Aug 4, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 31, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Jul 30, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Jul 22, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 22, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 8, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jul 8, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 27, 2025 Report · Deficiencies cited
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Cleanliness & sanitation Serious
During an investigation, 2 children in care indicated that food was being used as a form of discipline when a child in care was having some behavioral issues.
HHSC 749.1003(b)(4)(A)(iv) — Children's rights-Adhere to the child's rights to be free from being denied food, sleep, toileting facilities, mail, or family visits as punishment
HHSC risk weight: High. Corrected 2025-08-18. Correction verified 2025-08-19.
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Cleanliness & sanitation Serious
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Jun 26, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jun 12, 2025 Inspection
No violations cited on this visit.
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Jun 7, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Jun 2, 2025 Report
No violations cited on this visit.
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May 29, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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May 14, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 28, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 21, 2025 Report · Deficiencies cited
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Other Serious
During an investigation, a foster parent was having inappropriate conversations and interactions with a child in care.
HHSC 749.607(1) — Employee and caregiver responsibilities-Competency, prudent judgment, self-control in presence of children and when performing assigned tasks
HHSC risk weight: High. Corrected 2025-07-18. Correction verified 2025-07-22.
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Other Serious
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Apr 14, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Apr 3, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 6, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Mar 5, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 28, 2025 Assessment · Deficiencies cited
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Supervision & ratios
A variance allowing 6 children (3 being siblings) in a one-parent foster home expired for approximately two months. --A new variance has been submitted.
HHSC 749.2551(a) — Capacity-1 parent FH with 1 additional caregiver or 2 parent FH may care for up to 6, except as noted in chart below
HHSC risk weight: Medium High. Corrected 2025-02-28. Correction verified 2025-02-28.
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Supervision & ratios
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Feb 18, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 12, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 8, 2025 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Feb 4, 2025 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 31, 2025 Report · No deficiencies cited
No violations cited on this visit.
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Jan 17, 2025 Inspection · Deficiencies cited
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Illness & medication
During the inspection, we observed one of four children's records lacked documentation of the reason for a prescription.
HHSC 749.1541(c)(3) — Medication Record-Must include reason medication was prescribed, for prescription medication
HHSC risk weight: Medium. Corrected 2025-01-28. Correction verified 2025-01-27.
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Safety & premises
In three of the foster home records reviewed (one family was new), none of the foster parents documented a discussion of the fire or disaster drills.
HHSC 749.2908(b) — Disaster and Emergency-foster home must document discussions and drills, including date and time of each
HHSC risk weight: Medium. Corrected 2025-01-28. Correction verified 2025-01-27.
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Illness & medication
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Jan 17, 2025 Report · Deficiencies cited
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Other
During the course of the investigation, it was found that a child's information was shown during a zoom meeting.
HHSC 749.1003(b)(6)(C) — Children's rights-Adhere to the child's right to confidential care and treatment
HHSC risk weight: Medium Low. Corrected 2025-03-13. Correction verified 2025-03-13.
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Other
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Jan 2, 2025 Report · Deficiencies cited
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Supervision & ratios
Neither caregiver noticed a 13-year-old child was preparing alcoholic beverages for herself throughout the evening during a party at the foster home.
HHSC 749.2593(b)(4) — Supervision-When supervising a child, a caregiver must take into account the surrounding circumstances, hazards, and risks
HHSC risk weight: Medium High. Corrected 2025-02-04. Correction verified 2025-02-04.
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Food & allergies Serious
A foster parent became highly intoxicated in the presence of foster children. Additionally, the caregivers left several bottles of liquor on the kitchen counters --resulting in the inebriation of a 13-year-old child in care.
HHSC 749.607(1) — Employee and caregiver responsibilities-Competency, prudent judgment, self-control in presence of children and when performing assigned tasks
HHSC risk weight: High. Corrected 2025-02-04. Correction verified 2025-02-04.
