summary: A resident was transported to Arkansas Children’s Hospital after being hit in the head multiple times by a peer and banging his own head into a wall.

raw_content:
DHS Placement and Residential Licensing Unit
Office of the Secretary
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 019144
Date of Incident: 2/12/2024
Date Received by PRLU: 2/13/2024
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On 2/12/2024 at approximately 3:30 p.m. Client,
DOB: became dysregulated and threw water on a peer. Another peer then physically
attacked , hitting him in the head multiple times. Staff intervened and separated the two
clients. was seen by a nurse and the nurse noted significant swelling to the face and also
bruising. At approximately 4:05 p.m. while being examined by the nurse began banging
his head into the wall and being aggressive toward himself. At approximately 4:45 p.m.
was transported by staff to Arkansas Children's Hospital. S was seen by a doctor at
Childrens Hospital for a head injury and given ibuprofen. was released back to the
Centers. is in out of state DHS custody and his guardian was notified.
Interim Action Narrative: Residents were separated, resident was assessed by the nurse, and
resident was transported to ACH for an evaluation.
______________________________________________________________________________
Maltreatment Narrative:
Licensing Narrative: Program Coordinator reviewed provider reported incident for licensing
concerns. Program Coordinator will inquire what state resident is from and camera footage.
2/15/2024, Program Coordinator reviewed camera footage and requested nursing note.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


state: AR

facility_name: Centers for Youth and Families - Little Rock

summary: Officers responded to the facility in reference to a disturbance.

raw_content:
INCIDENT NUMBER 2024-016652 JUVENILE INFORMATION Report generated: 2/20/2024 12:05 PM
NARRATIVE
OFFICERS RESPONDED TO THE LISTED ADDRESS IN REFERENCE TO A DISTURBANCE. OFFICERS MADE CONTACT
WITH SUPERVISOR, BRITTANY ROSE. ROSE ADVISED THE SITUATION HAD BEEN HANDLED PRIOR TO OFFICERS
ARRIVAL. ROSE ADVISED POLICE WERE NO LONGER NEEDED. MVR AND BWC WERE IN USE.
Page 3 of 4

doc_type: Police Report


summary: A resident was transported for acute care after destroying property and attempting to elope from the facility.

raw_content:
DHS Placement and Residential Licensing Unit
Office of the Secretary
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 019126
Date of Incident: 2/10/2024
Date Received by PRLU: 2/12/2024
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On Saturday, February 10, 2024 client DOB
became dysregulated while in the dorm. was taken off the dorm and she then began to destroy
property and attempted to elope. kicked a door several times, which caused an alarm to sound,
and broke the door that goes into a staff breakroom from the courtyard. then pulled the fire
alarm, police arrived shortly after the fire department. LRPD stated that stated she had suicidal
thoughts and per LRPD policy was transported to Childrens Hospital by police and then was
taken to Conway Behavioral. is in DHS custody and her guardian was notified.
Interim Action Narrative: The police were called and transported resident to ACH. Resident was
admitted to acute care.
______________________________________________________________________________
Maltreatment Narrative:
Licensing Narrative: Program Coordinator reviewed provider reported incident for licensing
concerns. Program Coordinator inquired about property damages. Facility reported resident will be
returning to the facility. 2/15/2024, Program Coordinator reviewed camera footage. Facility
reported resident will not be returning to the facility.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

doc_type: Notice of Incident


summary: A resident was transported for acute care after expressing suicidal ideations and placing an ethernet cord around her neck.

raw_content:
DHS Placement and Residential Licensing Unit
Office of the Secretary
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 019119
Date of Incident: 2/10/2024
Date Received by PRLU: 2/12/2024
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On Saturday evening February 10, 2024 client
became dysregulated and was expressing suicidal ideations. Client verbally expressed that
she was depressed. Client placed the ethernet cord from the phone around her neck, staff were able
to intervene and prevent client from tightening the cord around her neck. The nurse reported there
was space for her hand between clients neck and the cord. Medical provider determined acute
placement was necessary, emergency services was contact to initiate referral. Client is in out of state
DHS custody. Guardian was notified. Client was transported by MEMS to acute the morning of
2/11/24.
Interim Action Narrative: Resident transported to acute placement.
______________________________________________________________________________
Maltreatment Narrative:
Licensing Narrative: Program Coordinator reviewed provdier reported incident for licensing
concerns. Facility reported they will be replacing landline phones with cordless phones. Program
Coordinator will inquire about camera footage. 2/15/2024, Program Coordinator reviewed camera
footage. Resident will be returning to the facility.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: Officers responded to the facility for a fire alarm. Upon arrival, officers made contact with staff members who reported that a resident had pulled the alarm, damaged property, and spit in a staff member’s face. The resident was detained and began to hit her head on the back seat of the patrol vehicle and express suicidal ideations. The resident was transported to Arkansas Children’s Hospital for evaluation.

raw_content:
SUSPECT #1
SUSPECT # AKA:
1
ARRESTEE # ADDRESS:
6501 W 12TH ST LITTLE ROCK AR 72206
SEX: (M) Male ETHNICITY: (H)Hispanic RACE: (W) White (B) Black (I) American Indian DATE OF BIRTH
(F) Female (U) Unk. (N) Non-Hispanic (U) Unk. (A) Asian / Pacific Islander (U) Unknown
RES. STATUS: (R) Resident MENTALLY AFFLICTED? OCCUPATION / EMPLOYER:
(N) Nonresident (U) Unknown (Y) Yes (N) No (U) Unk.
SUSPECTS ACTIONS RELATED TO: NIC: HEIGHT: WEAPONS AT ARREST:
V1 V2 V3 V4 Ft
V5 V6 V7 V8 In
(11) Firearm (Unk)
(99) Over 98 Years Old DISPOSITION OF JUVENILE: D.L. / ID No. (STATE) WEIGHT: (12) Handgun
(H) Handled within Department
(00) Unknown (R) Referred outside Department Lbs (13) Rifle
(14) Shotgun
THIS SUSPECT RELATES TO WHICH OFFENSES? ARREST TYPE: (O) On View Arrest
(15) Other Firearm
1 2 3 4 5 6 7 8 (S) Summons / Cited (T) Taken Into Custody
ARREST LOCATION: ARREST DATE:
CHARGE: 5-13-207
(A--
automatic)
Report Contains Juvenile Information
INCIDENT NUMBER 2024-016380 JUVENILE INFORMATION Report generated: 2/17/2024 11:07 AM
Redact Before Release
NAME (Last, First, Middle)
HOME PHONE: WORK PHONE: MOBILE PHONE: OTHER PHONE:
9999999999
AGE:
Exact Age: 17 (01) Unarmed
Range: -
(16) Illegal Cutting Instrument
(17) Club/Blackjack/Brass
ARRESTING OFFICERS
OFFICER 1: MVR OFFICER 5: MVR
OFFICER 2: MVR OFFICER 6: MVR
OFFICER 3: MVR OFFICER 7: MVR
OFFICER 4: MVR OFFICER 8: MVR
Suspect information continued on next page.
Page 4 of 8

Report Contains Juvenile Information
INCIDENT NUMBER 2024-016380 JUVENILE INFORMATION Report generated: 2/17/2024 11:07 AM
Redact Before Release
SUSPECT #1
SUSPECT # NAME (Last, First, Middle) AKA:
1
COMPLEXION: HAIR STYLE: HAIR COLOR: FACIAL HAIR: DEMEANOR: SCAR / MARK: TATTOO:
(1) Light (01) Afro (1) Black (01) Clean Shaven (01) Angry (01) Head (1) Designs
(2) Medium (02) Wavy (2) Blonde (02) Unshaven (02) Apologetic (02) Neck (2) Initials
(3) Dark (03) Straight (3) Brown (03) Full Beard (03) Calm (03) Hand (rt) (3) Names
(4) Acne (04) Curly (4) Grey (04) Must. (hvy) (04) Irrational (04) Hand (lft) (4) Pictures
(5) Freckled (05) Braided (5) Red (05) Must. (thin) (05) Nervous (05) Arm (rt) (5) Words
(6) Ruddy (06) Ponytail (6) Sandy (06) Brows (hvy) (06) Polite (06) Arm (lft) (6) Numbers
(7) Other (07) Military (7) Other (07) Brows (thin) (07) Professional (07) Body (7) Insignia
(8) Unknown (08) Processed (8) Unknown (08) Side Burns (08) Stupor (08) Leg (rt) (8) None
(09) Wig/Toupee (09) Goatee (09) Violent (09) Leg (lft) (9) Unknown
HAIR LENGTH: (10) Other EYE COLOR: (10) Other (10) Drunk / High (10) Other
(1) Long (11) Unknown (1) Blue (11) Unknown (11) Other (11) None TATTOO LOC:
(2) Medium (2) Brown (12) Unknown (12) Unknown (01) Arm (lft)
BUILD:
(3) Short (3) Grey (02) Arm (rt)
(4) Bald(ing) (1) Light (4) Green (03) Leg (lft)
CLOTHING DESCRIPTION:
(5) Other (2) Medium (5) Hazel (04) Leg (rt)
HAT
(6) Unknown (3) Heavy (6) Other (05) Hand (lft)
(4) Muscular (7) Unknown COAT (06) Hand (rt)
(5) Unknown SHIRT (07) Face
PANTS/DRESS (08) Neck
SHOES (09) Finger(s)
(10) Chest
(11) Back
ADDED DESCRIPTION:
n/a
Page 5 of 8

