Pathways Youth & Family Services,Inc. dba Habilitative Homes

Multiple expired medication products were stored with current medications.

Two medication logs reviewed did not have accurate counts.

Parents of children in care were not notified of recent deficiency related to abuse/neglect.

The video footage shows a caregiver held a child in care in a supine position with the child in care's arms folded across their chest while the caregiver balanced on their own knee above the child in care. A collateral contact familiar with restraint training indicated this does not appear to be approved. The video also shows the caregiver use their legs to move the child in care's body across the floor similar to a shoveling motion.

The video footage and care giver interviews indicate the staff initiated hands on physical intervention with a child in care, who in that moment wasn't displaying physically aggressive or high risk behaviors and was only refusing directives to stay in their room and there was a concern for other children in care's safety based on the child in care's previous behaviors.

The video footage reveals a care giver offering little other instructions to a child in care in a restraint other than repeating "Are you done?" repeatedly during the restraint.

3 out of 4 training records reviewed showed current staff had expired Trauma Informed Care training while still in ratio.

5 out of 11 records reviewed did not include time of medication for when the children missed a scheduled dose.

3 out of 4 training records reviewed showed staff had expired training for dispensing psychotropic medication.

2 out of 11 medication logs show a child in care did not discontinue their previous medication dosage soon after their doctor appointment which indicated a dosage change, but instead took anywhere from 3 to 11 days to comply with new dosage orders.

Licensing observed and phiotographed a wall niche fire extinguisher housing with a broken plastic door and a protruding plastic shard. The operation removed the damaged plastic screen to the secured staff room during inspection.

Multiple documents were not accessible by adminsitrator during visit.

Multiple food items were not stored securely.

Multiple bathrooms used by children in care had broken toilet paper holders.

Two windows being used for ventilation were found without screens.

Three medication logs were not updated with medication administered in required timeframe.

The operation failed to make a report within the required timeframe after 3 staff tested positive for COVID-19.

It was found an employee did not have up-to-date EBI training.

Staff fell asleep during overnight shift.

Staff did not report serious incident.

Children in care were left unsupervised for approximately 5 minutes and when found had no clothing and about to engage in sexual act.