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Supervision & ratios
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Dec 18, 2024 Report · Deficiencies cited
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Records & paperwork
Children in the home reported being yelled at by the caregiver.
HHSC 749.1957(8) — Other Prohibited Discipline-Humiliating, shaming, ridiculing, rejecting, or yelling at a child
HHSC risk weight: Medium High. Corrected 2025-01-23. Correction verified 2025-01-22.
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Records & paperwork
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Dec 18, 2024 Inspection · 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 8, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 7, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Oct 30, 2024 Assessment · Deficiencies cited
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Illness & medication Serious
During the inspection walkthrough for the home, the locking cabinet used to store medications was not working-- leaving all the medications unlocked.
HHSC 749.1521(1) — Medication Storage-Store medication in a locked container
HHSC risk weight: High. Corrected 2024-12-19. Correction verified 2024-12-18.
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Illness & medication Serious
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Oct 29, 2024 Report · Deficiencies cited
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Staff background & training Serious
The caregiver's adopted son is 14 years old. Background checks for this child were cancelled, and there is no current background check for this home member.
HHSC 745.621(a)(6) — AP Initial background check submitted - between 90 days before and 90 days after non-client resident becomes 14 years
HHSC risk weight: High. Corrected 2024-12-12. Correction verified 2024-12-12.
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Staff background & training Serious
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Oct 25, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 23, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 23, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Oct 11, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 4, 2024 Inspection · Deficiencies cited
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Illness & medication Serious
The family had Benedryl and vitamins on a shelf, unlocked, in the kitchen.
HHSC 749.1521(1) — Medication Storage-Store medication in a locked container
HHSC risk weight: High. Corrected at inspection. Corrected 2024-10-04.
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Illness & medication
The medication records for a child in the home had not been updated within 24 hours.
HHSC 749.1541(b) — Medication Record-Must update cumulative medication record within 24 hours of administering medication
HHSC risk weight: Medium. Corrected 2024-10-11. Correction verified 2024-10-07.
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Safety & premises
The fire extinguisher in the home required a yearly service inspection. The current inspection expired at the end of September 2024,
HHSC 749.2913(b)(2) — Fire Extinguisher-Have a maintenance check once a year by a person qualified to inspect fire extinguishers.
HHSC risk weight: Medium High. Corrected 2024-10-11. Correction verified 2024-10-07.
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Illness & medication Serious
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Oct 1, 2024 Report · No deficiencies cited (self-report)
No violations cited on this visit.
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Sep 23, 2024 Inspection · No deficiencies cited
No violations cited on this visit.
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Sep 17, 2024 Report · Deficiencies cited
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Other
Foster parent used a threat to gain compliance of a child to ensure task was completed properly.
HHSC 749.1003(b)(4)(A)(vii) — Children's rights-Adhere to child's rights to be free from being subjected to demeaning behavior to embarrass, control, harm, intimidate or isolate
HHSC risk weight: Medium High. Corrected 2024-11-07. Correction verified 2024-11-07.
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Other
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Aug 23, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Jul 19, 2024 Inspection · Deficiencies cited
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Illness & medication
Two of the monthly medication logs completed by the foster parent were missing the physician's name.
HHSC 749.1541(c)(2) — Medication Record-Must include prescribing health-care professional's name
HHSC risk weight: Medium. Corrected 2024-07-26. Correction verified 2024-07-29.
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Illness & medication
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May 6, 2024 Report · No deficiencies cited
No violations cited on this visit.
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May 4, 2024 Report · Deficiencies cited
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Staff background & training Serious
An adult home member and her 14-year-old daughter were living in the foster home since January of 2024 (per self-report).
HHSC 745.621(a)(5) — AP Initial background checks submitted - At the time a non-client resident 14 or older moves into your home or operation
HHSC risk weight: High. Corrected 2024-05-20. Correction verified 2024-05-20.
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Illness & medication
An untrained/unauthorized adult was administering medication to a PMN child in care.
