Shiloh Treatment Center

The review of two children records found that both children who are over the age of 6 did not sign the Child's Rights statement acknowledging they have read and understood the listed rights.

The review of two restraint reports showed the basis for EBI was not an emergency situation.

Four staff records reviewed were missing documentation of current CPR/First Aid certificate.

Two children did not received their dental exam within 90 days of admission.

Immunization record was missing from one of the children's records reviewed.

One staff record reviewed missing proof of education.

Three children records reviewed were missing TB screening results.

Two staff records reviewed were missing documentation of the results of any contact with an applicant's previous employers. Two other records did not include results of contact from all previous employers prior to application date.

Documentation of suicidal training that covers the risk factors, protective factors, and warning signs of suicide was missing in three staff records reviewed.

One staff record reviewed is missing documentation of supervised experience training.

All eleven interviewed children reported that they were not familiar with the administrator's name since their placement. Five of seven direct care staff identified someone else as the administrator. Additionally, all staff reported that staff meetings have been conducted by shift supervisors or trainers. The administrator acknowledged that her school responsibilities may have limited her involvement in her role at the RTC.

A caregiver failed to adhere to the child's rights to be free of abuse, neglect, and exploitation as defined in Texas Family Code 261.401.A child was injured by a staff member after an accident.

A staff member did not use prudent judgement and self-control while trying to de-escalate a child having maladaptive behaviors which led to the child being injured.

One of the two first aid kits did not contain tweezers.

The last weather drill was not completed within the last six months.

When conducting a walk through in the girl's unit, it was observed that one of the hand washing sinks did not have sufficient hot water pressure.

While reviewing employee files, it was observed that 1 out of the 6 files reviewed did not conduct reference checks.

While conducting a walkthrough of the girls unit, it was observed that the cleaning supplies were accessible and not locked back.

While reviewing staff files, 4 out of 6 staff files did not contain job descriptions.

Operation did not report a child's allegation of abuse by a staff member until four days after the allegations were made.

There was a delay in the child receiving medical care.

During the walkthrough it was observed in room #4 a dresser drawer and a window blind were damaged. In Room#2 the window blind was damaged. Work orders were submitted on 3/16/2023 during the inspection.

The parent orientation does not have any information on the frequency of notifications that will be made to parents.

A staff member witnessed a serious incident and did not immediately report it.

A staff member recognized another staff members actions were inappropriate and still failed to intervene.

A staff member removed items from a child's bedroom as punishment.

Operation employees failed to adhere to the child's rights to be free of abuse, neglect, and exploitation as defined in TFC ?261.001 and further defined in TAC Rule ?707.801, which resulted in an immediate danger to a child's physical health and safety.

A staff member failed to accurately depict the incident when completing the incident report. The staff member did not detail the role they played in the incident or the harm they caused to the child. The staff member falsified records by omitting dragging the child and portraying the child as the aggressor.

A staff member pulled a child by their hair.

A staff member failed to utilize proper de-escalation techniques when they realized a child was having a crisis and instead of professionally assisting the child, exhibited physical aggression to the child in care.

A staff member grabbed a child by the arm and dragged them off a couch and down a hallway. Then the staff member pushed the child into a bedroom.

Medication log does not have what time the residence medication is being given.

Staff member only has 1 hour of the T.I.C training when the requirement is 2 hourss.

Operation failed to assure staff Background checks are being verified every 3 months.

During the walkthrough two bottle of cleaning supply where left in unlocked cabinets.

There are 4 staff members currently working in the homes that do not have background checks.

During the walkthrough I observed toilets in 58C to not be cleaned properly, and the refrigerator door to be dirty. In house 58B I observed a cloth mattress to be without a mattress cover and exposed wire trimming.

One staff file lacks an valid drivers license/

The operations policy advises that the facility administers drug test quarterly but multiple staff have not had drug test in a number of years.

The facility is permitted to take children 3-17 years old but has excepted a resident who is 18 years old upon being admitted.