Pathways Youth & Family Services, Inc. dba Habilitative Homes

Risk level: Medium High : 748.535(2) - AP Child-care administrator responsibilities- Ensure the operation complies with current heightened monitoring plans, if applicable.

During a review conducted on 4/09/2026 it was determined that: -the Administrator failed to ensure compliance with the current HM Plan; and -12 months had elapsed since the effective date of the plan. The heightened monitoring plan for this operation included a specific “planned end date” at the 12-month mark by which the 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 the heightened monitoring plan, this operation is now unable to successfully move to post-plan monitoring. Furthermore, the operation’s “planned end date” must now be revised, and the period of heightened monitoring must be extended. Further details of the administrator’s failure 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.

Risk level: Medium : 748.3395(b)(4) - Hand-washing-Provide hand-washing sinks equipped with soap & a personal towel, single-use disposable towels, or hot air hand dryers

During the walkthrough, observations revealed there was no hand soap available at any of the sinks in the children's rooms.

Risk level: Medium High : 748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model

Two of the childrens records reviewed had pill count incorrect.

Risk level: Medium High : 748.2151(b)(1) - Medication record - update cumulative record within 2 hours of administering medication

One of the medication records for a child was not filled out and medication had been administered.

Risk level: High : 748.2551(c)(2) - EBI Implementation-Caregiver must use the minimal amount of reasonable and necessary physical force

Staff used excessive force when preforming an emergency behavior intervention. Staff held child with knee on child's chest during restraint.

Risk level: High : 748.1101(b)(4)(A) - Children's rights-The right to be free from any harsh, cruel, unusual, unnecessary, demeaning, or humiliating treatment or punishment.

In video footage staff members are taunting child in care as a way to get the child to comply.

Risk level: High : 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation

This standard was found deficient as part of a DFPS Investigation.

Risk level: High : 748.2307(6) - Other Prohibited Punishments-pinching, pulling hair, biting, or shaking a child

Through interviews it was confirmed a staff dragged a child in care by the hair to the bathroom to sprayed child off in shower as a form of punishment.

Risk level: Medium High : 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed

Staff did not try to deescalate the situation prior to implementing the emergency behavior intervention. The staff member was contradiction to trained de-escalation techniques.

Risk level: High : 748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety

Staff did not intervene when a child was repeatedly hitting head against wall.

Risk level: High : 748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work.

A child in care was physically disciplined.

Risk level: Medium High : 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks

During an incident a staff member pulled a child by their arms, as a form of redirection.

Risk level: Medium High : 748.2151(d) - Medication Record-must include accurate daily count of each prescribed medication, unless operate on a cottage home model

Two medication logs reviewed did not have accurate counts.

Risk level: Medium High : 748.317(a)(2) - Serious incidents-Notify parents of each child admitted any time the operation is deficient for standards related to abuse/neglect or exploitation.

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

Risk level: Medium High : 748.2101(7) - Medication storage & destruction-remove medication on/before the expiration date & destroy it in a way that ensures children do not have access

Multiple expired medication products were stored with current medications.

Risk level: Medium High : 748.2551(a) - EBI Implementation-Must be an appropriate response to the behavior demonstrated, and de-escalation must have failed

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.

Risk level: Medium High : 748.2551(e)(1) - EBI Implementation-As soon as possible, caregiver must explain to child the behaviors required for release or to have EBI reduced, as applicable

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.

Risk level: Medium High : 748.2551(b)(2) - EBI Implementation-The caregiver must consider the permitted types of emergency behavior intervention

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.

Risk level: Medium High : 748.930(b)(5) - Annual Training- Caregivers must have psychotropic medication training if the caregiver administers psychotropic medication.

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

Risk level: Medium High : 748.930(b)(2) - Annual Training- Caregivers must have 2 hrs trauma informed care.

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

Risk level: Medium High : 748.2003(b)(3) - AP Administration of prescription medication-Administer medications according to instructions or a prescribing health-care professional's orders

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.

Risk level: Medium High : 748.2203(c)(1) - Medication Error-Document the time & date of the error

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

Risk level: Medium High : 748.1531(d) - Medical care-Obtain follow-up medical treatment as recommended by the health-care professional

During the course of the investigation, it was determined the operation did not make and complete follow up medical appointments for children in care, as referred by medical professionals.

Risk level: Medium : 748.3301(a)(2) - Physical Site- Buildings must be clean and in good repair.

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.

Risk level: Medium : 748.399(a) - Records Available for Licensing-all active records immediately available for review and reproduction

Multiple documents were not accessible by adminsitrator during visit.