The most serious findings in the state inspection reports we hold: deaths, sexual and physical abuse, restraints that injured a child, suicide attempts, medical neglect and hospitalisations. Every quote below is the licensing agency's own wording, and each one was read against its report by a person before it was listed here.
A caregiver was slapping and threatening to slap children in care.
From the state's report. Risk level: High. Cited: 748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work..
On June 30, 2021, Community Care Licensing (CCL) received an allegation alleging staff member (Staff #1) physically assaulted resident (Child #1). [...] Based on record review and confidential interviews the allegation staff member (Staff #1) physically assaulted resident (Child #1) is substantiated.
From the state's report. Substantiated. Cited: 87072(d). "[...]" marks text left out between sentences. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
In plain words: The state investigated an allegation that a staff member had an inappropriate relationship with a child in the program. The state substantiated the claim, finding it valid based on the evidence. Our summary of the state's report. The state's own wording follows.
As a result of the interviews conducted, documentation reviewed and investigation conducted, the allegation that staff had an inappropriate relationship with client in care and staff engaged in conduct that is inimical to the health, morals, welfare, or safety of clients in the facility are SUBSTANTIATED at this time meaning that the allegation is valid because the preponderance of the evidence standard has been met.
From the state's report. Substantiated (one of several allegations). Cited: 84072(d).
As [Staff 1] stood by the door, other clients pushed [Staff 1] aside and began to physically assault [Child 1]. [...] [Staff 2] admitted not giving any verbal redirection to clients to de-escalate the incident because [Staff 2] "was in shock." The incident resulted a law enforcement response to the facility. [Child 2] was observed by law enforcement with seven punctures to the right hand, seven punctures to the right wrist, a scratch to the right forearm and a scratch to the right collarbone area. [...] Law enforcement recovered a hair pick on facility property which was identified as the weapon used to stab [Child 2]. [...] [Child 1] was detained at the conclusion of law enforcement's response.
From the state's report. Substantiated. Cited: 80078(a). "[...]" marks text left out between sentences. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
A staff member used unwarranted and excessive force on two children in care on two separate occasions.
From the state's report. Risk level: High. Cited: 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation.
The letter from DSS notes a Level 1 finding for the allegation of sexual abuse due to the following: Individual 1 remained fairly consistent with the disclosure made to Employee 3 and the Albemarle County Police Department detective regarding the sexual activity between Individual 1 and Employee 1. [...] Employee 4 reported rumors regarding Employee 1's sexual relationship with people at STARS previous to Individual 1's disclosure. [...] There is a preponderance of evidence to show Employee 1 sexually abused Individual 1. [...] Individual 1 had previously told Employee 2 about Individual 1's sexual relationship with Employee 1. [...] Employee 3 reported Individual 1 had told Employee 3 that Individual 1 had previously told Employee 2 about the sexual relationship with Employee 1.
From the state's report. Non-compliance, DBHDS human rights inspection. Cited: 12VAC35-115-50. B. (2) In receiving all services, each individual has the right to: 2. Be protected from harm including abuse, neglect, and exploitation.. "[...]" marks text left out between sentences.
A caregiver slapped a child in care in the face.
From the state's report. Risk level: High. Cited: 748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work..
The two staff pushed Youth A into his bedroom.
From the state's report. Repeat violation established, special investigation. Cited: R 400.159 Resident restraint.
Client #1 revealed: "Friday (10/8/21) at around dinner time ...staff (Staff #2) pushed me into the corner of the room under a shelf near window (back right corner) ...I attempted to go in another direction ...staff ...bent wrist in the process to stop client assault. [...] Was working light duty after sustaining an injury in a restraint;
From the state's report. Deficiency cited, annual, complaint, and follow-up survey, Type A1 violation. Cited: V 512. "[...]" marks text left out between sentences.
[Child 1] approached a Staff member, "bumped chests and began yelling and swearing." Staff admitted to pushing [Child 1] away from him when [Child 1] approached. [...] Based on observation, record review, and interviews, the allegation Staff pushed client in care is SUBSTANTIATED. [...] The Staff member who pushed the client received disciplinary action and will complete additional training.