HHSC 749.1463(b)(6) — Administration of Medication-Ensure a person trained in & authorized to administer prescription medication administers the medication
HHSC risk weight: Medium High. Corrected 2024-05-20. Correction verified 2024-05-20.
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Safety & premises
During an ANE investigation, it was determined that the new household members had not been added to the household, per home screening addendum.
HHSC 749.2453(a)(2) — You must update a foster home screening- When there is a major life change in the foster family as described in 749.2805
HHSC risk weight: Medium. Corrected 2024-05-20. Correction verified 2024-05-15.
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Staff background & training Serious
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Apr 10, 2024 Report · No deficiencies cited
No violations cited on this visit.
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Mar 27, 2024 Report · 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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Feb 14, 2024 Report
No violations cited on this visit.
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Feb 7, 2024 Inspection · Deficiencies cited
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Other
In one home study, it was noted that two foster children share a bedroom that is only 72 square feet.
HHSC 749.3021(b) — Space-single occupant bedrooms must have at least 80 square feet of floor space
HHSC risk weight: Medium. Corrected 2024-02-14. Correction verified 2024-02-09.
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Other
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Dec 20, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 13, 2023 Assessment · Deficiencies cited
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Illness & medication Serious
During a sampling inspection, there was an unlocked box of insulin in the foster parents' refrigerator.
HHSC 749.1521(1) — Medication Storage-Store medication in a locked container
HHSC risk weight: High. Corrected 2023-12-27. Correction verified 2024-01-04.
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Safety & premises
A fire extinguisher in the home lacked a tag showing the most recent service date.
HHSC 749.2913(b)(2) — Fire Extinguisher-Have a maintenance check once a year by a person qualified to inspect fire extinguishers.
HHSC risk weight: Medium High. Corrected 2023-12-27. Correction verified 2023-12-19.
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Other Serious
The gate to the foster parents' pool was not self-latching or self-closing.
HHSC 749.3133(e) — Swimming Pools-Pool gates self-closing/self-latching/locked when pool not used; keys inaccessible to kids under 12, poor swimmers or receiving tx svcs
HHSC risk weight: High. Corrected 2023-12-27. Correction verified 2024-01-05.
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Illness & medication Serious
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Nov 28, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 28, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Nov 28, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Nov 28, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Nov 14, 2023 Assessment · Deficiencies cited
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Safety & premises Serious
During the sampling inspection, the 4-month-old child's crib was observed to have a small tote with toys/objects inside. Foster mother reported she thought it was okay as the tote on the opposite end of where the child would lay her head.
HHSC 749.1813(b) — AP Prohibited for infants-Crib must be bare except for tight fitting sheet & crib mattress cover per 749.1813(c) for infant less than 12 months
HHSC risk weight: High. Corrected 2023-11-22. Correction verified 2023-11-28.
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Safety & premises Serious
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Oct 27, 2023 Assessment · Deficiencies cited
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Illness & medication
It was observed during a sampling inspection that there was no medication log for a baby's gas drops, and the multivitamin log had not been updated within the required 24 hours.
HHSC 749.1541(a) — Medication Record-Maintain cumulative record of prescription medications dispensed to child, include nonprescription meds for child under five yrs old
HHSC risk weight: Medium High. Corrected 2023-10-27. Correction verified 2023-10-27.
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Records & paperwork
It was noted during a sampling inspection that two of the family pets had expired rabies vaccinations.
HHSC 749.2917 — Animals-animals at the home must be kept free of disease; must be vaccinated and treated by a licensed veterinarian, must not be a health risk
HHSC risk weight: Medium High. Corrected 2023-11-03. Correction verified 2023-11-03.
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Illness & medication
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Oct 19, 2023 Inspection · Deficiencies cited
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Illness & medication
During the walk-through, there were two child medication logs that had not been signed that medication was administered in the past four days.
HHSC 749.1541(b) — Medication Record-Must update cumulative medication record within 24 hours of administering medication
HHSC risk weight: Medium. Corrected 2023-11-03. Correction verified 2023-10-24.
