Open Hearts Children and Family Services

A caregiver in the home choked a child in care resulting in injury.

A foster parent admitted to allowing two children under the age of 16 to babysit a six-year-old child in care.

A child's service plan did not include all team members signatures within the 10-day timeframe following its completion.

During a review conducted on December 9, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan; and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plan for your operation included a specific ?planned end date? at the original 12-month mark by which your 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 heightened monitoring plan, your operation is now unable to successfully move to post-plan monitoring. Furthermore, your 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: Your operation received a high weighted citation in a pattern/trend category on November 5, 2024. Specifically, the operation was cited for 749.1521(1) Medication Storage-Store medication in a locked container. The operation met compliance on November 19, 2024. - 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. Finding: 749.635(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plan.

During a sampling inspection conducted on 10/29/2024, prescription medication was observed to be unlocked and accessible to children in care.

A child's service plan was not reviewed and updated timely, as it expired on May 27, 2024.

A foster home file did not complete trauma informed care annual training timely.

A foster home file did not complete annual psychotropic medication training timely.

The initial service plan updates for two children in care were not completed timely. One service plan was updated two days past the plan expiration date and the second service plan was update over one month past the plan expiration date.

During the inspection, not all areas of the home were accessible.

Four supervisory visits summaries were reviewed for two foster homes and all of the summaries are missing documentation for the behviors of the childlren, discipline methods used and stressors in the home.

A foster home screening update was not completed when a child in care was adopted in 2018.

A child in care was refusing to take their medication. The caregivers were not keeping a medication record for the child and failed to document the child's refusal.

The foster parent failed to provide the level of supervision necessary for children placed in the home which allowed to two children in care to use illicit substances leading to each child overdosing and requiring emergency medical treatment.

The agency failed to ensure that a copy of children's service plans was reviewed and shared with the backup caregiver living in the home that was providing daily oversight of the children in care.

The foster parent failed to follow the recreational and therapeutic requirements documented in the initial service plan for a child in care.

A child in care was refusing to take their prescribed medication and the caregivers were not documenting the child's refusal.

A child in care with a known, documented history of swallowing cleaning products had access to and used the cleaning supplies in the home.

This standard was found deficient as part of a DFPS investigation.

When a child in care was discharged from a behavioral health facility, the foster parent did not take the child to the outpatient treatment program as required by the hospital psychiatrist.

Child placement management staff were aware of a child's increasing behavioral concerns and did not provide the level of support needed by the caregivers, nor the appropriate oversight needed to ensure the safety of the children placed in the home.

A foster home was providing transitional living services, and its agency is not licensed to provide these services.

The foster parent failed to participate in conferences with school faculty every six weeks as required per the child's initial service plan.

The caregivers did not bring a child in care their clothing for a week when admitted to the hospital.

The floor plan submitted does not have the room clearly identified with wall, nor the dimensions per room. The floor plan also does not indicate what areas will be for children's usage.

A child safety seat is not being strapped into the vehicle according to the printed manufactures instructions.

The agency did not change the foster home capacity when two children were adopted in 2019.

The foster parent adopted two children in 2019 and there were no interviews or observations of the children (then ages 2 and 3) documented in the home screening update. The following was also missing from the home screening update related to the children's adoption: No family/group interview or observation is documented (749.2449(a)(5)) There is no documentation that a visit was completed in the home with all household members present (749.2449(b)

There are no interviews documented for any of the references obtained for the home screening as required for family and community references in 749.2449(a)(7) and (a)(8).

The original foster home screening and the home screening update are missing the following requirements: Documentation on the method used to obtain proof of the foster parent's income(749.2447(6)) Service call information obtained from local law enforcement (749.2447(7)) There is no documentation in the home screening regarding any previous history with other child placement agencies (749.2447(23)) When a home screening update is complete, the agency must also assess the appropriateness of placement of children in the home. This was not documented in the home screening update. (749.2453(d)(1))

Kitchen counters were observed to be cluttered with items.

The 5-year-old was being transported without a booster seat.

There was medication on the kitchen counter, master bathroom, master bedrooms, both adult rooms that was not locked up.

A 6 week old infant was asleep in a bassinet on top of a blanket and there was a curved pillow near the head.

A child in care is sleeping on the couch as the designated sleep arrangements.

There was a 6-week-old infant observed sleeping on loose fitted sheets.

On 11/20/2023, the agency was cited when a background check was not completed for a household member. The compliance date for the deficiency was 11/22/2023. As of 12/4/2023, the agency has failed to meet compliance. Therefore, the deficiency will be re-cited.

Two foster home files reviewed indicated on the supervisory visit documentation that both foster parents were present for the visit, but the documentation did not include both foster parents' signature on the supervisory form.

Two of the two foster home files reviewed, there was no verification on how income was verified and it did not indicate if two consecutive bank statements or tax returned were used.

Interviews for references are documented with only a name, relationship type and a phone number.

Only one community reference is documented in the home screening.

An adult family member is living in the home and does not have an active background check.

The home screening does not have any documentation regarding service call information obtained by local law enforcement.

The caregiver is physically disciplining their adopted child in the presence of children in care.

There is no group interview with all household members documented in the home screening. There is also no documentation that the home was visited when all household members were present as required in minimum standard 749.2449(b).

There is no documentation of any discussion with the caregiver regarding the reimbursement process.

The home screening does not adequately discuss the assessment of the caregiver's ability or willingness to work with specific ages, behaviors or needs of children in care.

It was discovered during a sampling inspection that 3 frequent visitors to a foster home licensed with your operation, did not have required background checks

2 of 3 Children records reviewed during inspection at the operation did not have signatures for children in care or caretakers of children

Children's supervision plans in their service plans were not being followed.

Caregiver did not have a medication log for several medications dispensed to the child in the month of November. The caregiver also did not document all medications dispensed to the child on the log in the previous month of October.

Medication logs for the month of October did not include the name of the prescribing physician or the reason for the medication.

A caregiver made children in care hold their hands in the air while in time out.

A child in care was transported in the foster parents mini van without being placed in a car seat.

There is not a background check for an alternate caregiver of the home

5 of the six children interviewed all claimed that the foster parent would yell at them or that they heard the foster parent yelling at their siblings.

All three children were allowed to play at the park without adult supervision present.

A foster child was sleeping on the couch and did not have a bed.

There was a household member that did not have a cleared background.

The home screening did not address a household member moving into the home. In addition, the household member moving in would change the verification 749.2453(a)(3).

There was one medication log that was reviewed that showed a child did not receive his medication as prescribed

New employee record reviewed was incomplete.

It was discovered during a sampling of a foster home licensed with the operation that the foster parents biological child was residing in the home and did not have a required background check.

A foster parent 14 year old biological child did not have required background check

During an inspection prescription medications were locked in a single storage box.

The last discharge occurred on 03/16/2021. During an investigation inspection discharged children's medication was still being stored with medications for children currently placed.

The fire extinguisher in the home was last inspected in January 2020.

During the walk through inspection of the home several medication bottles were found to not be stored in a locked container.