New Horizons Ranch Residential Treatment Center

It was noted that during an investigation, a child was not properly restrained.

It was noted during an investigation that a child in care was being restrained which resulted in a child being restrained inappropriately as the child in care resisted.

It was noted in this investigation that a child in care was grabbed by the front of the shirt.

It was noted during the investigation that profane language was used during an incident that had escalated on a child in care.

Records were requested on 12/4/23 (by email), on 12/7/23 (by email), and on 12/18 (by email & by phone). Records were provided by the operation on 12/18/23.

The suicide screening indicates it was done 13 days late.

A staff member allowed children to go to an unauthorized outdoor area. As a result, the children ran away and committed inappropriate physical contact with each other.

Three children and two staff stated that staff will use curse words around children. Staff said they will repeat what children say as a way to have them rethink their own words.

Four children described excessive force being used during restraints, such as being slammed against a wall or floor, arms twisting back, and being bent over.

Four children described examples of being restrained for not following directions or situations that were not an emergency.

Upon reviewing letters and pictures from a caregiver it was determined that the caregiver has maintained an inappropriate relationship with a child in care.

A child with high-risk behaviors noted did not have a plan to address these behaviors in their service plan.

7 previous staff members who are no longer employed at the operation were not inactivated within 7 days of unemployment. The administrator inactivated these staff during the inspection.

One child did not have a TB test documented in their record. The child was at a doctor's appointment and recieved a test today. The results will be done in 48 hours.

4 out of 10 medication logs did not have the required signature of the person who administered the dose.

A child in care assisted staff by monitoring a restraint conducted on another child in care.

2 children's service plans noted high-risk behaviors but did not include specific plans that address these behaviors.

A few of The Ranch's policies were not followed regarding this incident. -Night staff members were sleeping. -Staff sleeping was not reported, and staff is trained to report this. -Concerns that hadn't been handled and needed more attention were not relayed to higher-up Supervisors/chain of command.

A caregiver was administering medication without having a signature on the medication file.

A child in care's prescription label was altered by a staff member. The instructions stated take 1 tablet by mouth every morning but morning was mark through and night was written by pen.

It was found that the child in care was not seen for a follow up medical appointment as it was requested by the ER doctor at the time of discharge.

A report to licensing that a child contracted a communicable disease was not made within 24 hours.

A child with a history of struggling with medical compliance, was made responsible for monitoring their blood sugar levels. The child was also able to sneak snacks, as other children in care reported.

The operation/staff failed to provide the level of monitoring and oversight necessary to help ensure a child's compliance with their diabetic treatment regimen. Staff was not aware of the child's supervision needs during blood sugar checks, which directly led to the child being hospitalized.

Staff was unaware of a child's medical needs outlined in the service plan, which resulted in the child's medical needs not being properly met.

During the investigation it was determined that the caregiver in charge failed to supervised children by falling sleep and not checking on them after waking up. As a result the children ran away from the operation.

A child's service plan contained inaccurate and outdated information and instructions for supervision

Three children in care were forced to do exercise as discipline

A child in care was not given their medication accordingly. Within the 3 month period reviewed, the child missed a total of 18 dosages from a total of 3 medications. The child was also given the wrong dosage of medication 3 times. Another child in care was given their medication specifically prescribed for 3PM after 4PM on 8 occasions. There was no documentation created to record these incidents.

A child in care was able to sexually act out with another due to a staff member neglecting to properly check on the child when going to have a conversation with the only other staff member in the house.

The Investigator visually witnessed a staff member caring for 5 children, who were on increased supervision due to sexually acting out, with their eyes closed for an extended amount of time while supervising 4 of the children. When their eyes were open, the staff had to ask the children were the fourth child was, as they were unaware.