From the state's report. Substantiated. Cited: 87072(d)(11). "[...]" marks text left out between sentences. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
In plain words: A staff member sexually abused a client multiple times during one‑on‑one walks on facility grounds, and the state gave the facility a report and civil‑penalty forms. Our summary of the state's report. The state's own wording follows.
LPA Yamamoto met with the facility representative named above and discussed the following: On 3/4/21, the Department received a complaint that staff sexually abused client in care and engaged in conduct inimical to clients in care. Confidential statements obtained during the investigation revealed that the sexual abuse occurred multiple times on facility grounds when client and staff went for one on one walks. [...] Per Health and Safety Code section 1548(2), "physical abuse" includes sexual abuse as defined by Penal Code section 11165.1 which includes Section 288a oral copulation. [...] A copy of this signed report, Confidential Names Form (LIC 811), Appeal Rights and Form LIC 421-D (CRP) Civil Penalty Assessment - Death / Serious Bodily Injury / Physical Abuse were provided to the facility representative.
From the state's report. Deficiency cited at inspection. "[...]" marks text left out between sentences.
On multiple occasions at the operation, a staff member sexually abused a child resident who was left in this staff member's care.
From the state's report. Risk level: High. Cited: 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation. The state recorded it as corrected at the inspection.
An IR (Incident Report) Narrative dated 10/24/21 documented, "...Time: 03:30 [3:30] PM; Patient Status: Personal Restraint; Intervention Description or Observation Narrative: While staff was performing a restraint pt [patient] began scratching a staff member and head-butting them.
From the state's report. Deficiency cited, complaint survey with poc. Cited: N 132 PROTECTION OF RESIDENTS N 132.
The allegation that staff sexually abused a foster child is related to a disclosure made on 6/30/21, by [Child 1] (see LIC811 dated DATE) that [Child 1] had engaged in sexual intercourse with [Staff 1] in the staff room at the facility. [...] As a result of the investigation and interviews conducted, the allegations that staff sexually abused a foster child and that staff gave a foster child non-prescribed medication for illicit use are SUBSTANTIATED at this time meaning that the allegation is valid because the preponderance of the evidence standard has been met. [...] The facility has a responsibility to accord personal rights to all children in care including the right to be free of physical, sexual, emotional, or other abuse... investigation showed that [Staff 1] sexually abuse [Child 1] in the facility.
From the state's report. Substantiated. Cited: 87072(d)(11). "[...]" marks text left out between sentences. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
Staff 3’s was substantiated for child physical abuse.
From the state's report. Repeat violation established, special investigation. Cited: R 400.4112 Criminal history check, subject to requirements; staff.
Based on record review and interviews [Staff 1] did pushed [Child 1]. The preponderance of evidence standard has been met, therefore the allegation [Staff 1] pushed [Child 1] is found to be Substantiated.
From the state's report. Substantiated (one of several allegations). Cited: 87072(d)(11). The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
However Supervisor 2 did fail to provide for the safety of Youth A when he was informed on 10/2/21 that Youth A reported being raped and failed to follow up, notify upper management or contact law enforcement.
From the state's report. Repeat violation established, special investigation. Cited: R 400.4112 Criminal history check, subject to requirements; staff.
LPA Yamamoto met with the facility representative named above and discussed the following: On 1/25/21, the Department received an incident report that on 1/23/21, a client in placement was found unresponsive at the facility after staff exited a bathroom. Staff called 911 and first responders arrived. Client was taken by paramedics to the hospital where client later died. On the same day, the Department received a complaint alleging neglect/lack of supervision resulting in a client's death. [...] A copy of this signed report, Confidential Names Form (LIC 811), Form LIC 421-D (CRP) Civil Penalty Assessment - Death / Serious Bodily Injury / Physical Abuse and Appeal Rights were provided to the facility representative.