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Illness & medication
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Oct 10, 2023 Report · Deficiencies cited
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Illness & medication
A child in care was seriously injured resulting in the child receiving medical attention. The agency failed to report the serious incident to Licensing in a timely manner. The incident was reported four days later.
HHSC 749.503(a)(2)(A) — AP Serious Incident-Report to Licensing critical injury or illness that warrants treatment by a medical professional/hospitalization
HHSC risk weight: Medium High. Corrected 2023-11-13. Correction verified 2023-11-01.
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Illness & medication
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Oct 8, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Aug 30, 2023 Report · Deficiencies cited
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Other Serious
The child in care was co-sleeping with the caregivers.
HHSC 749.3025(c) — Bedrooms-Child may not sleep in same bed with an adult unless adult is child's parent and child is 1 to 10 years old
HHSC risk weight: High. Corrected 2023-10-09. Correction verified 2023-10-06.
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Other Serious
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Aug 2, 2023 Inspection · Deficiencies cited
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Records & paperwork
The admission assessment for one child contradicted the common application. The assessment stated the child had been at the hospital since birth, but the common app reported the child was in a relative placement.
HHSC 749.1133(c)(7) — Admission Assessment-Includes child's history of placements outside child's home
HHSC risk weight: Medium Low. Corrected 2023-08-11. Correction verified 2023-08-15.
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Cleanliness & sanitation
One PMN child missed a follow-up dental appointment and a follow-up endocrinology appointment. If the foster parents could not get the child there, a written explanation should have been given to the agency.
HHSC 749.1409(d) — General dental requirements-Obtain follow-up dental work indicated, such as treatment of cavities and cleaning
HHSC risk weight: Medium High. Corrected 2023-08-11. Correction verified 2023-08-11.
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Supervision & ratios
No TB test was found in one of the child files reviewed.
HHSC 749.1417(a) — TB exam-Persons over 1 yr old who live, work, volunteer at operation have exam w/in 30 days, unless person had previous exam that meets requirements
HHSC risk weight: Medium. Corrected 2023-08-11. Correction verified 2023-08-03.
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Records & paperwork
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Jul 11, 2023 Assessment · Deficiencies cited
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Other
Elijah's bed was on the floor when the investigator visited the home. There was no variance for this arrangement.
HHSC 749.3031(c) — Beds and bedding-mattresses must be elevated from floor and have covers or protectors
HHSC risk weight: Medium. Corrected 2023-07-13. Correction verified 2023-07-13.
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Other
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Jul 6, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Jul 2, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Jun 19, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Jun 13, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Jun 13, 2023 Assessment · Deficiencies cited
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Staff background & training Serious
During a sampling, it was noted that the 15-year-old adopted son had no background checks. This should have been done prior to the child changing his name.
HHSC 745.621(a)(6) — AP Initial background check submitted - between 90 days before and 90 days after non-client resident becomes 14 years
HHSC risk weight: High. Corrected 2023-06-23. Correction verified 2023-06-15.
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Staff background & training Serious
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May 3, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Mar 1, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Feb 10, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Jan 26, 2023 Report · No deficiencies cited
No violations cited on this visit.
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Jan 4, 2023 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 21, 2022 Inspection · No deficiencies cited
No violations cited on this visit.
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Dec 10, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Dec 9, 2022 Inspection · Deficiencies cited
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Safety & premises
During the inspection, it was discovered that one of the four foster home records reviewed had an expired health inspection and another of the four foster home record had an expired fire inspection.
HHSC 749.2905(b) — Fire/health safety evaluations conducted by child placement staff using the State Fire Marshal?s checklist for foster homes is current for one year
HHSC risk weight: Medium High. Corrected 2022-12-23. Correction verified 2022-12-13.
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Staff background & training
During the inspection, one of four staff records reviewed did not contain the Affidavit for Applicants for Employment form that was signed and notarized. Also, one of four foster home records reviewed had expired liability insurance on their vehicles. The form and current insurance liability card was not located in agency records which needs to be done within 30 days of completion.
