Adiee, LLC

A child's file reviewed did not have an admission assessment for the child's re-admission; the child was previously admitted to the operation in Aug. 2024 and re-admitted on Jan. 4, 2025.

A video recording was provided of a staff member using inappropriate language towards a child in care.

A video recording indicates that a staff member provoked a child by using verbal commands and hand gestures in a manner that challenged the child to fight.

The two service plans obtained for the investigation were not signed by the youth nor was their refusal to sign documented.

The childs medication reviewed did not indicate the accurate count of the remaining pills.

A video recording indicated a staff member cursing at a child in care.

A video recording indicated a staff member yelling at a child in care.

Incident report received regarding AWOL was missing departure and return times.

AWOL log provided was for 1 child. Missing age, gender, and date of admission.

Discharge plan provided is missing several details including circumstances of discharge.

A service plan for a child in care identified as receiving treatment services did not contain two professionals on the service planning team.

During a review conducted on March 31, 2025, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation is now unable to successfully move to post-plan monitoring. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans.

The operation did not report two children in care's unauthorized absences to their CVS workers within the required time frame by minimum standards.

During the investigation, it was learned that the operation failed to notify the conservator of the child timely. Notification was not made about the incident until the following day.

There was no documentation indicating that a debriefing took place with all of the required components according to the minimum standards.

The operation reports they were unaware staff was required to complete an annual suicide prevention training.

During a review conducted on September 30, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation is now unable to successfully move to post-plan monitoring. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans.

During a review of incident reports and runaway incident reports, on multiple records the documentation was incomplete.

The operation failed to employ a licensed administrator within the 120-day allotted timeframe.

The operation failed to employ a licensed administrator within the 90-day allotted timeframe.

The operation was not able the triggered reviews and stated they are not required to complete triggered reviews.

The operation failed to employ a licensed administrator within the 60-day allotted timeframe.

There was an indication that containment was required in the serious incident report, but the operation did not complete a restraint report.

The caregiver did not have any type of discussion after the incident with the child.

The operation failed to report the serious incident after the children AWOL

Operation staff confirmed that they do not debrief the children following serious incidents.

The operation staff confirmed they do not conduct triggered reviews following 3 unauthorized absences within a 60-day timeframe.

During the inspection, it was found that there is no incident report regarding the unauthorized absence that took place on March 14, 2024

During the inspection, it was observed that the AWOL annual summary log did not display the proper information.

During a review conducted on March 26, 2024, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation is now unable to successfully move to post-plan monitoring. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended again. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Operation was unable to meet compliance with Medium-High or High weighted licensing citations, including having an open investigation(s). Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans.

The medication logs for two children could not be provided.

During the review of the incident report, it was noted that there was no report for March 12, 2024.

During the review of the summary log it was noted that the incident that occurred on 03/14/24 involving a child jumping from the second floor window and leaving unbeknownst staff was not recorded on the log.

During the course of the inspection, it was determined that the adminstrator does not maintain full time hours.

During a Heightened Monitoring Inspection, it was found that an incident of three children running away from the operation was not reported to licensing until 9 hours after the incident occured.

The victim child and several children who witnessed the restraint indicated that the staff used more physical force than required while conducting the restraint.

Medication logs reviewed did not have an accurate count, in addition the medication that was administered last night was not fully documented as the staff did not sign the log for the 7pm dose on 10/24/23 as required per the minimum standards.

There is no medication error protocol or documentation regarding children who have missed a dose of medication.

Children in care are running out of medication and miss doses of medication until the operation is able to get a refill.

During a review conducted on September 25, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) 12 months had elapsed since the effective date of the plan. As you know, the heightened monitoring plans for your operation included a specific ?planned end date? at the 12-month mark by which your operation was expected to meet all heightened monitoring criteria necessary to move out of active heightened monitoring to a phase of ?post plan monitoring?. As a direct result of the administrator?s failure to ensure timely compliance with heightened monitoring plans, your operation is now unable to successfully move to post-plan monitoring. Furthermore, your operation?s ?planned end date? must now be revised, and the period of heightened monitoring must be extended. Further details of the failure of your operation?s administrator to ensure compliance include the following: - Your operation received a Medium-High weighted citation in a pattern/trend category on March 31, 2023. Specifically, the operation was cited for 748.3353(c)- Monitoring Devices. The operation met compliance April 13, 2023. - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring; and - Operation was unable to meet compliance with Medium-High or High weighted licensing citations. Finding: 748.535(2) ? The licensed administrator must ensure the operation complies with current heightened monitoring plans.

During the investigation, multiple children were not allowed to back inside the facility following a short period of unauthorized absence.

During the investigation it was found that a child's (with a history of unauthorized absences) preliminary service plan failed to address their supervision needs.

