Nexus Neurorecovery Center - San Antonio

Residential Child Care Regulation observed the operation's emergency evacuation posters to be without documentation of a designated outside meeting point.

Two child files were reviewed. The orientation information provided to the children within seven days of admission did not include all information regarding operation policies.

2 of the 3 plans reviewed did not specify who was included or present in developing the service plans

Residential Child Care Regulation observed a care giver's training record to be without 40 hours of on-the-job training. The explanation note read that the care giver had this at a previous operation.

2 of the 3 plans reviewed did not have confirmation that required parties were notified of the date the service plans would be completed and did not give those parties an opportunity to respond

Two child files were reviewed, there were multiple items that were missing within each child's admission assessment.

Two child files were reviewed. The children's files did not include all necessary information within the file at the time of admission.

Two of two child placement agreements were reviewed, and neither were signed by the child's parent/managing conservator.

2 of the 3 service plans reviewed were unclear as to who received a copy of the plan

Child in care on 1:1 supervision swallowed a foreign object which required medical treatment such as x-rays as this could result in an unhealthy condition of the body and mind.

A child in care cheeked medication and took more than the prescribed amount.

An employee file did not have documented the number of attempts made to contact the employees' former employers or the employers refusal to provide information. In the result area of contact it stated "NA"

An employee file had reference checks; however, it was not documented if the references were professional or personal.

Two serious incident reports did not have the operation's phone number.

Operation utilized a drive sharing service to transport a child who was accompanied by staff from the hospital back to the operation.

During the inspection, record review of serious incident report reflected it did not contain all the required sections of a serious incident report to include: physical address, telephone number, names of adults involved and/or their role to child, witness information, interventions made during and after incident.

During an inspection at the operation, it was found an employee did not have a completed initial background check.

During an inspection, record review for 1 of 5 staff files reflected only one reference was contacted instead of two.

During an inspection, 1 of 5 staff files reflected the notarized affidavit was provided and signed but was not completed in the exception area.

During walk through of operation it was observed that fire extinguishers had not been inspected for the month of October 2023. Operation staff admitted no monthly check was completed on during the month of October 2023.