Report Contains Juvenile Information
INCIDENT NUMBER 2024-016380 JUVENILE INFORMATION Report generated: 2/17/2024 11:07 AM
Redact Before Release
PROPERTY DRUG INFORMATION
P.LOSS P.DES QTY Description (ser#, color, make, model) PROP TAG VALUE TYPE QUANTITY MEASURE
4 77 1.00 NA NA + 0 300 0.00
NA DOOR FRAME
4 07 1.00 NA DELL + 0 800 0.00
NA LAPTOP
4 77 1.00 NA NA + 0 100 0.00
NA FAN
TYPE PROPERTY LOSS: (0) Stored (1) None (2) Burned (3) Counterfeited/Forged (4) Damaged/Destroyed/Vandalized (5) Recovered (6) Seized (7) Stolen, etc (8) Unknown
PROPERTY DESCRIPTION: (10) Drugs/Narcotics (21) Negotiable Instruments (32) Structures-Industrial/Manufacture
(11) Drug/Narcotic Equipment (22) Nonnegotiable Instruments (33) Structures-Public/Community
(01) Aircraft (12) Farm Equipment (23) Office-Type Equipment (34) Structures-Storage
(02) Alcohol (13) Firearms (24) Other Motor Vehicles (35) Structures-Other
(03) Automobiles (14) Gambling Equipment (25) Purses/Handbags/Wallets (36) Tools-Power/Hand/Lawnmower
(04) Bicycles (15) Heavy Equipment Construction/ (26) Radios/TVs/VCR (37) Trucks
(05) Buses Industry (27) Recordings-Audio/Visual (38) Vehicle Parts/Accessories
(06) Clothes/Furs (16) Household Good (28) Recreational Vehicles (39) Watercraft
(07) Computer Hardware/ (17) Jewelry/Precious Metal (29) Structures-Single Occupancy (77) Other
Software (18) Livestock (30) Structures-Other Dwellings (88) Pending Inventory (of Property)
(08) Consumable Goods (19) Merchandise (31) Structures-Commercial/Business
(09) Credit Cards/Debit Cards (20) Money
TYPE DRUG MEASUREMENT:
DRUG TYPE: (D) Heroin (H) Other Narcotics (L) Amphetamines/ (O) Other Depressants
Units Weight
(A) Crack Cocaine (E) Marijuana (I) LSD Methamphetamines (P) Other Drugs
(DU) Dosage Unit (GM) Gram (OZ) Ounce
(B) Cocaine (F) Morphine (J) PCP (M) Other Stimulants (U) Unknown Type
(Pills, etc) (KG) Kilogram (LB) Pound
(C) Hashish (G) Opium (K) Other Hallucino. (N) Barbituates (NP) Number of Plants
Capacity
FOR BURGLARIES: Point of Entry: (ML) Milliliter (GL) Gallon
(LT) Liter (FO) Fluid Ounce
Tools Apparently Used:
Page 6 of 8

Report Contains Juvenile Information
INCIDENT NUMBER 2024-016380 JUVENILE INFORMATION Report generated: 2/17/2024 11:07 AM
Redact Before Release
NARRATIVE
OFFICERS RESPONDED TO THE LISTED ADDRESS FOR A FIRE ALARM. UPON ARRIVAL, OFFICERS MADE CONTACT
WITH VIC#1 WHO ADVISED SUSP#1(JUVENILE) PULLED THE FIRE ALARM AT THE FACILITY ALONG WITH DAMAGING
THE LISTED PROPERTY. OFFICERS ALSO SPOKE WITH VICTIM#2(WILBURD). WILBURD ADVISED DURING THE
DISTURBANCE CAUSED BY THE JUVENILE, THE JUVENILE SPIT IN HER FACE. WILBURD ADVISED OFFICERS SHE
WOULD LIKE A REPORT MADE AND WOULD LIKE TO SEEK WARRANTS. OFFICERS MADE CONTACT WITH THE
JUVENILE, THE JUVENILE WAS DETAINED FOR OFFICER SAFETY. THE JUVENILE BEGAN TO HIT HER HEAD ON THE
BACK SEAT THE PATROL VEHICLE, THE JUVENILE WAS IRATE AND UNCOOPERATIVE. THE JUVENILE ADVISED SHE
WAS SUICIDAL AND WOULD LIKE TO GO THE HOSPITAL. OFFICERS CALLED MEMS AND THEY RESPONDED. THE
JUVENILE WAS TRANSPORTED TO CHILDREN'S HOSPITAL AND RELEASED PENDING FURTHER INVESTIGATION.
21C658 IS MVR EQUIPPED AND IN USE.
Page 7 of 8


summary: A resident was transported to Arkansas Children’s Hospital after reporting cervical spine pain following a physical altercation with a peer.

raw_content:
DHS Placement and Residential Licensing Unit
Office of the Secretary
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 019005
Date of Incident: 2/5/2024
Date Received by PRLU: 2/6/2024
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On February 5, 2024 a client started a physical altercation with
DOB . After the altercation was taken to ACH for an evaluation
out of an abundance of caution, client was evaluated for cervical spine pain. Client was cleared and
transported back to the Centers. Staff was given instructions to care for muscle strain. Clients is in
out of state custody and the guardian was notified.
Interim Action Narrative: Resident was taken to AR Children's Hospital for an evaluation.
______________________________________________________________________________
Maltreatment Narrative:
Licensing Narrative: Program Coordinator reviewed provider reported incident for licensing
concerns. Program Coordinator will inquire about camera footage, nursing note, and if there are
witness statements. Facility reported that there is camera footage. Program Coordinator will
schedule a day and time to review camera footage. 2/12/2024, Program Coordinator reviewed
camera footage.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was taken to Arkansas Children’s Hospital for strep throat and possibly his tonsils swelling.

raw_content:
DHS Placement and Residential Licensing Unit
Office of the Secretary
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 019001
Date of Incident: 2/5/2024
Date Received by PRLU: 2/6/2024
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On February 5, 2024 client DOB : , was taken
to Arkansas Childrens Hospital for strep throat and possibly his tonsils swelling. Upon being seen by
ACH staff was diagnosed with . was given
medication and released back to the Centers from Arkansas Childrens Hospital. is private
placement and his guardian was notified of the incident.
Interim Action Narrative: Resident was taken and evaluated at AR Children's Hospital.
______________________________________________________________________________
Maltreatment Narrative:
Licensing Narrative: Program Coordinator reviewed provider reported incident for licensing
concerns.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: An officer was dispatched to the facility in response to an alarm. False Alarm.

raw_content:
LITTLE ROCK POLICE DEPARTMENT ABBREVIATED INCIDENT REPORT

JUVENILE INFORMATION INCIDENT Report generated: 2/3/2024 1:43 PM

INCIDENT NUMBER UNIT ASSIGNED CALL DATE CALL TIME TYPE OF CALL

2024-013121 1X61 02/03/2024 10:47:00 ALMBRG

INCIDENT DATE LOCATION OF INCIDENT (ADDRESS / BUSINESS NAME)

2/3/2024 10:47:29 AM

6501 W 12TH ST

OFFENSE

FALSE ALARM

ALL ACCESSIBLE WINDOWS AND DOORS APPEARED SECURE. NO SUSPICIOUS OR CRIMINAL ACTIVITY OBSERVED.

ENTRY DATE REPORTING OFFICER ORIGINAL APPROVING SUPERVISOR .
02/03/2024 19:39:18 | LUKE PATTON - LUKE PATTON - MVR in use

LRPD Form 5501-01 Rev. RMS-2019-01-23 Page 1 of 1


summary: A resident eloped from the facility by kicking the exit door. Staff never lost sight of the resident. The resident returned to the facility.

raw_content:
DHS Placement and Residential Licensing Unit
Office of the Secretary
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 018942
Date of Incident: 2/1/2024
Date Received by PRLU: 2/2/2024
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On February 1, 2024 client DOB , became
dysregulated, and began kicking the exit door. The client kicked the door several times before the
door opened. The client then exited the building with staff behind her. Staff never lost sight of the
client. The client then calmed down and returned back to the building. The clients guardian is DHS
and the guardian was notified.
Interim Action Narrative: Staff followed resident and did not loose sight. Resident was placed on
elopement precautions.
______________________________________________________________________________
Maltreatment Narrative:
Licensing Narrative: Program Coordinator reviewed provider reported incident for licensing
concerns. Program Coordinator will follow-up with facility to see how long the resident was gone
and if the police were called. Facility reported resident was gone for approximately five minutes, the
police were not called, and the door was repaired the same day of incident. 2/8/2024, Program
Coordinator inquired if resident was placed on any safety precautions. Facility reported resident was
placed on safety precautions.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was transported to Arkansas Children’s Hospital after experiencing an allergic reaction from eating peanuts.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 018421
Date of Incident: 1/7/2024
Date Received by DCCECE: 1/8/2024
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On January 7, 2024, EMAC client
went to the nurses station and stated she had ate some cookies and now felt like her throat
was becoming sore. The cookie wrapper was retrieved and it was determined that it
contained peanuts, which is allergic to. The doctor was notified and advised staff to
send client to Arkansas Childrens Hospital. was transported to Arkansas
Childrens Hospital by ambulance. Client was given Cetrizine and Famotidine and was
observed for a few hours before being released back to the Centers. guardian is her
and was notified of the incident.
Interim Action Narrative: Resident was assessed by the nurse and transported to ACH for
evaluation.
Maltreatment Narrative:
Licensing Narrative: Program Coordinator reviewed provider reported incident for
licensing concerns. Program Coordinator will inquire where the cookies came from and
resident's allergy. Facility reported they were investigating how resident got the cookies
since they are not part of her pre-approved snack. Resident is served an alternate
meal/snack anytime something containing nuts is served. 1/10/2024, Program Coordinator
followed-up with the facility to see if there were any updates about the snack that resident
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

received. Facility reported they are still investigating this incident. 1/19/2024, followed up
with facility to see if they had any updates. 1/22/2024, Program Coordinator requested an
update. 1/23/2024, facility reported the cookies the resident received did not contain
peanuts but were packaged in a factory that also packaged food that contained peanuts.