During the investigation it was found that a caregiver failed to exercise prudent judgement in the presence of children when the caregiver failed to actively search for children in the vicinity from which they had gone missing and when the caregiver transported children in the trunk of a vehicle.

During the investigation it was found that six children and one caregiver went on an outing in a vehicle that had five seatbealts.

A caregiver neglectfully supervised multiple children in care when she transported them in the trunk of a vehicle.

The operation failed to follow their own policy when they transported children without the use of seatbelts and when they failed to report several children's unauthorized absences from the facility within the timeframes required by their policy.

A child in care was able to access the operation's camera system to review the previous altercation he had with another resident. This caused him to re-escalate and try to fight a second time.

It was observed that the needle of the fire extinguisher on the second floor of the facility was not in the green zone.

Discharge summary was not completed for child who was discharged on 06/26/2022.

It was observed before todays HM inspection that the facility did not have Passed fire inspection. However, the facility was able to provide me with a copy of a recent Fire Inspection which is marked as Pass by Rosenberg Fire Department during my Inspection today.

During audit of medication sheet today, it was observed that a child on medication has not been able to take his sertraline HCL 50mg medication since 11-2-22 and also has not taking his Sertraline HCL 100mg medication since 11-6-22 because the child is out of medication. Sertraline HCL 100 mg was taken last on 11-5-22 and Sertraline HCL 50mg was taken last on 11-1-22. However, the facility was able to get a refill of the medications from the pharmacy during my inspection.

There was no discharge summary in the inactive child file.

The operation did not have an annual summary log available for review and reproduction upon request.

A child in care did not take his medication as prescribed for his morning dose of medication.

The operation did not have an annual summary log.

One staff member who supervises children in care did not have an active background check with the operation.

One of the two employee records evaluated did not have first-aid / cpr documentation

Both of the employee records evaluated did not contain training regarding the fire extinguishers nor first aid equipment.

Both of the staff records evaluated did not have a document showing the results of their TB screening in their records.

Both employee records evaluated did not address the characteristics of children in the orientation.

Both of the staff records evaluated were missing the second half of psychotropic medication training that must be instructor led.

One of the children records evaluated had an inaccurate count.

Both of the staff records evaluated were missing the emergency procedures in the pre-service curriculum.

All of the staff records evaluated were missing communicable diseases training.

Both of the staff records evaluated did not address the topics appropriate to the needs of the children in care in their pre-service curriculum.

One child in care has been at the operation for longer than 90 days.

There was no restraint documentation provided.

The operation failed to provide Initial service plan documents for two children previously in their care.

The operation failed to provide a written serious incident report.

The operation did not report that a resident was arrested.

Two fire extinguishers were observed to be expired as of February '22 and one lacked an inspection tag.

A child in care was not provided two different medications for multiple days.

The medical exam for a child in care was conducted -- days after admission.

The initial service plan required for a child in care was not completed within the 45 days.

Two child files reviewed did not contain a preliminary service plan in their file. One child file reviewed did not have an initial service plan in their file.

One staff file reviewed did not contain a signed statement stating he will immediately report suspected child abuse, neglect, or exploitation. One staff file reviewed did not have a job description.

One child's service plan reviewed contained inaccurate information in several areas.

A child's movements were restricted after refusing to go to bed.

Two children in care restrained two other children in care.

A staff was downstairs of the facility while all of the children were upstairs awake and a fight ensued.

A child's movements were restricted by a staff holding him across the chest from behind, and then staff using their hands to hold him against the wall.

Children and staff witnessed a staff use their body weight to restrict a child's movements.

One out of four youth files reviewed did not contain an acknowledgement signed by the youth of their rights.

one out of the four children records reviewed did not contain their admission assessments.

The first aid kits observed did not contain scissors.

All the children records had orientation documents that did not address the education program.

One out of two serious incident reports reviewed did not indicate which staff were involved in the incident.

Two children in care have been in placement past their maximum 90 day mark and without the proper extension paperwork.

None of the first aid kits observed contained a thermometer.

None of the first aid kits observed contained cotton balls.

One out of four youth files reviewed did not contain documentation to indicate the youth had received an orientation.

All the children records reviewed did not contain a preliminary service plan.

Three out of four youth files reviewed did not contain paperwork explaining the youth's reason for placement extension.

All of the children records reviewed had orientation documents that did not address trips away from the operation.

three children's medication logs were observed with count errors.

The operation hired a new administrator and failed to notify licensing. They have had a new administrator since 07/06/2021.

During the inspection food was observed on the counter uncovered waiting to be eaten by children. Flies were also present in the kitchen.

During the walk through there were 6 mattresses that did not have protectors on them. Pictures were taken.

Five children's medication logs were observed with count errors.

Records were not provided timely.

The incident occurred on February 17, 2021 but was not reported until 2/23/2021.