Dream Residential Treatment Center, Inc.

The medication log does not have an accurate count of remaining medication.

A child right form has not been by the child.

During walk through, it was observed that the far left window, on the back of the home, was missing a screen.

Records reviewed show service plans not signed by all required parties as a form of acknowledgment or a child's refusal to sign is not noted.

There is no medication error report completed for a medication log that shows a change in medication dosage prescribed vs. the dosage of medication administered.

Records reviewed show multiple staff members did not renew annual trainings timely.

Medication logs reviewed listed "N/A" as reason for medication.

Records reviewed did not documented how identified high-risks behaviors will be mitigated.

The operation has not conducted a weather drill.

Staff file is missing an Affidavit for Employment.

The operation failed to report a serious incident in time.

An overnight shift staff member did not follow the RTC's policy when they prefilled out the bed check log form, notating all children were asleep the entire night until 6am.

In review of two child service plans, it was found that service plans are being reviewed after 90 days from the last service plan.

A child in care in missing documentation of the TB exam.

Both the front and rear exit doors from the facility required a code/key to leave building.

Three out of three youth interviewed stated staff will get in their personal space as a means of intimidating or getting them to comply.

Two out of three youth interviewed stated multiple staff have twisted their arms behind their back and held them in this position as a restraint.

There is a whole in the upstairs bathroom

During the medication review, it was found that the Medication log for one of the 5 children shows that he should have a remaining 7 pills and the count reflects a remaining 6.

Four medication records were reviewed and all of them contained medication count errors.

Two out of the four medication records reviewed were missing the health professionals name or had the wrong health care professional's name on the form and did not reflect the medication.

Staff put residents at risk for substantial physical injury when she failed to remove both from an unsafe environment. Staff continued to put resident at risk by allowing another resident to restrain and hit the resident numerous times without removing either from the situation, resulting in the resident receiving a black eye due to the other resident striking him in the face with no intervention from Staff. Staff continued to put resident at risk by allowing him to remain present after resident broke the glass. Due to the severity of the situation, resident was transported to the hospital because he had major cuts on his arm and lost a lot of blood.

One of the two child files reviewed is missing a signed statement for the child's rights.

Trigger review has not been conducted for a child who has run away more than 3 times within a 60 day period.

One of the two child files reviewed were missing documentation of a TB screening.

Both staff files reviewed were missing a signed statement for reporting and suspected incident of child abuse, neglect or exploitation.

Staff did not report to Licensing that a child ran away within the 6 hour timeframe.

Children reported that 2 children were smoking vape pens in the game room and a child in care was able to offer drugs to other children in care in their bedroom.

Two children have more than three documented Unauthorized Absences, with no documented Triggered Review.

Unauthorized Absence Log is missing pertinent information required by standards: (1) gender, DOA, (2) time the unauthorized absence was discovered, (4) the name of the caregiver responsible for the child at the time the child?s absence was discovered, (5) the intake report number,if a report was made to Licensing or the DFPS, and (6) whether law enforcement was contacted, including the name of any law enforcement agency that was contacted and the number of the police report, if applicable.

Staff members use corporal punishment by punching a child and pushing another.

A background check for a maintenance person was submitted on 12/01/2021 as a Contracted Service Provider. It was cancelled by the operation on 12/16/2020 but the person was still allowed to be at the operation performing work for the operation.

The owner of the operation was negligent in their duty by allowing a contracted person to continue being present at the facility, despite admitting knowledge that the contracted person was not allowed to be on the property, and in doing so exposed the children placed at the facility at immediate risk of harm.

The permit holder allowed a contractor access to the facility with children in care without a background check.

The medication record for one child was for March but he arrived at the facility in April.

Over five medication records reviewed determined that the operation did not administer the meds as the doctor prescribed for certain days.

Multiple records did not include the daily amount given each day.

Mulitple medication logs did not include the date and time.

Two of five children interviewed stated that when they are restrained, they are in a supine position. Two of five children interviewed stated that other residents are restrained in a supine position. One of five children interviewed stated that during restraints, residents are in a supine position or prone position.

The 72 hours plan provided is the exact same information found in the admissions assessment.

2 children's medication count wrong all children's medication count prefilled

No documentation of how operation will meet the needs of the child being admitted.

no documentation of siblings

1 out of 3 staff files reviewed did not have the date of hire documented in the file.

No documentation of the reasons in 2 out of the 2 files reviewed.

No place to document high risk behaviors

Serious Incident report document does not list all minimum standard requirements.

The facility does not have an annual summary log for a child who has an unauthorized absence

In review of two staff files, there is no documentation that verifies education requirements.

Each child file reviewed is missing the child allergy information on the front of the file.

In review of restraint reports, there are no mention of what method of EBI was administered.

In review of Drug test, it is found that staff is only being tested for Marijuana and nothing else.

Administrator is missing Normalcy training

In review of 4 staff files, I was found that three of the four staff members lacks the proper amount of EBI training hours before being counted into ratio.