summary: A resident was transported to Ortho Arkansas after falling in the shower. Upon arriving back to the facility, the resident jumped out of the van and eloped from the premises.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 018333
Date of Incident: 1/1/2024
Date Received by DCCECE: 1/2/2024
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On January 1, 2024, at Elizabeth Mitchell Adolescent Center (EMAC)
6501 West 12th Street in Little Rock Arkansas, client
reportedly fell in the shower and hit her previously injured knee. The client reported to the
nurse to be assessed. After being assessed by the nurse, they arranged for the client to be
seen at Ortho Arkansas. The client was transported to Ortho Arkansas by Centers? staff at
approximately 2:30 pm. After the client?s appointment at Ortho, the client was transported
back to the Centers by staff. Upon arriving back at the Centers, after the vehicle was parked,
the client jumped out of the van and ran west on 12th street. Staff began looking for the
client. Local, state, and federal law enforcement were notified to assist in searching for the
client. On January 2, 2024, at approximately 9:15 am Centers? staff were notified by law
enforcement that the client had been located and they were going to transport her to
Arkansas Children's Hospital (ACH). Centers? staff went to ACH while the client was being
evaluated by hospital staff. The client was released by ACH to the care of the Centers at
approximately 4:00 pm. The Client arrived back at The Centers at approximately 4:30pm.
The client?s guardianship was notified and kept informed throughout the events.
Interim Action Narrative: Resident was assessed by the nurse, evaluated at ACH, and law
enforcement were called. Resident was placed on assaultive and elopement precautions.
Maltreatment Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: Program Coordinator reviewed provider reported incident for
licensing concerns. Program Coordinator Inquired about diagnosis and restrictions. Facility
reported that ACH ran test and x-rays on the resident's knee. Facility reported moving
forward, when transporting residents away from the facility, staff will pick and drop off at
the entrance of the building.


summary: A resident was sent to Arkansas Children’s Hospital for headache, dizziness, and nausea.

raw_content:
DHS Placement and Residential Licensing Unit
Office of the Secretary
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 018320
Date of Incident: 12/30/2023
Date Received by PRLU: 1/2/2024
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On December 30, 2023 EMAC client
, was taken to Arkansas Childrens Hospital on doctors leave orders for a headache,
dizziness, and nausea. Once at the hospital was given IV fluids, Toradol, and Benadryl.
was taken back to the Centers with orders to take Ibuprofen and Tylenol if the
symptoms continue. Guardian with DCFS was contacted.
Interim Action Narrative: Resident was taken to ACH for an evaluation.
______________________________________________________________________________
Maltreatment Narrative:
Licensing Narrative: Program Coordinator reviewed provider reported incident for licensing
concerns. Program Coordinator will inquire about resident's diagnosis. Program Coordinator was
informed that resident was diagnosed with an acute nonintractable headache, unspecified headache
type.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A staff member was observed placing a resident in multiple holds that were not CPI-approved, and other staff members were seen grabbing the resident’s clothing and arm. The resident sustained a bruise above her eye during the incident. One staff member was terminated. The facility was cited 1091.1.g as a result of this incident.

raw_content:
Division of Childcare & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
R
Notice of Serious Incident
Case Number: 018293
Date of Incident: 12/27/2023
Date Received by DCCECE: 12/29/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Dual
Report Description: On December 28, 2023, client ,
reported to the nurse?s office and a bruise to the left side of her face above her eye was
observed. When client was asked about the bruise, she stated that she hit her head on the
underside of the desk in the dorm room while she was ?acting out?. During the video review
of the incident on December 27, 2023, at approximately 6:20 am, staff members were
observed grabbing the client?s clothing and grabbing her by the arm. The staff supervisor
( ) responded and placed the client in multiple holds that were not CPI-
approved. This incident lasted for approximately 35 minutes. After the client was able to
calm down, she was observed on camera footage holding and rubbing the left side of her
face and pointed to an area around her left eye. The staff supervisor was observed on video
looking at the area and acknowledged it. The staff supervisor was terminated and the other
staff in the room at the time of the incident have been suspended. is in the
guardianship of DCFS, which was notified of the situation. A call was placed and
accepted.
Interim Action Narrative: Resident was assessed by the nurse. Staff Supervisor was
terminated and other staff were suspended.
Maltreatment Narrative: AV is . PRFC is . Out of Home AO
is approx. 45yo Shift Supervisor at The Centers . AV was in common area of
her dorm at approximately 6:20am on 12/27/2023. AV became dysregulated and started
attempting to run into peers' rooms. Staff members and were
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

present and intervened. Shift Supervisor/AO responded and placed AV in
multiple holds which were not approved. AO pushed student into a chair, stood over her,
and would not allow her to get up. AO was observed wrestling with student (all while
standing), pulling on her arms, grabbing her while she was trying to get away or run into
peers' rooms. This lasted for approximately 40 minutes. Nurse was present
and observed a portion of the incident while administering medications. Student was also
observed banging the back of her head against the wall a few times. After AV was able to
regulate, she was observed holding the left side of her face and pointing to an area on the
left side of her face near her eye to AO. AO is observed looking at the area and
acknowledging it. This morning (12/28/2023), AV presented to nurses station and a bruise
to the left side of her face near her eye. AV stated that she had hit her head on the desk, but
was unable to state when it occurred. The bruise had not been previously observed. Of note,
while AV was banging her head, the area where the bruise was located did not make contact
with the wall, so was not sustained while she was banging her head.
Licensing Narrative: Program Coordinator reviewed complaint for licensing concerns.
Program Coordinator will inquire about camera footage and the assigned investigator.
Program Coordinator informed camera footage available. Program Coordinator will contact
investigator for permission to reach out to facility. Program Coordinator received
permission to contact the facility. 1/3/2024, Program Coordinator reviewed camera footage.
1/5/2024, Program Coordinator requested nurse note and staff termination letter.
1/29/2024, investigator reported that case is still pending. 1/30/2024, facility provided
documentation from the investigator and inquired if staff members could return to work.
1/31/2024, Program Coordinator reached out to facility and inquired about plan of action for
staff members to return. Program Coordinator checked CHRIS case unfounded. 2/1/2024,
Program Coordinator informed facility that documentation is needed once training has been
completed. Facility provided documentation of training for 2 staff members. 2/8/2024,
Program Coordinator inquired if third staff member had been trained. Facilty provided
documentation.


summary: A resident was transported to Arkansas Children’s Hospital due to positive strep and RSV tests.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 12/26/2023
Date Received by DCCECE: 12/27/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On December 26, 2023, at approximately 12:00 pm, client,
reported to the nurse that he was not feeling well. The
nurse evaluated the client and contacted the on-call doctor and client was sent to Baptist
urgent care via Center?s staff. Baptist urgent care preformed a strep and RSV test, which
both were positive. The client was transported to Arkansas Children?s Hospital via Center?s
staff where he was admitted to the hospital. The client?s guardian DCFS was notified of the
situation.
Interim Action Narrative: Resident was assessed by the nurse and transported to Baptist
Urgent Care.
:
Licensing Narrative: 12/27/2023- Program Manager CV reviewed the report for licensing
concerns.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was transported to Arkansas Children’s Hospital due to an allergic reaction from eating peanut butter.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 12/25/2023
Date Received by DCCECE: 12/27/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On December 25, 2023, at approximately 6:00 pm, an incident occurred
at Elizabeth Mitchell Adolescent Center (EMAC) located at 6501 West 12th Street. Client
ate an Reese?s peanut butter cup without realizing it
had peanut butter in it. Client has a recorded severe allergy to peanuts. Client reported to
Victoria Poirrier (Nurse on duty). Client complained of a ?scratchy? and ?painful? throat
and stated, ?this is how it always starts?. The client was sent to Arkansas Children?s
Hospital (ACH) ER via Centers Staff for evaluation and treatment. The client?s guardian
( was notified of the incident. Client, was discharged on
December 25, 2023, at approximately 8:20 pm back to the care of The Centers.
Interim Action Narrative: Resident was sent to the emergency room for evaluation and
treatment.
:
Licensing Narrative: Program Coordinator reviewed provider reported incident for
licensing concerns. Program Coordinator inquired about allergy alert and how resident got
the candy. 12/28/2023, Program Coordinator informed resident does have a peanut allergy
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

alert. Resident was unaware that Reese contained peanut butter. Some Christmas candy was
delivered to the facility and that is how the resident got the candy.


