Camp Worth, LLC

Agency policy requires staff not sleep during their shifts; one staff member was found sleeping on their shift.

Several staff members failed to effectively intervene when three children were involved in a physical altercation which failed to protect the children's safety in the operation.

The operational administrative staff failed to ensure that staff in ratio included staff that were capable of providing an appropriate EBI response to manage child behaviors. The staff at the time of an incident were relying on intervention from a contractor who was not readily available.

Two of the staff files reviewed did not have the pre-service training documented in the file.

Condition 1 was not met. The supervision of all the children were not reviewed. Condition 2 was not met. The minimum number for the unannounced visits were not met. The minimum number of hours per week of observing video were not met. Condition 3 was not met. One staff did not complete required trauma training. Condition 4 was not met. All staff and all children did not have a monthly meeting. Condition 5 was not met. There is no log with the current investigations. Condition 6 was not met. There was no documentation for the restraint conducted.

The pill count was off by one pill on two days for two count the ten medication logs reviewed.

One out of two staff files reviewed did not document the orientation completed.

A child's service plan called for the child to be "given distance", along with use of "non-threatening and non verbals", and "avoid overacting by the caregivers". Staff did not use these techniques on the child prior physical intervention techniques.

A staff member did not use proper de-escalation techniques before attempting to implement the EBI on a child.

A 15 year old child in care was provoked to engage in a physical altercation with a staff person where the child was slammed to the ground and held in an inappropriate hold.

One of the child service plan's was assessed and it listed 3 different children's names that were not applicable to the child's service plan that was reviewed.

A caregiver engaged in physical contact with the child after escalating the child's behaviors.

A staff member wrapped his arm around a child's neck during a restraint.

A caregiver used an inappropriate technique on a child which caused him to the be thrown on the ground with excessive force.

One of the service plans reviewed was not signed by the child.

The fire or the severe weather drill do not document the time of evacuation or relocation.

Two of the two medical consenter forms designated staff from the operation.

Condition 1 was not met. The review before placement for one youth did not address supervision. The admission assessments for two new youths did not document specific information required in the plan for supervision. Condition 2 was met. Condition 3 was met. Condition 4 was not met. Monthly staff documents were missing detailed information. Condition 5 was met. Condition 6 was met.

There were not copies of the current insurances cards in the two vehicles used for transportation during the inspection. The insurance cards were obtained during the inspection and placed in the vehicles.

There were two bowls of uncovered food and a plate of uncovered burgers in the refrigerator. The uncovered food was removed during the inspection. The dishes were washed. There was no longer any food left uncovered in the refrigerator.

Condition 1 was met. Condition 2 was not met. The videos were not reviewed during the week of December 11, 2022. Condition 3 was met. Condition 4 was met. Condition 5 was met. Feedback was provided. Condition 6 was met. There were no restraints conducted to review.

A child was allowed to throw an object at another child who was involved with an incident with a caregiver. A child was also allowed to pick up a broom during the incident. There was a staff member who did not intervene with the child to prevent injury to another child.

A child in care was allowed to remain in the same area during an incident involving multiple restraints of another child for eight minutes and fifteen seconds.

After a staff member made an aggressive gesture by removing his jacket and lanyard, a child in care was escalated. The child was not allowed to continue with his preferred de-escalation method of playing with the Legos.

A staff member used a supine restraint on a child in care.

Condition 1 was met. Condition 2 was not met. The videos were not reviewed during the proper hours. There were not at least two visits per week for a minimum of two hours. Condition 3 was met. Condition 4 was met. Feedback was provided. Condition 5 was met. Condition 6 was not met. There was an EBI not documented.

There was an EBI conducted an and documentation was not completed.

Condition 1 was met. Condition 2 was met. Feedback was provided. Condition 3 was met. Posttest will be completed by November 30. Condition 4 was not met. The service plan and date of the service plan were not documented on the staffs? monthly conference. Condition 5 was met. Feedback was provided. Condition 6 was met.

One out of two children files reviewed did not document the reason for the medication for three medications and the time or initials for one day.

There were two medications reviewed where the medication count was incorrect.

An incident where a child swallowed an item and needed to be hospitalized was not reported within the proper time frame.

A child who has a history of self-harm was unsupervised in the kitchen looking for items that could have caused harm.

Condition 1 was met. Condition 2 was met. Condition 3 was not met. Training information was not submitted to meet the condition. Condition 4 was met. Feedback was provided. Condition 5 was met. Feedback was provided. Condition 6 was met.

A child's initial service plan has the name and electronic signature of an individual that did not participate in the service plan development for a child in care.

One out of two employee files reviewed did not provide the high school or equivalate documentation.

A staff person was present at the operation, after notification that they were ineligible.

The service plan was not signed by the child in care.

The PLSP did not sign the child's service plan.

The EBI documentation does not document the conversation or the child's reaction.

A child was arrested on 8/22. The incident was not reported for 42 hours later.

A supervisor did not document their review of the use of the intervention.

Condition 1 was met. Feedback will be provided to operation. Condition 2 was not met. No visits were documented for the first week. The week for video observations was for week one was 2 hours. Week 2 for video observation was 2 hours and 40 minutes. Week 3 for video observation was 30 minutes. The documentation was missing the staff observed. Also, the master log was not signed by the LCCA or approved designed. Condition 3 was met. Feedback will be provided to operation. Condition 4 was not met. There is a log of the meetings but there is no summary of the meetings and the issues discussed. Condition 5 has been met. Condition 6 was not met. There was 2 restraints reviewed. There was only 1 reviewed for documentation by the operation. There was no documentation where the staff and children were debriefed.