HHSC 749.535(a)(1) — Active records-All documentation in the record no later than 30 days after the occurrence or event
HHSC risk weight: Low. Corrected 2022-12-09. Correction verified 2022-12-13.
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Safety & premises
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Nov 23, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Nov 17, 2022 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 16, 2022 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 16, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Nov 9, 2022 Report · Deficiencies cited
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Other Serious
There was a bb gun out and a 22 caliber out and unlocked when a worker visited.
HHSC 749.2961(a)(1) — If weapons/explosives/projectiles allowed, must enforce policy w/precautions to ensure no unsupervised access for children/ kept in locked storage
HHSC risk weight: High. Corrected at inspection. Corrected 2022-11-17.
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Cleanliness & sanitation
There was wasp spray and mosquito repellent out and in the reach of the child, but this was corrected and cleaned up by the foster father. Additionally, a can of premade margarita (possibly hazard) was seen in the inside refrigerator.
HHSC 749.3041(7) — Physical Environment-Foster home must ensure that flammable or poisonous substances are stored out of reach of children, as needed
HHSC risk weight: Medium High. Corrected at inspection. Corrected 2022-11-17.
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Other Serious
The pool fence and pool cover had been down for several days, but the foster home corrected this and this was observed on this day.
HHSC 749.3133(c) — Swimming pools- Must have fence or wall that prevents children from gaining unsupervised access.
HHSC risk weight: High. Corrected at inspection. Corrected 2022-11-17.
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Other Serious
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Nov 7, 2022 Inspection · No deficiencies cited
No violations cited on this visit.
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Oct 30, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Oct 28, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Jun 9, 2022 Inspection · Deficiencies cited
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Other
The health inspection for a foster home (done in March 2022 by an agency worker) did not include the phone number for the person who completed the inspection.
HHSC 749.2902(b) — Health Safety Measures-Each health inspection or evaluation must be documented, including name and phone number of person who conducted it
HHSC risk weight: Medium. Corrected 2022-06-16. Correction verified 2022-06-15.
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Other
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Jun 6, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Jun 4, 2022 Report · No deficiencies cited
No violations cited on this visit.
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Apr 12, 2022 Inspection · Deficiencies cited
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Safety & premises
The auto insurance in one of the foster family charts had been expired for two months.
HHSC 749.3103 — Driver & passengers must follow all laws when driving, including laws on use of child passenger safety seat systems, seat belts & liability insurance
HHSC risk weight: Medium High. Corrected 2022-04-21. Correction verified 2022-05-01.
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Safety & premises
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Feb 25, 2022 Inspection · No deficiencies cited
No violations cited on this visit.
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Feb 18, 2022 Inspection · Deficiencies cited
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Other
One of the 6 preliminary plans reviewed had not date on it at all, and another was done in 6 days, rather that than in the 72 hour time limit.
HHSC 749.1301(a) — Preliminary Service Planning-Complete a preliminary service plan that addresses child's immediate needs within 72 hours of admission
HHSC risk weight: Medium. Corrected 2022-02-28. Correction verified 2022-03-07.
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Illness & medication
In one of the files, there were two pages of medication logs (PMN) that were not completely filled out -- including the reasons the meds are given and the strength of the medications, etc
HHSC 749.1541(c)(3) — Medication Record-Must include reason medication was prescribed, for prescription medication
HHSC risk weight: Medium. Corrected 2022-02-28. Correction verified 2022-03-07.
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Illness & medication
A caregiver turned in no medication logs for November, December, and January - and a prescription was given on 10/21/21.
HHSC 749.1543(b) — Medication Records-Foster parents submit copies of the records to the agency each month; agency files these records in the child's record
HHSC risk weight: Medium Low. Corrected 2022-02-28. Correction verified 2022-03-07.