From the state's report. Deficiency cited at inspection. "[...]" marks text left out between sentences.
It was alleged that staff handled youth in a rough manner. Based on confidential interviews, staff handled [Child 1] in a rough manner by grabbing [Child 1] which resulted in both staff and client falling onto the floor. Based on records reviewed, this was an improper restraint.
From the state's report. Substantiated. Cited: 87072(d)(11). The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
3/30/21 Inappropriate Sexual Behavior: [Former client 1] reported to staff that she had been forced to have oral sex with someone while at school.
From the state's report. Deficiency cited, complaint survey. Cited: V 367. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
On 10/5/21 at 12: PM, Licensing Program Analyst (LPA) Robin Sullivan went to the facility and met with Devin Johnson, Supervisor, to deliver findings for the allegations that staff inappropriately touched minor, staff made sexual advances towards minor, and facility did not notify licensing of an incident. [...] Based on the interviews conducted and incident reports reviewed the allegations that staff inappropriately touched minor, staff made sexual advances towards minor, and the facility did not notify licensing of an incident are SUBSTANTIATED.
From the state's report. Substantiated. "[...]" marks text left out between sentences.
On May 17, 2021, Community Care Licensing received a complaint alleging Staff Member #1 provided alcohol to minors and [Staff 1] exposed minor to CSEC (Commercial Sexually Exploited Children) activity.
From the state's report. Substantiated. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
The suspension was due to reviewing video footage of the incident and Administrators determining [Child 1] was pushed by [Staff 1].
From the state's report. Substantiated. Cited: 87072(d)(11). The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
Staff allowed client to reside with staff and engaged in continued sexual abuse of client, when client went AWOL.
From the state's report. Substantiated (one of several allegations). Cited: 87072(d)(11).
Video footage shows a caregiver uses an improper restraint when they twist the child's arm and place the arm behind the child's back.
From the state's report. Risk level: High. Cited: 748.2461(b)(6) - Short Personal Restraint-Caregiver may not use restraint that twists or places the child's limb(s) behind the child's back.
The Department received a complaint alleging that a client, who was left unsupervised, choked on food resulting in client's death. [...] Staff called 911 and was instructed to perform chest compressions by the 911 operator. [...] Client passed away at the hospital.
From the state's report. Substantiated. "[...]" marks text left out between sentences.
In plain words: The state investigated a complaint that a staff member failed to properly supervise a fifteen-year-old resident before the child died. The state determined the violation resulted in the resident's death and issued an immediate seven thousand dollar fine to the program. Our summary of the state's report. The state's own wording follows.
On July 23, 2021, the Department concluded a complaint investigation alleging that staff #1 (See the Confidential Names List, LIC 811, dated September 3, 2021) neglected to provide the supervision necessary to meet the needs of fifteen-year-old client #1, prior to [Child 1]'s death. [...] Pursuant to the Enhanced Civil Penalty law, the Health and Safety (H&S) code section 1548 (e)(3)(A) states a violation the Department determines "...resulted in the death of a person receiving care through a Short Term Residential Therapeutic Program," the Department will be issuing an immediate civil penalty of $7,000.00." An exit interview was completed and appeal rights discussed. Copies of this report, the Confidential Names List, Appeal Rights and a Civil Penalty Assessment - Serious Bodily Injury/Physical Abuse (Form 421-D) were provided to the executive director.
From the state's report. Deficiency cited at inspection. "[...]" marks text left out between sentences. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
The complaint allegation, lack of supervision resulting in minor being sexually abused by an adult while in care, is valid because the preponderance of the evidence standard has been met.
From the state's report. Substantiated. Cited: 87072(d)(11).
Caregiver spanked a child in care as result of toileting issues.
From the state's report. Risk level: High. Cited: 748.1101(b)(4)(A)(ii) - Children's rights-The right to be free from being subjected to or threatened with corporal punishment, including spanking or hitting.
Staff members use corporal punishment by punching a child and pushing another.