summary: Licensing visited the facility to conduct a buildings and grounds walkthrough. No deficiencies cited.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203-1437
P: 501.508.8910 F: 501.683.6060 TDD: 501.682.1550
521 Visit Compliance Report
Licensee: Elizabeth Mitchell Centers
Facility Number: 157
Licensee Address: 6501 W 12TH ST
LITTLE ROCK AR 72204-1511
Licensing Specialist: Kendra Rice
Person In Charge: John Hogue
Record Visit Date: 12/18/2023
Home Visit Date: 12/18/2023
Purpose of Visit: Subsequent Building and Grounds
Regulations Out of Compliance:
Regulations Needing Technical Assistance:
Regulation Not Applicable:
Regulations Not Correctable:
Narrative:
Time of visit: 12:15 pm to 1:15 pm
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 1 of 2

Census: 47
Program Coordinator completed buildings and grounds for EMAC and EMCC. The following areas were
observed: lobby, therapy hall, cozy corners, day areas, rage room, dryer rooms, washrooms, bathrooms,
bedrooms, dining area, library, and play area outside.
Program Coordinator was escorted by Ms. Jade, Caseworker. Walking between the buildings, the grounds
were maintained. Parked cars and vans were observed on the parking lot. Walking through the buildings,
Program Coordinator observed holiday decorations.
EMAC – residents were in their classrooms. Ratios were 2:10, 2:9, and 2:9. Residents were sitting down,
walking around, or talking with staff or other residents. All dorms were and clean bedrooms were organized.
There were no more than three (3) residents to a bedroom. Program Coordinator observed housekeeping
cleaning Dorm 2.
EMCC – residents were outside playing, ratio 8:29. Program Coordinator observed residents playing kickball,
playing on playground equipment, running around, standing in line to kick the ball, and standing or sitting by
staff. Walking into the dorms, Program Coordinator smelled a fresh fragrance. No more than two residents
were observed to a bedroom.
Provider Comments:
CCL Staff Signature : Date: 12/18/2023
Provider Signature : Date: 12/18/2023
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 2 of 2

doc_type: Compliance Report


summary: A resident reported that a peer grabbed her around the neck and attempted to touch her on the breasts and between the legs. The complaint was UNFOUNDED by Licensing.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 12/16/2023
Date Received by DCCECE: 12/18/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Dual
Report Description: On December 16, 2023, at approximately 8:05 P.M. at EMAC located at
6501 West 12th Street in Little Rock Arkansas. Client
stated that Client ( grabbed her around
her neck and attempted to touch her on the breasts and between her legs.
stated that she hit to make her stop. was removed from the dorm and
was placed in another. called the abuse hotline, which was Reference
number 2245478. Client?s guardianship is and was contacted in guards of the
incident.
Interim Action Narrative: Residents were separated. .
: Client stated that Client
grabbed her around her neck and attempted to touch
her on the breasts and between her legs. stated that she hit to make
her stop.
Licensing Narrative: Program Coordinator reviewed complaint for licensing concerns.
Program Coordinator reviewed camera footage with Investigator Rudley at the
administration building. 1/16/2024, Program Coordinator informed case was still pending.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

1/24/2024, Program Coordinator informed case is still pending. 1/30/2024, CHRIS
indicated case unfounded.


summary: A resident reported that a staff member squeezed his shoulders while attempting to led him back to his room, leaving bruises and red marks. The complaint was FOUNDED by Licensing. The facility was cited 109.1.g and 905.4.g as a result of this incident.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 12/9/2023
Date Received by DCCECE: 12/11/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Dual
Report Description: On December 09, 2023, an incident occurred at EMCC located at 6601
West 12th Street in Little Rock, AR regarding client,
The nurse (Saige Davis) was completing weekly vital signs checks and observed
multiple bruises and red marks to the right side of the student?s neck and clavicle area. The
student reported that staff squeezed his shoulders when attempting to lead him back into
his room. There is no reference number
currently. Client?s guardianship is with who was contacted about the incident. Staff
member (who client identified following the hotline call) was suspended
on December 09, 2023, pending investigation.
Interim Action Narrative: Resident was assessed by the nurse and
: The nurse was completing weekly vital signs checks and observed
multiple bruises and red marks to the right side of the student?s neck and clavicle area. The
student reported that staff squeezed his shoulders when attempting to lead him back into
his room.
Narrative: Licensing Specialist reviewed complaint for licensing concerns.
Licensing Specialist will inquire about the timeframe of incident, nursing note, and
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

investigator. Licensing Specialist received the nursing note. 12/13/2023, Licensing
Specialist will inquire if there any witness statements and camera footage. Licensing
Specialist received witness statements and scheduled day and time to review camera
footage. 12/18/2023, Program Coordinator requested permission to contact the facility.
Program Coordinator reviewed camera footage with Investigator Rudley. 1/16.2024,
Program Coordinator inquired about an update on the case. Investigator informed Program
Coordinator case was still pending. 1/18/2024, investigator informed case was closed
1/17/2024.


summary: A resident was transported to Arkansas Children’s Hospital after complaining of severe abdominal pain.

raw_content:
Division of Childcare & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
R
Notice of Serious Incident
Case Number: 017941
Date of Incident: 12/7/2023
Date Received by DCCECE: 12/8/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On December 7, 2023, , who is a
client at Elizabeth Mitchell Adolescent Center (EMAC) was complaining of severe
abdominal pains. The client was seen by medical staff at EMAC. She was recommended to
go to Arkansas Childrens Hospital by Dr. Thomas. The client was transported to ACH by
Centers staff. The client was diagnosed with constipation. She was prescribed MiraLAX.
Client returned to the Centers care on December 8, 2023. Her guardian is
which was notified.
Interim Action Narrative: Resident was assessed by facility's medical staff and transported
to ACH for further evaluation.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was transported for acute care due to property destruction, self-harming and assaultive behaviors.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 11/28/2023
Date Received by DCCECE:11/28/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On November 28, 2023, client DOB: ) was
transported to Acute (Rivendell) for unsafe behavior. Client displayed behaviors such as
property destruction, self-harming and assaultive behaviors during staff interventions. DHS
is the guardian of the client and was notified of the transfer.
Interim Action Narrative: Resident was sent to acute care for unsafe behaviors.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. Licensing Specialist will inquire if resident will be able to return to the facility.
11/29/2023, Licensing Specialist informed that resident will be able to return to the facility.
Licensing Specialist will follow-up with facility in a few days to see when resident returns.
12/4/2023, Licensing Specialist inquired if resident had returned to the facility. 12/5/2023,
Licensing Specialist informed resident discharged on 12/4/2023 and will not be returning to
the facility
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was transported for acute care due to unsafe behaviors.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 11/28/2023
Date Received by DCCECE:11/29/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On November 28, 2023, client DOB: )
was transported via MEMS to Acute (Perimeter) for unsafe behavior. Client displayed
behaviors such as property destruction, self-harming, and assaultive behaviors towards
peers. DHS is the guardian of the client and was notified of the transfer.
Interim Action Narrative: Resident was transported to acute care via MEMS.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. Licensing Specialist will follow-up with facility to see if resident will be returning.
11/30/2023, Licensing Specialist informed that resident will be returning to the facility.
Licensing Specialist will follow-up with facility at a later date regarding resident's return.
12/4/2023, Licensing Specialist inquired if resident had returned to the facility. 12/5/2023,
Licensing Specialist informed that resident had not returned to the facility but she will be
returning. 12/7/2023, Licensing Specialist informed that resident is scheduled to discharge
on 12/11/2023. Licensing Specialist will follow up on 12/11/2023 to see if resident returned
to the facility. 12/12/2023, Licensing Specialist informed that resident transferred to another
facility and will not be returning.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was transported to Arkansas Children’s Hospital after reporting eye redness.

raw_content:
Division of Childcare & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
R
Notice of Serious Incident
Case Number: 017712
Date of Incident: 11/25/2023
Date Received by DCCECE: 11/27/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On November 25, 2023, a peer at EMCC noticed that client,
eye was red. The staff took to the nurse to be
checked on. told the nurse he did not know his eye was red and that he had no pain
or discomfort. The nurse contacted the on-call doctor and was sent to Childrens
Hospital Emergency Room. was diagnoses with a Subconjunctival hemorrhage of
the left eye and the discharge paperwork stated the eye would heal on its own. Staff
attempted to make contact with guardian twice by phone but was unable to make
contact. Staff then sent an email to guardian. was released from Childres
Hospital and returned back to the Centers.
Interim Action Narrative: Resident was assessed by the nurse and transported to ACH
emergency room.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. Licensing Specialist inquired about guardianship.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was transported for acute care due to unsafe behavior.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 11/17/2023
Date Received by DCCECE:11/20/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On November 17,2023, client ( DOB:
) was transported by MEMS to Acute (Rivendell) for unsafe behavior. Client
displayed behaviors such as property destruction, self-harm and assaultive behaviors during
staff interventions. DHS is the guardian of the client and was notified of the transfer.
Interim Action Narrative: Resident was transported to acute placement.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. Licensing Specialist will follow-up with facility to see if resident will be returning.
Facility informed Licensing Specialist resident will be returning to the facility. 11/27/2023,
Licensing Specialist inquired if resident returned to the facility. Licensing Specialist
informed resident returned to the facility on 11/24/2023.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was transported for acute care after destroying property, self-harming, and exhibiting assaultive behaviors during staff interventions.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 11/9/2023
Date Received by DCCECE:11/10/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On November 9, 2023, client ( DOB:
) was transported by MEMS to Acute (Methodist) for unsafe behavior. Client
displayed behaviors such as property destruction, self-harm and assaultive behaviors during
staff interventions. DHS is the guardian of the client and was notified of the transfer.
Interim Action Narrative: Resident was transported to acute care.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. 11/13/2023, Licensing Specialist will follow-up with facility at a later date to see if
resident has returned. 11/15/2023, Licensing Specialist informed that resident returned to
the facility on 11/14/2023.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was transported to Baptist Urgent Care for a foreign item that was lodged in her ear.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 11/8/2023
Date Received by DCCECE:11/9/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On November 8, 2023, client who is a client at
Elizabeth Mitchell Adolescent Center was taken to Baptist Urgent Care for a foreign item
that was lodged in her ear. The items was an orbi and stated she fell asleep with
it in her hand. The orbi and was removed from the left ear. then returned back to
The Centers. guardian was notified.
Interim Action Narrative: Resident was assessed and sent to urgent care to have foreign
object removed.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. Licensing Specialist inquired about guardianship and the foreign object.
Licensing Specialist informed that foreign object (orbi) is used for foot/hand spa.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: Licensing visited the facility to review personnel files. All files reviewed complied with minimum licensing standards.