The caregivers did not provide privacy for a child that was being restrained and allowed two children to observe the incident.

The operation did not notify the parents of a child in care, that a restraint was conducted.

A caregiver immediately put a child in a restraint without using any de-escalation method with the child.

The caregivers did not document or inform management that multiple EBI restraints were conducted with a child in care.

A caregiver was observed putting her entire body weight on a child's torso while the child was being restrained.

A caregiver was observed with her arm around a child's neck while conducting a restraint.

The caregiver restrained a child in the prone position.

A child that was having a behavioral crisis and destroying property and breaking windows. The caregivers did not implement a restraint to ensure the child didn?t injure themselves. The child did have to seek medical treatment.

A staff member did not use any de-escalation methods with a youth in care.

A restraint was conducted on a child and the child's parent/case worker was not informed.

Multiple staff members were informed of an allegation of a staff member hitting a child and did not report the allegation.

A supervisor did not document their review of the use of the intervention.

A youth in care was injured in the face during an attempt of a restraint by a staff member.

The training certificate does not document the trainer's qualification for the staff's EBI training.

Of the 6 incident reports reviewed, 4 were missing informaiton required in 748.311(3) and 3 were msising informaiton required in 748.311(1)

3 of 3 children files reviewed did not have allergy information documented on the exterior of the file.

The operation reported a video was not available due to IT issues. This statement was not true.

After a child was escalated. A caregiver was responsible for attempting to fight a child in care. The caregiver had to be restraint by another caregiver.

The staff engaged in aggressive behavior with the security guard in front of a child in care and made the child feel unsafe.

The EBI documentation did not include any details on the de-escalation techniques utilized prior to the restraint. The space for this on the form is blank

The EBI documentation did not include any details of what occurred prior to the restraint. Further the caregiver who performed the restraint could not recall what the situation was prior to the restraint.

The EBI report did not document any post discussion with the child

The initial service plan was not in the youth's file within 30 days.

The unauthorized log does not document how long the child was gone, the the name of the caregiver responsible for the child at the time the child's absence, the intake report number, and whether law enforcement was contacted, including the name of any law enforcement agency that was contacted and the number of the police report.

The trigger review did not document the previous unauthorized absences, including previous debriefings, alternatives to minimize the unauthorized absences, and a written plan to reduce the unauthorized absences of the child.

A staff member fell asleep during the her shift and supervising children.

A staff file was unavailable for review.

RCCR Investigator requested the footage for certain days on multiple occasions and it was never obtained. The footage was for different days that was regarding the investigation.

A staff member's last day of employment was 3/15/22. However, the background check was inactive on 4/21/22.

The cord to a space heater plugged in the hallway caused a child to trip resulting in an injury requiring treatment by a medical professional.

A child that has a history of running away and was required to be in visual sight of a caregiver was allowed out of sight of caregivers which allowed him to run away twice within two days.

Two of the children's service plans document a supervision of 1:1 during awake hours. There was only one staff with the two children.

The caregiver placed a child in a choke hold resulting in the child not being able to breath and caused discomfort.

A caregiver called a child names and taunted a child instead of de-escalating the situation which resulted in an inappropriate restraint hold.

The administrator did not ensure the child's needs were met by having a staff member who was a risk to children continue to provide care.

A 17-year-old child in care was hit several times and put in chokehold by a caregiver resulting in the child needing medical treatment.

Caregiver hit a child in the head and head butted a child because the child was not doing homework.

A caregiver was involved in an altercation with a child in care and did not provide a safe environment for other children in the area.

A staff member used profane language and yelled at youth in care.

A staff member denied youth in care the right to make phone calls.

A staff member did not have the complete training on restraints that are used in the operation.

The service plan for a child in care was not developed specifically for that individual. There were several different names listed throughout the service plan indicating that the service plan was copied and pasted.

A staff member shut a door on a child as an attempt to control a child's behavior. The child's de-escalation method of supervised separation was not implemented.

The service plan indicates that a child in care requires a 2:1 supervision ratio and that was not followed.

One out of three medication logs that were reviewed did not have the time the medication was administered.

A caregiver admitted to sitting on a couch and placing his arm across the chest of a child in care in order to keep him from getting up, prior to de-escalating the situation.

A caregiver admitted to getting very close to a child?s face and yelling in order to intimidate him.

A child had a vision appointment due on 11/16/2020 but did not attend.

There were fourteen people who were still active but were no longer associated with the operation.

There was not a name or signatures on a child?s medication log for the dates of March 5 through 11, 2021.

A staff member used a restraint hold on a youth that was not warranted.

The staff member used a restraint instead of using the youth's preferred de-escalation method.

The staff blocked the door and not allowing a child to leave the area.

Caregivers used force with children in care that caused children to be uncomfortable by applying pressure to the chest and neck, causing pain to the point of difficulty breathing.

The staff did not provide adequate supervision with youth engaged in sexually acting out.

Four youths, three with high risk sexual behavior history engaged in sexually activities with one another while under care of the operation.

A staff member threatened a child with harm from another resident