Helping Hand Home for Children

A caregiver failed to adhere to the child's rights to be free of abuse, neglect, and exploitation as defined in Texas Family Code 261.401, as a caregiver strained a child's arm after grabbing them by their arm and escorting the child into their room.

It was discovered during the course of this investigation that a caregiver used physical force to get a child to comply and made inappropriate comments to a child in care.

A Program Manager who facilitated the EBI training in October 2024 signed off on their own training hours. It was explained the trainers are recertified every 2 years and receive their bi-annual EBI training hours from facilitating trainings.

A child in care exhibited signs of an injury and did not receive medical care for about 14 hours after the injury occurred.

A caregiver failed to adhere to the child's rights to be free of abuse, neglect, and exploitation as defined in Texas Family Code 261.401 after failing to get timely medical care for a child who had dislocated their hip.

During the inspection, a caregiver had contact with children on 10/30/23 but did not have an eligible background check until 11/7/23.

During the investigation, a caregiver admitted to utilizing an inappropriate EBI when she pulled a child by the wrists to his room when he dropped to the floor. There were no injuries.

During the investigation, it was found that a child's right wrist was strained during a restraint conducted by a staff and the child received medical care for this. It was reported by collaterals that this staff holds too tightly during restraints.

During the course of this inspection, it was determined that a caregiver used inappropriate language in front of children and used unnecessary force on a child.

During the investigation, a Service Plan for a child in care had several areas where a different child's name was listed.

One of four records reviewed was missing the date and the reason for separation in the personnel record.

At the time of the inspection, documentation required to be in the chart was unable to be located in the electronic record. Some documentation had to be printed from and provided to the inspector as it was also not in the paper file.

Five of five child records reviewed did not have the 14 day notification to the parent included in the chart record.

One of four child records reviewed showed the child participated in the service plan on 1/10/24 which is after the service plan meeting took place. The service plan meeting was completed on 1/4/24. The remaining three child records reviewed did not have a date indicating child participation.

During the walkthrough of the facility, a corner piece of the wall next to the window had excessive paint peeling and exposed support frame.

The health inspection for the operation expired on 07/11/2023.

It was found that, a child was not taking to direction to an expectation set by staff to go to their room and was restrained on 11/14/23 for approx. 8 minutes from 5:49 pm until 5:57 pm. The child was not harming themselves or others prior to this restraint. Additionally, in an incident on the same day at approx. 3:55 pm, prior to the above incident, it appears staff further escalated the situation to where the child was restrained.

It was found, that a child was restrained to get the child to comply and this was not reported to the A/N hotline.

Two of ten bathrooms observed showed significant paint peelings in the paint on the walls above the showers. This was corrected at the inspection when the maintenance team sealed the area and repainted the ceilings.

During the course of the investigation, it was determined a caregiver failed to adequately supervise a child in care, who was on a safety plan, which resulted in inappropriate sexual behaviors.

During the course of the investigation, it was determined that the operation failed to notify a parent or get permission for a child to travel out of the state.

During the investigation, it was found that the child was not administered one of their doses of prescription medication antibiotic suspension for their injury on 8/10/23 as ordered by the doctor for the knee cut.

In reviewing the investigations documentation and interviews verified at the time it was decided to escort the child, it was to get them to go to their room.

In reviewing the investigations documentation and interviews verified at the time it was decided to escort the child, it was to get them to go to their room.

24 children medication administration records with their medication inventory form were reviewed for medications administered between 07/29/2022-8/11/2022 and there were times that the reason medication was prescribed was not documented.

During the follow up inspection on 4/18/23 it was found that the facility had not determined a plan to have a qualified medical professional conduct the training.

Review of the video showed the child was grabbed by the arm in an abrupt manner and put into the corner.

Video showed a caregiver grabbed a child by the arm and put the child in the cool down corner.

In reviewing documentation required areas were missing.

During the review of Medication Training it was found the trainer did not have Medical Training.

A child in care was administered an OTC, over the counter, antibiotic cream after an injury. The operation did not have any notation and/or medical documentation on when the antibiotic cream was administered or how often.

Two Medication Administration Records were provided for March 2023. One was provided in April and one in May 2023, which noted altered documentation.

It was determined that the operation did not seek immediate medical attention for a child in care who had a substantial injury which resulted in a concussion diagnosis days after the incident.

After reviewing multiple Medication Administration records, Medication Inventory records, and Drug Count Sheets, it was determined that there were multiple errors in the total number of doses remaining.

A child in care was administered an OTC, over the counter, topical ointment after an injury. The operation did not have medical documentation on when the ointment was given to the child and how often it was given.

The child's service plan documented the child "must remain in eyesight of staff at all times due to incidents of history..." However, while interviewing staff, it was determined the child was allowed to be in their bedroom with the bedroom door shut. Staff noted to check on the child in their bedroom every 5-10 minutes.

When reviewing 4 service plan notifications for 3 children in care, 3 notifications weren't sent timely to notify parents.

Through interviews with children and staff, it was determined that staff are not giving children in care privacy when making phone calls.

2 prescribed PRNs, Ondansetron and Ibuprofen, were not counted daily count, rather only on the days when they were administered to the child.

During the inspection 2 child charts and 4 staff charts were reviewed and found to have several items not placed in the chart timely.

During the reivew of Backgrounds it was found a staff was inactive but scheduled to work.

In reviewing 3 of the 4 charts for staff, three did not have the Licensing Affidavit notarized.

The EBI reports for 1/12/22 at 11:00 AM & 12/10/21 at 1:45 pm do not have in the narrative the type of EBI that was used and when the restraint was initiated and ended. The 12/10 report is also missing what each staff was doing during the restraint (i.e. witnessing, monitoring, assisting, etc...) and if a staff was monitoring the restraint.

Staff failed to document a complete assessment of circumstances that led to a restraint not providing appropriate rational for the restraint.

There is sufficient evidence to show that children are being kept in holds in an excess of 30 minutes and sometimes up to an hour.

There is sufficient evidence to show that staff on at least three occasions failed to completed the appropriate documentation after a medical error occurred.

After conducting the investigation, it was found that there were two staff with a provisional background check with conditions set by CBCU. The two staff were left alone with children in care during their shifts and also administered medications to children in care during their shift(s). One of the two staff worked on and administered meds to the child involved on 1/11/22 and 1/18/22 and the other staff worked on and administered meds to child involved on 2/4/22. Both staff initials are on the med logs (MAR) provided by the operation.

A direct care staff was in the care of children with a pending background check.

During the course of this investigation, seven of seven medication records were found to be incomplete, illustrating lack of information and/or documentation.

During the course of the investigation, it was discovered a child was given correct medication but was documented incorrectly.

During the course of the investigation, it was discovered May records for a child were shredded.

Due to the information gathered throughout the investigation, a child in care who was kicking a bean bag and talking to staff was then subjected to an unapproved EBI without providing de-escalation. The incident did not arise to an emergency situation that warranted an EBI.

It was determined that a caretaker was hired on 5/17/2021. Fingerprint was cancelled on 08/09/2021 due to non-compliance, fingerprints not completed by the due date. It is documented that caretaker was fingerprinted on 08/20/2021. caretaker?s fingerprints were not received and cleared until 08/25/2021. The incident subject to this investigation was on 08/08/2021. caretaker was allowed to care for children without having a cleared background check.

On 04/22/2021 the operation was emailed requesting documents, pertinent to the investigation to be provided in five business days. After not receiving a response, a follow-up email was sent on 05/10/2021. requesting the aforementioned documents be provided by 05/11/2021. A response was again not received therefore an unannounced inspection was conducted.