From the state's report. Risk level: High. Cited: 748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work..
On June 4, Community Care Licensing (CCL) received an allegation alleging Staff member (Staff #1) sexually abused group home child (Child #1). [...] Based on record review and confidential interviews the allegation Staff member (Staff #1) sexually abused group home child (Child #1) is substantiated.
From the state's report. Substantiated. Cited: 84072(d)(11). "[...]" marks text left out between sentences. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
A staff member was observed on video to swing and hit a child in care multiple times, wrestled with the child and placed the child in an improper restraint where the child appeared to be knocked to the ground and have the staff member's arm across their neck.
Several nurses were observed on video to not intervene when a child was placed in a supine hold and when another caregiver was hitting a child.
From the state's report. Risk level: High. Cited: 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation; 748.685(a)(5) - Caregiver responsibility - being able to intervene when necessary to ensure child's safety.
In plain words: A staff member placed a client in physical, chemical and seclusion restraints after the client became verbally and physically aggressive, kicked doors, tried to leave the building and self‑harmed. The client was injured, receiving bruises, and the incident was recorded in multiple reports. Our summary of the state's report. The state's own wording follows.
restraint/seclusion, not in terms of Based on interview and record review, the facility practicing techniques, but with regard to failed to ensure no injury occurred during a which techniques are approved, when to physical restraint for 3 (Clients #5, #7, and #9) of use restraint/seclusion or not use it 12 (Clients #1-#12) sampled clients who had and the emphasis on avoiding injuries to documented use of restraints and or seclusion. clients and staff and avoiding restraint The findings are: whenever possible. [...] Staff was able to keep client and peer from making it out of the building but client became very physically aggressive with staff, punching them, pushing them, being verbally aggressive. [...] At 1:19:23, the client kicked door and walked down the hallway with four staff following him, pacing with his head down, kicking doors.
Staff pushed, then grabbed the client and drug to the door, then placed Client #7 in a hold at the door. [...] Client and peer used laundry basket to break light covers and used pieces to self-harm with ...1. [...] Client then started kicking doors open in an attempt to elope ...1.
Client then was trying to elope by kicking doors around the unit. [...] Client threw staff phone on the floor and while staff attempted a restraint client hit and grabbed at staff until being place in a restraint." 2.) An Incident Report Packet dated 4/11/21 by BI #4 documented, "...client became verbally aggressive with staff. [...] Once client entered room she began to self-harm.
This will be effective as that caused the injuries and developed and of 9-12-21. implemented a plan to prevent further potential injuries for 1 (Client and #9) 3 (Clients #5, #7 and #9) sampled clients who received an injury during a personal restraint. [...] At 1:19:23, the client kicked a door and walked down the hallway with four staff following him, pacing with his head down, kicking doors. [...] On 8/13/21, at 9:05 a.m., Registered Nurse (RN) #2 was asked, "How did [Client #9] get injured during a restraint on 7/27?" She stated, "He's a very aggressive, big child. He was attacking staff, and staff had to put him in a restraint, and he was taken to the floor and he got bruising.
A Seclusion and Restraint Form dated 4/12/21, documented, "Date and Time Initiated; 4/12/2021 7:21 AM; Date and Time Ended: 4/12/21 8:20 AM...Behavior demonstrated to justify use of procedure: Physically and verbally aggressive with staff, kicking doors, attempting to elope, property damage...Beginning Time: 7:23 AM; Procedure: Seclusion...Client Behavior: Combative, Cursing...Beginning Time : 7:32 AM; Procedure: Chemical Restraint; Location: Seclusion Room;...Client Behavior: Cursing..." A Report To Quality Assurance dated 4/12/21 documented, "...he began kicking doors and being non-compliant, client was asked by staff to stop but he continued until he kicked and broke one of the doors, the nurse was notified and from there client was placed in seclusion and given a chemical..." A Behavioral Intervention Observation Log dated 4/12/21 documented, "...Time 7:23 am; Procedure: 3 (Seclusion); ...Client Behavior: 2 (Calm)...Time: 7:32 am; Procedure: 4 (Chemical);...Client Behavior: 2...Time: 7:33 am; Procedure: 4...Client Behavior: 2...Time: 7:48; Procedure: 3 (Seclusion)...Client Behavior: 2...Time 8:03 am; Procedure: 3...Client Behavior: 2...8:03 am; Procedure: 3...Client Behavior: 2...8:18 am; Procedure: 3...Client Behavior: 2...8:20 am; Procedure: 3...Client Behavior: 2...release from procedure ...." Documentation indicated the client was calm at the time he was placed in seclusion, was calm at the time of the administration of the chemical restraint in the seclusion room and remained calm for 57 minutes before he was released. b.
