The Grandberry Intervention Foundation (TGIF)

Condition #1 was unmet due to no documentation on the log verifying that a LCPAA was present at the operation for a minimum of 16 hours during the month of February. Condition #6 was unmet due to two tasks on the Heightened Monitoring tasks being unmet on February 23, 2023.

During a review conducted on March 6, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans 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 plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on December 14, 2022, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the administrator?s failure to ensure compliance include the following: Your operation received a low-weighted citation in a pattern/trend category on December 14, 2022. Specifically, the operation was cited for 749.1313 (b) Initial Service Planning Team-The child's record must include documentation of advance notice to parents and any responses. The operation met compliance on December 29, 2022. - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring An administrative penalty will be assessed as a result of this citation, per HRC 42.078(a-1). The maximum daily amount of a penalty for your operation is $100.

A child in care's medication logs for November 2022 were incomplete. The child is prescribed 5 medications, but the log only shows administration for 3.

A child in care's record did not include medication logs for the month of December 2022.

A child in care's record did not include documentation of the notice to the child's parents and foster parents for the initial service plan meeting.

A foster family adopted two children on 11/18/22. Licensing was not notified of this change in capacities until 11/29/22.

According to their background checks in CLASS, a family's adult daughters are now frequent visitors instead of household members. Their background checks were submitted as frequent visitors on 10/19/22. The agency's case manager confirmed that the adult daughters are no longer living in the home. There is not a home screening addendum in the file for this change in household composition.

Condition #1 was met. Condition #2 was met. Condition #3 was met. Condition #4 was unmet because inspections from 08/09/22 and 09/22/22 were not listed on the system for tracking deficiencies, and the system does not include information on corrections or follow-ups. Condition #5 was met. Condition #6 was met.

The reason the medication was prescribed to a child in care is not listed on any of his medication logs for the months of August and September 2022.

One employee file did not have form signed

A foster home liscenced in 2018 did not have pictures of the outside of the home and pictures were obtained of the home during inspection.

The monthly contacts for two children in care files did not have enough detail.

During a review conducted on September 2, 2022, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans 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 plans, your operation was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citations issued on June 20, 2022, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. 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 August 9, 2022. Specifically, the operation was cited for 749.1463 (b)(3) AP Administration of Medication-Administer medications according to label instructions or a prescribing health-care professional's subsequent orders. The operation met compliance on August 15, 2022. - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring

The child in care is prescribed Escitalopram Oxalate 5mg tablet 3 tablets once daily by a physician per the 3/28/2022 Texas Health Physicians Group After Visit Summary. The May 2022 medication log shows the child in care received 1 tablet two times a day. The child in care is prescribed Escitalopram Oxalate 5mg tablet 3 tablets once daily by a physician per the 5/27/2022 Texas Health Physicians Group After Visit Summary. In June 2022 medication log shows the child received one tablet a day.

The newest Addendum dated 8/24/21 shows the Foster Capacity at 4 kinship foster children and total Capacity at 4 children. In Class, it shows Foster Capacity at 3 foster children and a Total Capacity of 5 children. The addendum date 1/26/21 also shows a total of 4 kinship foster children with a total capacity of 4.

One foster home file did not address stess level of the home.

Home screening not address involvement of any of the family members.

One home proof of income did not match up with "2500 a month" claim. The budget had 0 listed for medical/dental/auto/clothing/rec entertainment, rent was listed as 900, either 1605 or 1307. The foster parent owned 2 cars but did not have any payments, gas or maintenance listed.

One home file did not have dimensions for the home. Two home file had no pictures of outside areas.

Condition 3 was not met there were no signature for administrator for 4-28-22 meeting. There was no documentation for May meeting. Condition 4 did not meet due to not have a completed attendance log. Condition 6 did not meet because citations for 5-5-22 were not address.

There were 3 investigations involving allegations of inappropriate discipline. Compliance was not addressed in any of them.

Foster parent experienced corporal punishment as a child, said she agreed with its use. Further the biological and adoptive children admitted to physical discipline including stating hit with a belt in HS, The home screening did not asses this.

There is no conversation with Ms. Williams during the home screening regarding closures with previous CPA s.

There is no documentation in the home screening regarding information being requested or assessed from previous CPA s.

A caregiver admitted to smoking cigarettes inside of the foster home.

An active home did not have any supervisory visits completed.

The specific results of the Foster Parents Background Check was not document or assessed.

The home screening did document any person that would provide support to the foster parent in case of an emergency or need to provide care for foster youth.

The home screening did not show how the foster parent relationships ended and how she coped with the relationship.

There were several trainings that did not include the qualifications of the trainer.

The home screening did not document the agency inquiring to foster parent if there were any service calls made within two years.

A foster parent moved out of the home June 2021.

Serious incident reports did not include the age, date of birth, and date of admission.

The foster parent became unemployed in 2019, yet no addendum was completed to evaluate her financial status and ability to continue caring for foster children.

Pet expenses are not listed on the foster home screening.

An 18-year-old is sharing a bedroom with a 3 year old in care when she stays at the residence a few times per week.

Four children are sharing one bedroom, which is 147.58 square feet according to the home screening and floor plan. Minimum standards requires 40 square feet per occupant, so the room would need to be at least 160 square feet.

1 out of 6 children was not administered one medication as perscribed by doctor.

1 child's file did not indicate if it were an emergency placement. The admissions assessment did not document the reason the child was placed in substitute care, neonatal history, religion, placement goals, and other services required. The admissions assesment for one file does not show the date it was completed, does not state if it was a non-emergency placement or emergency placeemnt and other required information is completed on the form.

1 out of 6 children file did not have immunization record in the file. Note: This was corrected at inspection due to the child being discharged on 6-21-2021.

An allegation of inappropriate touching of a child by another child was not reported to the hotline. Note: This standard was corrected due to being called in on 5-27-2021.

The affidavit for employment was not filled out completely.

The CPMS has a bachelors degree in business. The case file does not support that courses related to the family were obtained.

One out of 4 home files reviewed did not have a closing summary of the home.

One out of 4 home files reviewed had 2 quarterly visits during 2020. One document from the quarterly visits did not entail if the visit was announced or unannounced.

1 child's file did not indicate if it were an emergency placement. The admissions assessment did not document the reason the child was placed in substitute care, neonatal history, religion, placement goals, and other services required.

One out of 3 child files reviewed did not address supervision requirements or immediate needs.

A bed for a child in care was observed to not have a mattress cover or protector.

The room where two girls in care sleep was observed to have a stain of a liquid in the wall beside the closet. The carpet was observed to have stains. The clothes of a child in care were all over the room.