raw_content:
521 Visit Compliance Report

Licensee: Elizabeth Mitchell Centers

Facility Number: 157

Licensee Address: 6501 W 12TH ST
LITTLE ROCK AR 72204-1511

Licensing Specialist: Kendra Rice
Person In Charge: John Hogue
Record Visit Date: 11/7/2023
Home Visit Date: 11/7/2023

Purpose of Visit: Personnel Records

Regulations Out of Compliance:

Regulations Needing Technical Assistance:

Regulation Not Applicable:

Regulations Not Correctable:

Narrative:

Time of Visit: 10: am to 12:30 pm

www.arkansas.gov/dhs
Serving more than one million Arkansans each year

_ ARKANSAS
) DEPARTMENT OF

«| SERVICES

Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203-1437
P: 501.508.8910 F: 501.683.6060 TDD: 501.682.1550

Page 1 of 2

Census: 42
Licensing Specialists reviewed twelve 12) personnel files:

(12/29/1995) Mental Health Technician/QBHP
| | | (12/12/2022) Mental Health Technician/QBHP

i ER (1 2/12/2022) Mental Health Technician/QBHP
| Y | (9/11/2023) Mental Health Technician/QBHO

Wi BM (6/19/2023) Mental Health Technician/QBHP
(9/11/2023) Mental Health Technician/QBHP

Wl (1 0/23/2023) Mental Health Technician/QBHP
BE (10/19/2023) Residential Training Coordinator

| Fe (10/19/2023) Mental Health Technician/QBHP
«(3 /2:1/2022) Mental Health Technician/QBHP

| | (3/28/2022) Mental Health Technician/QBHP

Wi BN (10/24/2022) Mental Health Technician/QBHP (PERSONNEL FILE ONLY)

Personnel files reviewed complied with the minimum licensing standards.

Provider Comments:

CCL Staff Signature :

www.arkansas.gov/dhs
Serving more than one million Arkansans each year

Date: 11/7/2023

Date: 11/7/2023

Page 2 of 2


summary: A resident was sent to Cornerstone Women’s Clinic after reporting major swelling and breakouts around the vaginal area.

raw_content:
Division of Childcare & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
R
Notice of Serious Incident
Case Number: 017267
Date of Incident: 11/3/2023
Date Received by DCCECE: 11/6/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On Friday November 3, 2023, client,
, visited the Cornerstone Women's Clinic. had major swelling and breakouts
around the vaginal area. used a cavi wipe after someone told her it would cure HSV.
was seen by Taryn King at Cornerstone. guardian is DHS and an attempt to
contact guardian was made but no one answered. was prescribed medication by
Taryn King at Cornerstone.
Interim Action Narrative: Resident was seen at Cornerstone Women's Clinic.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. Licensing Specialist will inquire about the cavi wipe. Licensing Specialist
informed that facility was investigating how the resident obtained the cavi wipe. 11/9/2023,
Licensing Specialist followed-up with facility on how resident obtained the cavi wipe.
Licensing Specialist informed that facility is still investigating this incident. 11/14/2023,
Licensing Specialist requested an update on this provider reported incident. Licensing
Specialist informed all cavi wipes will be stored at the nursing station moving forward. All
staff have been informed of this directive and shift supervisors will reiterated during shift
report.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A mother reported that a resident’s clothes were being urinated on by other residents on laundry day after the clothes were clean. Staff would not allow the resident to re-wash the clothes until the specified laundry day and reported to mom that the resident refused to bathe. The mother also reported that the resident had been physically assaulted and cussed out by staff members. The complaint was UNFOUNDED by Licensing.

raw_content:
Placement and Residential Licensing Unit
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 018729
Date of Incident: 11/1/2023
Date Received: 1/25/2024
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Dual
Report Description: Mom reports that clothes were being urinated on by other
residents on laundry day and after clothes were clean. Staff wouldn't allow him to re-wash
clothes until specified laundry day - another week but reported to mom refused to
bathe. didn't have clean clothes to change after a bath. Physically assaulted -
bruising, black eyes (mom has pics). & other residents were called the N word and
cussed out by staff members. Mom has more reports
Interim Action Narrative:
Maltreatment Narrative: Mom reports that clothes were being urinated on by
other residents on laundry day and after clothes were clean. Staff wouldn't allow him to re-
wash clothes until specified laundry day - another week but reported to mom
refused to bathe. didn't have clean clothes to change after a bath. Physically
assaulted - bruising, black eyes (mom has pics). & other residents were called the N
word and cussed out by staff members.
Licensing Narrative: Program Coordinator reviewed complaint for licensing concerns.
Program Coordinator will reach out to the reporter. A voicemail was left for the reporter to
call Program Coordinator back. Program Coordinator spoke with the reporter ( ) who
reported what she was told by the guardian and provided contact information for the
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

guardian. Program Coordinator left a voicemail for guardian to call back. Guardian called
back and was encouraged to call the hotline. Program Coordinator gathered information
from the guardian. 2/9/2024, Program Coordinator reached back out to parent, no answer.
2/14/2024, Program Coordinator called AR Hotline and reported the allegations. Hotline
call accepted an investigator has not been assigned. 2/16/2024, Program Coordinator
checked CHRIS for investigator. 3/13/2024, Program Coordinator requested an update.
3/14/2024, parent reached out to Program Coordinator via text message. Parent provided
pictures via email but Progam Coordinator was unable to open files. Program Coordinator
requested pictures via text message. Program Coordinator inquired about timeframe of
pictures. Parent reported pictures were taken on 10/1/2023, note 10/5/2023, 10/8/2023,
10/10/2023,10/22/2023, and 11/8/2023. 3/29/2024, Program Coordinator checked CHRIS
case found unsubstantiated.


summary: A staff member reported that during a disturbance, a resident wrapped a towel around the staff member’s neck, attempting to tighten it. Later that day the resident began striking the staff member all over and groping and grabbing both inside and outside the staff member’s clothing in an attempt to gain access to a key fob that would open all the doors.

raw_content:
LITTLE ROCK POLICE DEPARTMENT INCIDENT REPORT

[_]JUVENILE INFORMATION

INCIDENT

Report generated: 10/25/2023 9:02 PM

INCIDENT NUMBER

2023-124275

UNIT ASSIGNED

1X70

CALL DATE

CALL TIME

10/25/2023

13:10:00

TYPE OF CALL

BATTERY

INCIDENT DATE

LOCATION OF INCIDENT (ADDRESS / BUSINESS NAME)

10/25/2023 1:10:09 PM

6501 W 12TH ST

OFFENSE

THE CENTERS FOR YOUTH AND FAMILY

INCIDENT OFFENSE TYPE

1 BATTERY 3RD DEGREE
2 HARASSMENT

3

4

[_]@) Drugs

VI Unknown

(N) Not Applicable /

TYPE OF CRIMINAL ACTIVITY:

(1®) Buying / Receiving
[_]@ Exploiting Children

[_](©) Cultivate / Manufacture / Publish
[_]©) Operating / Promoting / Assisting

[_]CE) Transport / Transmit / Import [_]@©) Using / Consuming

[_]®) Distributing / Selling

[_]@) Possessing / Concealing

OFFENSE STATUS

eed
54 6H 7H 4
GANG RELATED INFO:
C10 Juvenile Gang
[1@ Otter Gang
[V]@X) None / Unknown

LOCATION CODE:

[](01) Air / Bus / Train Terminal
(02) Bank / Savings & Loan

(03) Bar / Night Club

(04) Church / Synagogue / Temple
[_](05) Commercial / Office Building
(06) Construction Site

(07) Convenience Store

(08) Department / Discount Store
(09) Drug Store / DR Office / Hospital
[_](10) Field / Woods

