Rob & Simon's Hawthorne House

During a review of a child's file there was not a Consent for Treatment with Psychotropic Medication in the file for Strattera which the child began taking on 9.15.24 after the doctor was contacted on 9.12.24 and the change was made to discontinue Intuniv and start Strattera.

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.

It was determined that the operation did not follow the Attachment A that included a safety plan pertaining to a child not being able to share a room with certain residents.

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.

CCR arrived at the operation in December, after the incident occurred, and the operation did not have a written incident report to provide to CCR.

Based on the review of the investigation it was determined one staff member was left with a group of 10 children due to a second staff member leaving to assist another staff member with a restraint.

Based on the review of the investigation it was determined that a restraint was conducted and witnesses other than direct care staff were present.

During a Heightened Monitoring visit the administrator stated that 3 children were positive for COVID however this was not reported.

Medication was signed and documented as given prior to the child receiving the medication making the count inaccurate.

Child in care did not receive prescribed medication for 3 days due to running out of refills.

It was observed during the backyard walk through that the operation had one loose brown wood post in the yard, and four new light brown playground box post next to the metal shed.

Two children in care reported a staff bent a child's fingers backwards as a form of punishment.

2 of 4 contraindication forms were missing from the binders.

Parent orientation information is missing from 2 of 4 children's files reviewed.

Two of 4 forms were missing their orientation checklist outside of the allotted timeframe.

It was observed during the walk through that the operation had food being thawed in the kitchen sink.

Children interviewed by A/N Investigator reported restraints with their limbs placed behind their back.

A serious incident report reviewed did not contain information of a short personal restraint that had been implemented. That incident report was signed by a staff member that had acknowledged the restraint had taken place.

Staff violated a child in care from their right to be free of abuse, neglect and exploitation. Staff physically endangered a child in care.

A caregiver placed his hands around a child's neck impeding the child's breathing. Also, it was not determined that the situation constituted an emergency, the caregiver failed to minimized the risk of physical discomfort, harm/pain during the restraint, and failed to use the minimal amount of reasonable and necessary physical force. It was also determined that the EBI was used as retaliation for the child throwing a brick at the staff member.

Serious incident documentation did not indicate that a restraint occurred, or include that the injury was a result of a short personal restraint.

Staff members failed to report suspected abuse and neglect or exploration of a child in care after observing lumps on the child's head.

Staff used an EBI as a means to get a child to comply.

According to the investigation, two staff were witnessed inappropriately grabbing children in the neck area of the shirts and using as a lever/device to control the children.