A Seclusion and Restraint Form dated 6/21/21 documented, "...Aggressive with staff and kicking open unit doors attempting to elope... [...] Self-Inflicted... [...] The Seclusion and Restraint form dated 5/12/21 at 10:02 a.m. documented, "...kicking unit doors, self-harming, physically aggressive with staff..." RN #2 was documented as participating in the ESI for Client #3 but was not listed as participating in the Client Debriefing.
From the state's report. Deficiency cited, complaint survey with poc. Cited: N 128 PROTECTION OF RESIDENTS N 128; N 140 ORDERS FOR USE OF RESTRAINT OR N 140 Upon review of these identified issues, it is; N 149 ORDERS FOR USE OF RESTRAINT OR N 149; N 202 MEDICAL TREATMENT FOR INJURIES N 202 This deficiency has the potential to impact 9-15-21; N 130 PROTECTION OF RESIDENTS N 130 This deficiency has the potential to impact; N 188 POST INTERVENTION DEBRIEFINGS N 188 This deficiency has the potential to impact 9-15-21. "[...]" marks text left out between sentences.
A caregiver did not demonstrate self-control by having inappropriate sexual conversations, exchanging nude photos, and propositioning to engage in sexual activities with a child in care.
From the state's report. Risk level: Medium High. Cited: 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks.
The allegation is that the minor was sexually assaulted by another minor while in care.
From the state's report. Substantiated.
Based on the information obtained, there is preponderance of the evidence to prove that client [Child 1] (See LIC 811, dated 08/05/21 for Confidential Names) was sexually assaulted by ([Child 2]) due to lack of supervision on 3/15/21.
From the state's report. Substantiated. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
Police found the illegally concealed firearm (belonging to [Staff 2]) during a search of the vehicle. Multiple charges were filed against [Staff 1] by police, including assault with a deadly weapon, criminal threats, and cruelty to a child.
From the state's report. Substantiated. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
A caregiver pushed a child in care.
From the state's report. Risk level: High. Cited: 748.2307(1) - Other Prohibited Punishments-any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline/punishment.
A child in care was sexually abused by a staff member.
The operation did not report to Licensing concerns of an inappropriate relationship between a child in care and a staff member for possible sexual abuse.
From the state's report. Risk level: High; Risk level: Medium High. Cited: 748.1101(b)(1)(B) - Children's rights-Adhere to the child's rights to be free of abuse, neglect, and exploitation; 748.303(a)(3)(A) - Serious Incident-Report to Licensing as soon as aware of allegations or indications of abuse, neglect, or exploitation of a child.
A staff member utilized corporal punishment when a child in care was choked.
From the state's report. Risk level: High. Cited: 748.2303(a) - Corporal Punishment-May not use/threaten corporal punishment, such as hitting/spanking, forced exercise, holding physical position, unproductive work..
Caretakers at the operation did not provide proper supervision to a child in care allowing for the child to cause a self injury to themselves requiring hospitalization
From the state's report. Risk level: High. Cited: 748.685(a)(4) - Caregiver responsibility - providing the level of supervision necessary to ensure each child's safety and well-being.