[_](11) Government / Public Building
(12) Grocery / Supermarket

(13) Highway / Road / Alley

(14) Hotel / Motel / Etc

[_](15) Jail / Penitentiary

[_](16) Lake / Waterway

[_]7 Liquor Store

[_](18) Parking Lot / Garage

[_](9) Rental / Storage Facility

(20) Residence / House

[_](21) Restaurant

[_](22) School / College

[_](23) Service / Gas Station

[_](24) Specialty Store (TV, Fur, Etc)
[_](25) Other / Unknown

[_]@7) Abandoned/Condemned Structure
[_]G8) Amusement Park

(39) Arena / Stadium / Fairgrounds
[_](40) ATM Separate from Bank
(41) Auto Dealership New / Used
[_](42) Camp / Campground

[V] (44) Daycare Facility

[_](45) Dock / Wharf / Freight Terminal
[_](46) Farm Facility

[_]47) Gambling / Casino / Racetrack
[_]48) Industrial Site

[_](49) Military Installation

[_](60) Park / Playground

[_](1) Rest Area

[_] (52) School - College / University

[_] (53) School - Elementary / Secondary!
[_] 4) Shelter - Mission / Homeless
[_]©5) Shopping Mall

[_] ($6) Tribal Lands

[_](S7) Community Center

WEAPON FORCE:
(_]Q) Firearm (Unknown)
(_]@2) Handgun
(3) Rifle
[_]@4) Shotgun
[_] C5) Other Firearm

[_] 20) Knife / Cutting Instr (Axe, etc)

(FOR BURGLARY ONLY)

NUMBER OF PREMISES ENTERED

METHOD OF ENTRY:

C] @®) Forcible

[_]@) No Force

[_] G0) Biunt Object (Club, etc)
C] (35) Motor Vehicle (as weapon)
(40) Personal Weapons (hands, etc)

(on 11-15, an "A" denotes Automatic or Semi-Automatic)

[_ ](50) Poison
L_|(60) Explosives

(65) Fire / Incendiary Device
(70) Narcotics / Drugs /
Sleeping Pills

(85) Asphyxiation

(90) Other

(95) Unknown

(99) None

NARCAN USED: | No

Yes

Other

ENTRY DATE REPORTING OFFICER ORIGINAL APPROVING SUPERVISOR .
10/25/2023 20:33:21 | JAMES ANDERSON - gj HARMON TOBLER - MVR in use

LRPD Form 5501-01 Rev. RMS-2019-01-23

Page 1 of 6

INCIDENT NUMBER 2023-124275 [_] JUVENILE INFORMATION Report generated: 10/25/2023 9:02 PM

NAME (Last, First, Middle) or BUSINESS

6501 W 12TH ST LITTLE ROCK AR 72204

HOME PHONE: WORK PHONE: MOBILE PHONE:
5016668686 5016668686

SEX: [_]() Male ETHNICITY: [_](@)Hispanic RACE: [¥](W) White [_](B) Black [_]@ American Indian | DATE OF BIRTH
[V]@® Female [_](U) Unk. | [V](N) Non-Hispanic [_](U) Unk. (JA) Asian / Pacific Islander [_](U) Unknown 40/01/1979

(N) Nonresident (U) Unknown | [_](Y) Yes [V]()No [_]( Unk.

RES. STATUS: |_|) Resident MENTALLY AFFLICTED? | OCCUPATION / EMPLOYER:

Exact Age: 44 SUSPECT(S) VICTIM WAS: (by Suspect Number)
Range: __ > s @) 7-364 Days Old (SE) Spouse (AQ) Acquaintance
[_]@NN) Under 24 Hrs. Old [[] 99) Over 98 Years Old DL. /ID No. (STATE) (ER) Friend

(NB) 1-6 Days Old [_] 00) Unknown (NE) Neighbor

(BE) Babysitter (baby)
THIS VICTIM RELATED TO WHICH OFFENSES? (BG) Boy/Girl Friend

AGE: | NIC: RELATIONSHIP OF THIS VICTIM TO SUSPECTS

Yili [vj2 []3 4 5 6 []7 [Js (CF) Child of BF / GF
(HR) Homosexual Rel

VICTIMTYPE: [¥]@ Individual [_](B) Business [_](F) Financial Inst’. = [_](U) Unknown

[_]@ Government [“]

(EE) Employee
VICTIM INJURY: (ER) Empl
[_]QN) None [V](M) Apparent Minor Injury ({_]@) Apparent Broken Bones (SS) Stepsibling (OK) Otherwise Known
[_]@ Possible Internal Injury — [__](T) Loss of Teeth [_]@) Severe Laceration
[_] ©) Other Major Injury [_]@) Unconsciousness

[ ](R) Religious [](S) Society / Public [](O) Other = |-—— SSS er

(OF) Other Family ————————_—RU) Relationship Unknown
(ST) Stranger ____ (VO) Victim Was Suspect

AGGRAVATED ASSAULT / HOMICIDE: [_](01) Argument [_](2) Assault on Law Enf Officer [_](03) Drug Deal

[_]4) Gangland [_] 5) Juvenile Gang [_] (06) Lover's Quarrel [_] 07) Mercy Killings
[_](08) Other Felony Involved [_] 9) Other Circumstances [_](10) Unknown Circumstances [_] (20) Criminal Killed by Private Citizen
[_](21) Criminal Killed by Police Officer [| (30) Child Playing w/ Weapon [_]G1) Gun-Cleaning Accident [_](32) Hunting Accident

[_]G3) Other Negligent Weapon Handling [_] (34) Other Negligent Killings

CLOTHING DESCRIPTION

Page 2 of 6

INCIDENT NUMBER 2023-124275 [_] JUVENILE INFORMATION Report generated: 10/25/2023 9:02 PM

SUSPECT #1

6501 W 12TH ST LITTLE ROCK AR 72204

NAME (Last, First, Middle)

HOME PHONE: OTHER PHONE:
5016668686

sEx: [_]() Male ETHNICITY: [_](@)Hispanic RACE: [_](W) White [V]() Black []@ American Indian | DATE OF BIRTH
W|() Female [_](U) Unk. | [V](N) Non-Hispanic [_](U) Unk. [_](A) Asian / Pacific Islander [_](U) Unknown
RES. STATUS: [V]®) Resident MENTALLY AFFLICTED? OCCUPATION / EMPLOYER:
[_]@) Nonresident [—](U) Unknown (%) Yes [V](N)No [_](U) Unk.
(on

AGE: SUSPECTS ACTIONS RELATED TO: | NI WEAPONS AT ARREST:
feat lA ere [VJv1 v2 v3 [_]@1) Unarmed

—— ——_ | L]vs V6 v7 Can i Unk)

(99) Over 98 Years Old DL. / ID No. (STATE) a (a2) Handgun
[]0) Unknown He : ~ [Ja3) Rifle

___ _[1@4) shotgun

—__ [J@5) Other Firearm

(o neugne --Vy)

THIS SUSPECT RELATES TO WHICH OFFENSES? [_]©) On View Arrest
Yji | C13 4 5 [_](S) Summons /Cited — [_](T) Taken Into Custody

[_](6) Megal Cutting Instrument
[]a7 CtubBlackjack/Brass

ARREST LOCATION: | ARREST DATE:

CHARGE: 5-13-203

ARRESTING OFFICERS
OFFICER 1:

OFFICER 2:
OFFICER 3:
OFFICER 4:

Suspect information continued on next page.

Page 3 of 6

INCIDENT NUMBER 2023-124275

[_]JUVENILE INFORMATION

SUSPECT #1

Report generated: 10/25/2023 9:02 PM

SUSPECT #

1

NAME (Last, First, Middle)

COMPLEXION:
[_]q) Light
[_](2) Medium
[_]@) Dark
[_]@) Acne
[_|(5) Freckled
[_]@ Ruddy
[_](7) Other

lv (8) Unknown

[_](1) Long
[_]@) Medium
[_]@) Short
[_](4) Bald@ing)
[_](5) Other

lv] (6) Unknown

HAIR LENGTH:

HAIR STYLE:

[_]@1) Afro

[_] (02) Wavy
[_](03) Straight
[_](04) Curly
[_]@5) Braided
[_](06) Ponytail
JO? Mititary
LJ (08) Processed
[_](09) Wig/Toupee
[_]@0) Other
[V](11) Unknown

BUILD:

(_]q) Light
[_]@) Medium
[_]@G) Heavy
[_]4) Muscular
|v] (5) Unknown

ADDED DESCRIPTION:

n/a

HAIR COLOR:
(1) Black
[_](2) Blonde
(3) Brown
(4) Grey

(5) Red
[_]© Sandy
(7) Other
VY ](8) Unknown

EYE COLOR:
(1) Blue

(2) Brown
(3) Grey

[_ ](4) Green

(5) Hazel

(6) Other
\¥|(7) Unknown

FACIAL HAIR:

[_] (02) Unshaven
(03) Full Beard
|_| (04) Must. (hvy)
(05) Must. (thin)
|_| (06) Brows (hvy)
(07) Brows (thin)
(08) Side Burns
(09) Goatee

(10) Other

[V] (11) Unknown

(01) Clean Shaven

DEMEANOR:

L]
L]
L]
L]
L]
L]
L]
L]
L]
L]
L]
Vv

(01) Angry

(02) Apologetic
(03) Calm

(04) Irrational
(05) Nervous
(06) Polite

(07) Professional
(08) Stupor

(09) Violent
(10) Drunk / High
(11) Other

(12) Unknown

SCAR / MARK:
(01) Head
[_](02) Neck
(03) Hand (rt)
|_](04) Hand (ift)
(05) Arm (rt)
[_](06) Arm (ift)
(07) Body
(08) Leg (xt)
(09) Leg (1ft)
(10) Other
[_](1) None
(12) Unknown