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Other
There was no written (or typed ) date by the CPMS signature for admission assessments in one of the caregivers' home.
HHSC 749.669(1) — Child placement management staff responsibilities-Review, approve, sign and date assessment/admission forms
HHSC risk weight: Medium. Corrected 2022-02-28. Correction verified 2022-03-07.
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Other
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Jan 19, 2022 Inspection · No deficiencies cited
No violations cited on this visit.
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Jan 7, 2022 Report · Deficiencies cited
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Discipline & child guidance Serious
A caregiver pulled his hand back and threatened physical harm to a child in care.
HHSC 749.1953(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 2022-02-18. Correction verified 2022-02-25.
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Records & paperwork
The children in the home all report that the caregivers yell loudly when the boys get in trouble, break things, or are arguing/fighting with one another.
HHSC 749.1957(8) — Other Prohibited Discipline-Humiliating, shaming, ridiculing, rejecting, or yelling at a child
HHSC risk weight: Medium High. Corrected 2022-02-18. Correction verified 2022-02-25.
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Discipline & child guidance Serious
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Nov 30, 2021 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 24, 2021 Inspection · No deficiencies cited
No violations cited on this visit.
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Nov 19, 2021 Report · No deficiencies cited
No violations cited on this visit.
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Oct 28, 2021 Report · Deficiencies cited
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Supervision & ratios
The foster mother allowed the kids to go outside after dark, and one of the boys was shooting a target, then shot his brother when he ran across the path. These boys required more supervision.
HHSC 749.2593(c)(1) — Supervision-Caregivers counted in child/caregiver ratio must be aware of children's habits, interests, & any special needs including supervision
HHSC risk weight: Medium High. Corrected 2021-12-23. Correction verified 2021-12-30.
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Safety & premises Serious
Not only was the bb gun not locked in a safe, the child accessed this gun and shot his brother.
HHSC 749.2961(a)(3) — Weapons-No child may use a weapon-firearm-explosive material-projectile-toy that explodes or shoots, unless directly supervised by a qualified adult
HHSC risk weight: High. Corrected 2021-12-23. Correction verified 2021-12-30.
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Supervision & ratios
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Oct 16, 2021 Report · Deficiencies cited
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Other Serious
The caregiver admits to grabbing the child's arm while he was running from him. There were also indications of the child being pushed to the ground, and an allegation of being choked.
HHSC 749.1957(6) — Other Prohibited Discipline-Pinching, pulling hair, biting, or shaking a child
HHSC risk weight: High. Corrected 2022-01-24. Correction verified 2022-01-14.
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Other Serious
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Oct 1, 2021 Report · No deficiencies cited
No violations cited on this visit.
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Sep 20, 2021 Report · Deficiencies cited
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Illness & medication Serious
Multiple prescription medications were found to be accessible to anyone. This was corrected at inspection.
HHSC 749.1521(2) — Medication Storage-Keep medication inaccessible other than to caregivers responsible for stored medication
HHSC risk weight: High. Corrected at inspection. Corrected 2021-11-17.
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Illness & medication Serious
Get the full file
HHSC publishes inspections, investigations and assessments from October 2017 onward, with each cited deficiency and its risk weight. Investigation narratives, complaint files and older history require a public information request. The Texas Public Information Act (Texas Government Code Chapter 552) gives anyone the right to ask. You don't have to say why.
Email the request Printable letter (fax or mail)
- Send to
- HHSC Open Records Coordinator, MC-1070 · OpenRecordsRequest@hhs.texas.gov · fax 512-424-6586 · 4601 W. Guadalupe Street, Austin, Texas 78751-3146 · agency instructions
Show the letter text
If something is happening now, report a concern to HHSC Child Care Regulation. For suspected abuse, contact your county child protective services or law enforcement.
Source: Texas Health and Human Services Commission, Child Care Regulation datasets on data.texas.gov. Last read Oct 1, 2026. Violation text is HHSC's own wording. The categories are ours, added to help you scan. About this data.