On February 16, 2021, CCL received an allegation that staff (Staff #1) neglected a minor (Child #1) resulting in a death. [...] Based on record review, observation of video footage, and confidential interviews the allegation that staff (Staff #1) neglected a minor (Child #1) resulting in a death is substantiated.
From the state's report. Substantiated. Cited: 87078(b). "[...]" marks text left out between sentences. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
The purpose of inspection is to deliver the case management investigation findings of the reported death of non minor dependent participant on 02/26/21. [...] Confidential Interviews and documentation reveal that program staff were aware of ongoing issues that were happening at the apartment complex which resulted in the death of a non-minor dependent participant in care.
From the state's report. Deficiency cited at inspection. "[...]" marks text left out between sentences.
On May 5, 2021, the Department received a complaint alleging that staff pinched minor causing bruising. It was alleged that [Staff 1] pinched [Child 1] causing bruising to the arm. [...] Then, [Staff 1] went over to [Child 1] and pinched [Child 1] on the back of the arm. [...] Based on interviews, the preponderance of evidence standard has been met regarding the allegation that [Staff 1] pinched [Child 1] causing bruising and that [Staff 1] made inappropriate comments to [Child 1].
From the state's report. Substantiated. Cited: 87072(d)(11), 87072(d)(10). "[...]" marks text left out between sentences. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
A direct care staff had sexually inappropriate web searches on her phone (accessible to the kids) and used adult/inappropriate language while driving three girls in the operation's van.
From the state's report. Risk level: Medium High. Cited: 748.507(1) - Employee general responsibilities-Demonstrate competency, prudent judgment, self-control in presence of children and when performing assigned tasks.
In plain words: A staff member denied dragging or touching a child in the program. However, another child stated on a recorded phone call that the staff member dragged and kicked the child. Our summary of the state's report. The state's own wording follows.
RP stated that [Child 1] does at times inflict self-injury but usually does so by biting and the injuries that RP observed did not appear to be self-inflicted. [...] [Staff 1] denied ever dragging or going "hands on" with [Child 1]. [...] Administrator sent IB investigator an audio recording of the phone call between [Staff 4], [Child 2], Administrator where [Child 2] confirms that [Staff 1] dragged [Child 1] up to the steps" and kicked [Child 1].
From the state's report. Substantiated. Cited: 84072(D)(11). "[...]" marks text left out between sentences. The state numbers or abbreviates the people in a report instead of naming them; we spell its codes out in square brackets, such as [Staff 1] for S1 or [Former client 3] for FC #3.
Evidence provided through interviews, written documentation and video review do support the allegations of Supervisor 1 not following the written policies and procedures during the restraint of Youth A. Although, the allegation of Supervisor 1 choking Youth A is not supported as evidenced by most witnesses and the video recording.
From the state's report. Violation established, special investigation. Cited: R 400.10177 Resident restraint.
Then [Staff #8] is pushing my arm against the ground, pushing wrist down, pushing my elbow up.
From the state's report. Deficiency cited, complaint survey with poc. Cited: N 128 PROTECTION OF RESIDENTS N 128; N 202 MEDICAL TREATMENT FOR INJURIES N 202; N 214 EDUCATION AND TRAINING N 214.
He released the resident with excessive force.
From the state's report. Deficiency cited, complaint survey with poc. Cited: N 126 PROTECTION OF RESIDENTS N 126; N 216 EDUCATION AND TRAINING N 216.
On , child 1 was improperly restrained by staff member A. The staff member had child stomach to the ground and the staff members hands were seen around child's neck.
From the state's report. Citation, complaint inspection. Cited: 55 Pa. Code § 3800.32.b Specific Rights.
A program reads every inspection report we collect and picks out findings that describe serious harm, using the state's own severity rating or complaint outcome where there is one. A person then reads the report and approves or rejects each one. Only findings the state substantiated are listed: a citation, or a complaint the investigator upheld. A child running away is listed only when it ended in a death or a serious injury. This page is not complete: it covers the states and reports reviewed so far, and a facility's absence here says nothing about its record. Every report we hold, flagged or not, is on the state trackers.