CLOTHING DESCRIPTION:

HAT

COAT

SHIRT

PANTS/DRESS
SHOES

(01) Arm (ift)
(02) Arm (rt)
(03) Leg (ft)

|_| (04) Leg (xt)

(05) Hand (ft)

|_| (06) Hand (rt)
|_| (07) Face

(08) Neck

[|_| (09) Finger(s)

(10) Chest

[_](11) Back

Page 4 of 6

INCIDENT NUMBER 2023-124275 JUVENILE INFORMATION Report generated: 10/25/2023 9:02 PM

NARRATIVE

WR sre THAT ON SUNDAY, OCTOBER 22ND, POLICE HAD TO BE CALLED TO 6501 WEST 12TH STREET
TERS FOR YOUTH AND FAMILY MULTIPLE TIMES, ON BOTH DAY SHIFT AND THE EVENING SHIFT.
 asioerania AE THAT THIS IS A FACILITY THAT HOUSES TROUBLED YOUTH AND HAS PROBLEMS WITH FIGHTS

L BAD BEHAVIOR INSIDE ON A REGULAR BASIS. I STATED THAT SHE WAS AN EMPLOYEE AT
THE CENTERS FOR YOUTH AND FAMILY.

anim STATED THAT ON SUNDAY SHE WAS WATCHING OVER A DORM, LOCKED INSIDE, WITH A GROUP OF
. WHEN A LARGE DISTURBANCE BROKE OUT ALL OVER THE FACILITY AND POLICE WAS CALLED.
Wess" WHILE POLICE WERE IN ANOTHER PART OF THE FACILITY,

TOWEL AROUND HER NECK, AND MADE AN ATTEMPT TO TIGHTEN T1--
BREAK FREE FROM IT BEFORE SHE COULD.

CAME UP BEHIND HER,
WAS ABLE TO

LATER THAT DAY ANOTHER DISTURBANCE BROKE OUT. SHE STATED THAT cae TO HER AND
STARTED STRIKING HER ALL OVER, IN AN ATTEMPT TO GAIN ACCESS TO H WHICH HAD A KEY FOB ON IT
THAT WOULD OPEN ALL THE DOORS. STATED THAT THE WRIST FOB BROKE BUT SHE WAS ABLE TO PUT

IT IN AN INTERIOR POCKET OF HER J COULD NOT GET IT. ADVISED
THEN BEGAN GROPING ING HER BOTH OUT OTHING AND INSIDE
G. CONTI RIKE AND TOUCH WITH THE PURPOSE OF ALARMING,
HARASSING, OR ER. THERE WAS NOTHING TO SHOW RECEIVED ANY SEXUAL
GRATIFICATION FROM THE ACTIONS SHE TOOK. IT WAS POSSIBLE SHE POSSIBLY JUST BEEN

LOOKING FOR THE KEY FOB.

 vermesiesl IS A QUALIFIED HEALTH CARE PROFESSIONAL AND SHE IS IN NURSING SCHOOL. BUT. e's
SE AND WAS NOT ACTING IN A MEDICAL PROFESSIONAL CAPACITY. STATE WAS
GOING TO HER ATTORNEY AND JUST NEEDED A REPORT NUMBER. E BRUISE ON HER
WRIST AND STATED SHE JUST CAME FROM THE DOCTORS, WHO T! ‘AS SPRAINED FROM THE
INCIDENT. [WAS GIVEN THE INCIDENT NUMBER.

Page 5 of 6

INCIDENT NUMBER 2023-124275 [_]JUVENILE INFORMATION Report generated: 10/25/2023 9:02 PM

ADDITIONAL HOMICIDE CIRCUMSTANCES (Chinn Sih bcl's alien [J Criminal resisted arrest
[_](A) Criminal attacked police officer, that officer killed criminal [_]@) Criminal attempted flight from a crime [© Unable to determine /
[_]@) Criminal attacked police officer, criminal killed by other officer [_]) Criminal killed in commission of a crime not enough information

RELATED CASE NUMBER(S)

CAR JACKING? [_]YES [V]NO DRIVE-BY? [_]YES [V|NO GANG RELATED? [_]YES [V|NO

HATE/BIAS RELATIONSHIP: [V](88)None [_] YES, SEE BELOW
RACIAL (Anti-) RELIGIOUS (Anti-) ETHNICITY / NATIONAL ORIGIN (Anti-) SEXUAL (Anti-)

(11) White (21) Jewish [_] G2) Hispanic [_](41) Male Homosexual (Gay)

(12) Black (22) Catholic [_] (3) Other Ethnicity [_](42) Female Homosexual (Lesbian)
-— (13) American Indian / (23) Protestant . [_](43) Homosexual (Gay and Lesbian)
LI Alaskan Native (24) Islamic (Muslim) SSE) [_](44) Heterosexual

(14) Asian / Pacific Islander (25) Other Religion [_](51) Physical Disability [_](45) Bisexual

[_](15) Multi-Racial Group [__](26) Multi-Religious Group [__] (52) Mental Disability
[_](27) Atheist/A gnostic

Page 6 of 6


summary: A resident was transported for acute care after exhibiting destructive and assaultive behaviors during staff interventions.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 10/23/2023
Date Received by DCCECE: 10/24/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On October 23, 2023, client ( DOB:
) was transported to Acute (Bridgeway)from EMAC for unsafe behavior. Client
displayed behaviors such as property destruction and assaultive behaviors during staff
interventions. DHS is the guardian of the client and was notified of the transfer.
Interim Action Narrative: Resident transported to acute care due to unsafe behaviors.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. Licensing Specialist will follow-up with facility in a few days to see if resident has
returned. 10/30/2023, Licensing Specialist followed-up with facility to see if resident has
returned. Licensing Specialist informed that resident's scheduled discharge date is
10/31/2023. 11/1/2023, Licensing Specialist followed-up with the facility to see if resident
has returned to the facility. Licensing Specialist informed that resident has returned to the
facility.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A staff member advised officers that she was bitten by a resident during a restraint.

raw_content:
LITTLE ROCK POLICE DEPARTMENT INCIDENT REPORT

JUVENILE INFORMATION

Report.generated: 10/27/2023 8:38 AM

2023-122970

INCIDENT DATE

10/22/2023 12:57:06 PM

LOCATION OF INCIDENT (ADDRESS / BUSINESS NAME)
6501 W 12TH ST
CENTERS FOR YOUTH AND FAMILIES.

OFFENSE

OFFENSE STATUS

1 3 3 4
Mod
3

‘ 5H 6H 7H eH
TYPE OF CRIMINAL ACTIVITY:

(1®) Buying / Receiving
[_]@ Exploiting Children

INCIDENT OFFENSE TYPE

1 BATTERY 3RD DEGREE

GANG RELATED INFO:
me) Juvenile Gang
[1@ Otter Gang

[_]@) Drugs

a ~ Not Applicable /

[_](©) Cultivate / Manufacture / Publish
[_]©) Operating / Promoting / Assisting

[_]CE) Transport / Transmit / Import [_]@©) Using / Consuming

[_]®) Distributing / Selling

[_]@) Possessing / Concealing

[V]@X) None / Unknown

LOCATION CODE:

[_](2) Bank / Savings & Loan
(03) Bar / Night Club

[_](06) Construction Site
[_](07) Convenience Store

[_]d0) Field / Woods

(12) Grocery / Supermarket
(13) Highway / Road / Alley
(14) Hotel / Motel / Etc
[_](15) Jail / Penitentiary

|_|(01) Air / Bus / Train Terminal

(04) Church / Synagogue / Temple
[_](05) Commercial / Office Building

[_](08) Department / Discount Store
[7] (09) Drug Store / DR Office / Hospital

[_]1) Government / Public Building

[_](16) Lake / Waterway

[_]7 Liquor Store

[_](18) Parking Lot / Garage

[_](9) Rental / Storage Facility

(20) Residence / House

[_](21) Restaurant

[_](22) School / College

[_](23) Service / Gas Station

[_](24) Specialty Store (TV, Fur, Etc)
[_](25) Other / Unknown

[_]@7) Abandoned/Condemned Structure
[_]G8) Amusement Park

(39) Arena / Stadium / Fairgrounds
[_](40) ATM Separate from Bank
(41) Auto Dealership New / Used
[_](42) Camp / Campground

[_](44) Daycare Facility

[_ (45) Dock / Wharf / Freight Terminal
(146) Farm Facility

[_](47) Gambling / Casino / Racetrack
[_]48) Industrial Site

[_](49) Military Installation

[_](60) Park / Playground

[_](1) Rest Area

[_] (52) School - College / University

[_] (53) School - Elementary / Secondary!
[_] 4) Shelter - Mission / Homeless
[_]©5) Shopping Mall

[_] ($6) Tribal Lands

[_](S7) Community Center

(FOR BURGLARY ONLY)

NUMBER OF PREMISES ENTERED

METHOD OF ENTRY:

C] @®) Forcible

[_]@) No Force

WEAPON FORCE:
(11) Firearm (Unknown)
(12) Handgun
(13) Rifle
(14) Shotgun

[_] C5) Other Firearm
[eo Knife / Cutting Instr (Axe, etc)
[_] G0) Biunt Object (Club, etc)
C] (35) Motor Vehicle (as weapon)
(40) Personal Weapons (hands, etc)

_U
_U
_ Uo
_U

(on 11-15, an "A" denotes Automatic or Semi-Automatic)

[_ ](50) Poison
L_|(60) Explosives

(65) Fire / Incendiary Device
(70) Narcotics / Drugs /
Sleeping Pills

(85) Asphyxiation

(90) Other

(95) Unknown

(99) None

NARCAN USED: [

Yes

No

Other

ENTRY DATE REPORTING OFFICER ORIGINAL APPROVING SUPERVISOR .
10/22/2023 18:28:15 | MALIK AUSTIN - RONALD CROSON - fj MVR in use

LRPD Form 5501-01 Rev. RMS-2019-01-23

Page 1 of 6

INCIDENTNUMBER 2023-122070 Report Copfadasnbnenuedplormation Report generated: 10/27/2023 8:38 AM

VICTIM

NAME (Last, First, Middle) or BUSINESS

WORK PHONE:

MOBILE PHONE:

SEX: [_]() Male
[V]® Female [_](U) Unk.

