Brownstone Residential Care

One out of two employee files reviewed did not contain documentation to show employment history was verified.

The administration/owner did not use prudent judgment when requiring the child to get back to the operation and not offering to get the child a ride back to the operation when the child made him aware that he could not get a ride.

Children in care were assisting staff and intervening with another child in care having a manic episode.

Four out of four first aid kits observed during the inspection was missing adhesive tape, thermometers, tweezers, and disposable gloves.

During the inspection, the operation was observed to not be clean evidenced by a urine smell in two of the bedrooms and old food on the floor behind the stove.

Three out of three employee files reviewed did not contain reference checks.

One of three youth files reviewed did not include an immunization record or reasoning explaining for the lack of it.

The serious incident reports reviewed did not detail interventions made following the incidents.

Two medications reviewed for one youth in care was documented with the wrong ending count.

One out of three youth files reviewed had a dental appointment dated longer than the required maintenance of 6 months.

A cleaning product was observed during the inspection accessible to youth in care under an unlocked bathroom sink.

The operation has been without an administrator for more than 120 days.

Operation staff laid on top of a child in care to gain control during a restraint.

Two out of three employee files reviewed only contained verification for 8 hours completed for EBI training instead of the required 16 hours.

The operation has not had an administrator for more than 90 days.

Records requested from the operation on 11/21/2023 were not received until 12/20/2023.

Service Plan completed for a child in care on 08/12/2023 indicates that the child should not be placed in a bedroom with any other children. This child was instead placed in a room with two roommates.

Operation provided an inaccurate copy of a child's service plan.

During walk through, it was observed that substance controll medication was not double lock.

During walk through, it was observed that the childrens bathroom was unequipt with handsoap and tissue.

The operation has not had an administrator for more than 60 days.

The staff list provided still included 4 previous employees.

An attempt was made by CCI to do an on-site inspection and no one was there.

Records were requested at the start of the inspection licensing did not have access by the conclusion of the inspection.

It was observed that there were two originally packaged packs of fish in the sink in water thawing. The staff removed the packages of fish and begin to prepare dinner.

2 same medications log for the month of September 2023 for 1 child med log was reviewed. One of the med logs stated that Fluticasone Propio 50 MG was administered for the 1st of September 2023 at 7:15am and initialed by one staff while the second medication log for the month of September 2023 for same child stated that same medication was administered on the 1st of September at 7am and initialed by another staff.

CCI Investigator requested for medication logs for all children for 2023 but the operation was not able to provide the records upon request.

The unauthorized absence incident is documented to have occurred on 9/12/23 at 3:45pm, but the children's parent was not notified until 9/13/23 at 8:37pm.

Three out of three youth files reviewed were missing several documents in the files that the operation provided separately.

One out of three employee files reviewed did not include a signed and notarized Affidavit for Employment.

A staff member admitted to calling a child in care a "crackhead".

One out of two employee records reviewed indicated the TB skin test was completed more than 30 days after hire.

The operation's Treatment Director's personnel file was not provided as requested.

Two out of two serious incident reports reviewed did not include the interventions made by staff or the resolution to the incident.

Cleaning supplies were observed to be stored in two accessible areas for youth in care.

One out of two employee files reviewed did not contain a signed affidavit for employment, indication of date of hire, or verification of completed TB skin test.

Twelve fire drills conducted by the operation were indicated to have lasted significantly longer than three minutes.

Two out of two first aid kits did not contain a guide, tweezers, gloves, scissors, tape, or gauze pads. One out of two first aid kits did not contain a thermometer.

Staff members were observed not being in the proper caregiver/child ratio. Two staff were interviewed and confirmed they were out of ratio for a short period of time.

Not all requested child documents were provided or provided within the specified timeframe.

Two discharged youth's medications were stored in the same box with current youth's medications.

A medication label was said to have had the wrong quantity printed compared to the medication log reviewed, but the operation failed to get the label corrected.

All active records were not in the files reviewed timely.

There is not always administrative staff present at the operation during normal business hours to assist with administrative duties such as allowing Licensing to conduct an inspection.

The unauthorized absence log was not available upon request.

The serious incident report did not have the names of the children involved in the incident.

During the inspection, observed a window to be broken in a bedroom. Window was taped with Plexiglas glass for temporary repairs. Observed a part of a bedroom door frame to have been detached from the wall.

During my inspection, it was observed in each bathroom to not have personal towels to dry hands. In one bathroom, there was no handwashing soap.

Three out of four child records reviewed did not contain the known allergies on the exterior of the child's file.

The unauthorized absence log was not available upon request.

One out of three youth records reviewed did not contain an immunization record or documentation to verify attempts to obtain were made.

Two window blinds were observed to be damaged.

Two out of three medication records reviewed did not list all medications, strength, dosage, and frequencies prescribed.

Two out of three employee files reviewed did not have an identifiable date of employment for the employee.

