A New Day Foundation

The administrator reported becoming aware of the child's absence around 4pm of 05/19/23; the report was made to SWI at 1:24am on 05/20/23.

During a review conducted on March 31, 2023, it was determined that: (1) your operation?s administrator failed to ensure compliance with the current HM Plan(s); and (2) more than 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 original 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 was unable to successfully move to post-plan monitoring by the original ?planned end date? necessitating previous extension. Furthermore, due to your recent citation issued on September 22, 2022, your operation?s ?planned end date? must now be revised again, and the period of heightened monitoring must be extended again. Further details of the administrator?s failure to ensure compliance include the following: Your operation received a high-weighted citation in a pattern/trend category on September 22, 2022. Specifically, the operation was cited for 748.685(a)(5) Caregiver responsibility - being able to intervene when necessary to ensure child's safety. The operation met compliance on October 7, 2022. - Operation failed to demonstrate 6 months of successive compliance with the standard and contract requirements that led to heightened monitoring. - 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 a review conducted on September 30, 2022, 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. Further details of the administrator?s failure to ensure compliance include the following: Your operation received a High-weighted citation in a pattern/trend category on September 22, 2022. Specifically, the operation was cited for 748.685(a)(5) Caregiver responsibility - being able to intervene when necessary to ensure child's safety. The operation has not met compliance. - 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.

Several medication records did not align with the medication count.

Staff was not able to intervene fast enough due to the fact she was driving when the altercation started and the children in care where able to punch one another in the face.

One child file reviewed was found that the medical annual check up was due in May 2022 however it was completed today July 11, 2022.

Upon viewing child's file, there was no documentation of TB test for child.

It was observed in the child's file reviewed, that the admission assessment was completed a day after the child was placed at operation.

The operation did not have an annual summary log to review.

The operation did not report to licensing when a child ran away for three hours.

Upon viewing staff file, 4 hours of EBI was missing.

Two of two discharged children's file reviewed does not contain the required discharge documentation such as the discussion with the child about being discharged or the medication the child was prescribed.

The fire inspection has not been completed within the required timeframe.

Several serious incident reports reviewed in two children's files did not include the date or start time the incidents occurred. The serious incident report documentation doesn't include the operation's contact information. The incident reports do not include surrounding circumstances of the incident that occurred.

Two of four child files reviewed did not include the required orientation documentation such as policies on mail or gifts.

Two of four child files reviewed does not contain the managing conservator's contact information.

The medication log was observed on a shelf in the common area.

Three of three staff files reviewed did not contain an evaluation or assessment tool.

A caregiver at the operation has engaged in inappropriate behavior by pinching, punching, and pushing children in care. The same caregiver has intervened in behavioral intervention when it was not necessary as the situation was already being handled by another caregiver.

It's confirmed that a physical restraint took place; the operation was unable to produce the necessary documentation following the intervention.

Three of thirteen children medication inventory proved to be inaccurate. The pill count did not match the documented pills remaining.

One child medication log recorded the incorrect dosage compared to the actual prescription. The employee list has the incorrect name of an employee compared to the background check system and employee file.

One of four child files did not contain a child rights document.

The child's Intial Service Plan did not have all signatures required.

An employee of the operation has demonstrated an unstable mental capacity by making concerning comments to others.

Operation was out of ratio at art time transitioning into lunch. it was one staff with 6 children. The operation devided the children to meet ratio requirements.

I reviewed one staff file and the job discription was not signed and dated.

The medication in a child's medication log was not properly documented. Ms. Fields corrected the med log during the inspection.

One medication log was found to be signed and dated for the following day.

It was observed that one caregiver was supervising 8 children for at least 10 minutes. Staff returned to their assigned area, operation was back in ratio.

One child's file reviewed only had one licensed professional signature.

Two children in care were left unattended for a short period of time. Upon the caregivers return to the presence of the children; they were observed in a compromising position.

There were several incident reports documenting what caregivers observed upon entering any particular area. Repetitively the same child in care was either making inappropriate comments or interacting inappropriately with peers.

A serious incident took place during the time the operation's caregiver was responsible for a total of four children. At least one of the children the caregiver was responsible for; was required 1:1 supervision.

The operation failed to provide the necessary supervision to prevent inappropriate child on child interaction. One of the two children required heighten supervision.