A youth did not obtain follow up treatment in the recommended timeframe as recommended by a healthcare professional.

Two out of three employee files reviewed did not contain a signed affidavit for employment.

Some active child records were not available to be reviewed due to not being at the operation at the time of inspection.

Two out of two first aid kits were observed to be missing scissors, gloves, cotton balls, adhesive tape, tweezers, thermometers, adhesive bandages, and the first aid guide.

One out of three youth files reviewed did not contain documentation to indicate immunization records were attempted to be obtained.

One out of one employee file reviewed did not contain a signed Employee Affidavit.

Two out of three youth orientation did not include process for making complaints to outside agencies.

One out of three youth files reviewed did not contain the PLSP's signature on the admission assessment.

Two staff members with pending background checks were supervising children in care.

Smoke detector was observed to have a beeping sound indicating that battery was low or needs to be replaced.

One of three child records read did not have a signature of professional level service provider not a date.

Fence on backyard was exposed with barbb wire and other boards were observed to be warped. Some boards in the backyard fence were missing. There broken chairs both in the front and back yards. Standing water was observed on the trash can lid in the backyard of facility. Standing water was observed in two buckets in the backyard yard. Grass in both front and back yards was failed to be maintained.

A hole was observed in the wall of the dining room of facility. A broken cabinet door was observed in the wet bar area. Door of 2nd restroom was observed to be cracked. Carpet in storage room was observed to be soaking wet. Outlet covering in the living area was observed to be exposed. Cracks were observed in a couple of the walls along with the floor in the dining area appearing to be slanting.

One current employee did not have an active background check.

Staff records were not available to be reviewed immediately at operation.

One of three staff records read was observed to be missing date of pre-service training.

Multiple broken furniture were observed in the front yard of the operation.

Three doors off the hinges were observed leaning against a wall in a storage room easily accessible to youth in care inside a youth bedroom.

One out of three child files reviewed did not contain a discharge summary with all required components per the minimum standards.

Two out of three child files reviewed did not have in a clearly visible place to indicate if the child had any known allergies or chronic conditions.

Three out of three child medication logs reviewed did not document the exact time administered.

The operation's administrator does not work full time hours at the operation.

Three out of three medication records reviewed did not contain the dosage documented on the medication record.

Two out of three child files reviewed did not contain a preliminary service plan.

During the walk-through an operation of holes were observed in the children in care bedroom walls, 30 gallon trash can filled with water in the backyard, missing boards on the fence outdoors, and mold in a closet in children bedroom,

Two out of two youth files reviewed did not have the youth's known allergies or medical conditions documented in a clearly visible place within the file.

One out of three staff files reviewed did not contain documentation of a TB skin test being completed.

Two out of two youth files reviewed did not have a second means of identification for the youth in care such as a client number.

During the walkthrough, two wood plank boards were observed lying on the floor exposed in one of the common areas.

One out of one serious incident report reviewed was not fully completed to contain all required information.

One out of three employee files reviewed did not contain an Affidavit for Employment.

Three employee files reviewed did not contain verification of the required pre-service training regarding location and proper use of the fire extinguisher and first aid equipment.

Two out of three employee records reviewed did not contain an acknowledgement signed of reporting abuse/neglect.

Two out of three employee records reviewed did not contain verification of the employee's educational qualifications.

Three staff files reviewed did not contain verification of pre-service training regarding the needs of children.

Three employee records reviewed did not contain verification of orientation completed.

Two out of three employee records reviewed did not contain an acknowledgement signed of the operational policies.

Three employee files reviewed did not contain verification of the required pre-service training regarding emergency procedures.

There is no verification of licensure for the treatment director in the file.

Two out of three employee files reviewed did not contain verification of the required pre-service training regarding normalcy.

Three employee records reviewed did not contain verification of pre-employment drug tests completed.

Three employee files reviewed did not contain verification of the required pre-service training regarding communicable diseases.

One out of three employee records reviewed did not contain documentation of a current TB test to meet the requirements.

Missing from policy.

The shed in the backyard is not in good repair or structurally sound.

In staff file missing a place for how they meet the age requirement.

Missing entire policy

No thermometer in refrigerator.

Missing from policy.

Missing a log for unauthorized absences.

In staff file missing a place for TB test.

In staff file missing a place for the job description.

Missing how to make outside complaints.

Missing a place for medications child is taking.

In admission assessment missing a spot for the phone number and address of the conservator.

Policy does not indicate the area designated inside of the house to take shelter.

Missing policy.

Missing from policy.

Missing a general daily schedule for children.

In staff file missing a place for a statement that staff has read the operations policies.

In staff file missing a place for certifications such as high school diploma.

There is no abuse neglect policy.

No policy about fiscal requirements.

No thermometer in freezers.

In staff file missing a place for staff evaluations.

Missing from policy.

Loose wooden boards and a broken pipe were observed lying around in the backyard.