ETHNICITY: [_]()Hispanic
(N) Non-Hispanic [—](U) Unk.

RACE: [_](W) White [¥](B) Black [_]@ American Indian
[_]@) Asian / Pacific Islander [~](U) Unknown

DATE OF BIRTH

Q) Nonresident

RES. STATUS: |W |(R) Resident
(U) Unknown

MENTALLY AFFLICTED?

(WY) Yes |V|(N) No

] (U) Unk.

| OCCUPATION / EMPLOYER:

AGE:
Exact Age:
Range:

36

(NB) 1-6 Days Old

C

(NN) Under 24 Hrs. Old ~~ [_] (99) Over 98 Years Old

O

NIC:

(BB) 7-364 Days Old

(00) Unknown

D.L./ID No. (STATE)

THIS VICTIM RELATED TO WHICH OFFENSES?

6 (]7 [Js

[]@) Business

(_]@® Financial Inst.
[](R) Religious [_](S) Society / Public

[_]@) Unknown
[_] ©) Other

[_]CN) None

[_] ©) Other Major Injury

[V] (MD Apparent Minor Injury

[_]@ Possible Internal Injury — [__](T) Loss of Teeth

im (U) Unconsciousness

[_]@) Apparent Broken Bones
[_]@) Severe Laceration

(SE) Spouse
(CS) Common-Law
Spouse

(PA) Parent
(SB) Sibling

(SS) Stepsibling
(OF) Other Family
(ST) Stranger

RELATIONSHIP OF THIS VICTIM TO SUSPECTS
SUSPECT(S) VICTIM WAS:

(by Suspect Number)
(AQ) Acquaintance
(FR) Friend
(NE) Neighbor
(BE) Babysitter (baby)
(BG) Boy/Girl Friend
(CF) Child of BF / GF
(HR) Homosexual Rel
(XS) Ex-Spouse
(EE) Employee
(ER) Employer
(OK) Otherwise Known
(RU) Relationship Unknown
(VO) Victim Was Suspect

AGGRAVATED ASSAULT / HOMICIDE:
[_](04) Gangland
[_](08) Other Felony Involved

(21) Criminal Killed by Police Officer
[_]G3) Other Negligent Weapon Handling

(01) Argument

[](05) Juvenile Gang

[_] (09) Other Circumstances

[| (30) Child Playing w/ Weapon
[_](34) Other Negligent Killings

[_] (02) Assault on Law Enf Officer
[_] (06) Lover's Quarrel

C] (10) Unknown Circumstances
[_]G1) Gun-Cleaning Accident

(03) Drug Deal

[_] (07) Mercy Killings
[_] (20) Criminal Killed by Private Citizen
[](2) Hunting Accident

CLOTHING DESCRIPTION

Page 2 of 6

INCIDENTNUMBER 2023-122970 Report Copfasasnbnyenilndpformation Report generated: 10/27/2023 8:38 AM

SUSPECT #1

NAME (Last, First, Middle)

HOME PHONE: WORK PHONE: MOBILE PHONE:

ETHNICITY: [_](@)Hispanic : [JW White [¥]() Black []@ American Indian | DATE OF BIRTH
¥]() Non-Hispanic [_](U) Unk. [_](A) Asian / Pacific Islander [|

RES. STATUS: [V](R) Resident MENTALLY AFFLICTED? OCCUPATION / EMPLOYER:
[_]@) Nonresident [_](U) Unknown

AGE: SUSPECTS ACTIONS RELATED TO: | NIC: WEAPONS AT ARREST:
Exact Age 16 V1 v2 v3 [_]@1) Unarmed

Range: 2 We bal We (JQ) Firearm (Unk)
(99) Over 98 Years Old | DISPOSITION OF JUVENILE: DL. /ID No. (STATE) , i []2) Handgun
4 () Handled within Department — :

AOD Unknown: (Rem asks Ieee eee 13) Rifle

THIS SUSPECT RELATES TO WHICH OFFENSES? : _ IGS sega
? ARREST TYPE: [_](O) On View Arrest Has Fi
Yji | L]3 4 5 6 (7 [Js | LJ© Summons / Cited [_](D Taken Into Custody _—

(o neugne --Vy)

[_](6) Iegal Cutting Instrument
[]a7 CtubBlackjack/Brass

ARREST LOCATION: ARREST DATE:

CHARGE: 5-13-203

ARRESTING OFFICERS
OFFICER 1: OFFICER 5:

OFFICER 2: OFFICER 6:
OFFICER 3: OFFICER 7:
OFFICER 4: OFFICER 8:

Suspect information continued on next page.

Page 3 of 6

INCIDENTNUMBER 2023-122970 Report Copfasasnbnyenilndpformation Report generated: 10/27/2023 8:38 AM

SUSPECT #1

SUSPECT #

1

NAME (Last, First, Middle)

COMPLEXION:
[](1) Light

[V] (2) Medium
[_]@) Dark
[_]@) Acne
[_](S) Freckled
[_]@ Ruddy
[_]() Other

L | (8) Unknown

[_](1) Long

[V] (2) Medium
[_]@) Short
[_]@ Bald(ing)
[_](5) Other
Mm) Unknown

HAIR LENGTH:

HAIR STYLE:
[_]@1 Afro
[_] 02) Wavy
[_](03) Straight
[_] (04) Curly
[_]5) Braided
[_](06) Ponytail
[_]©7) Military
LJ (08) Processed
[_](9) Wig/Toupee
[V7] (10) Other
LJ (11) Unknown

BUILD:

(_]q) Light
[V](2) Medium
[_]@) Heavy
[_]4) Muscular
L] (5) Unknown

ADDED DESCRIPTION:

n/a

HAIR COLOR:
(1) Black
L_|(2) Blonde
(3) Brown
(4) Grey

(5) Red
[_]@ Sandy
(7) Other

L | (8) Unknown

EYE COLOR:
(1) Blue
¥|(2) Brown
G3) Grey

[_ ](4) Green

(5) Hazel
[_](© Other
L_|(7) Unknown

FACIAL HAIR:

[_] (02) Unshaven
(03) Full Beard
|_| (04) Must. (hvy)
(05) Must. (thin)
|_| (06) Brows (hvy)
(07) Brows (thin)
[ ](08) Side Burns
(09) Goatee

(10) Other
[_](11) Unknown

(01) Clean Shaven

DEMEANOR:

L]
L]
L]
L]
L]
L]
L]
L]
L]
L]
L]
Vv

(Ol) Angry

(02) Apologetic
(03) Calm

(04) Irrational
(05) Nervous
(06) Polite

(07) Professional
(08) Stupor

(09) Violent
(10) Drunk / High
(11) Other

(12) Unknown

SCAR / MARK:
(01) Head
[_](02) Neck
(03) Hand (rt)
[_](04) Hand (ft)
(05) Arm (rt)
[_](06) Arm (tft)
(07) Body
(08) Leg (st)
(09) Leg (ift)
(10) Other
[_](11) None
(12) Unknown

lv

[_] 1) Arm (ft)

(02) Arm (rt)
[_] (03) Leg (tft)
|_| (04) Leg (rt)
|_| (05) Hand (1ft)
[_] (06) Hand (xt)
|_| (07) Face
|_| (08) Neck
|_] (09) Finger(s)

(10) Chest
[]a1) Back

Page 4 of 6

INCIDENTNUMBER 2023-122970 Report Copiainsrancauedntiormation Report generated: 10/27/2023 8:38 AM
Redact Betore Retease

NARRATIVE

OFFICERS WERE DISPATCHED TO THE LISTED LOCATION IN REFERENCE TO A DISTURBANCE CALL. WHILE AT THE
LOCATION A STAFF MEMBER ADVISED OFFICERS, SHE NEEDED TO A MAKE A BATTERY REPORT FROM AN INCIDENT
THAT OCCURRED EARLIER IN THE DAY.

(GEN ADVISED OFFICERS THAT AT APPROXIMATELY 0930 HOURS THIS MORNING A JUVENILE
) WAS HAVING AN ERRATIC EPISODE AND HAD PHYSICALLY ATTACKED

DVISED HAD PUNCHED SEVERAL STAFF MEMBERS STRIKING THEM IN
LSO STA IHAD THROWN WATER ON THEM.

SEVERAL ;
THE FACE AND ARM AREA.

ADVISED OFFICERS IN AN ATTEMPT TO GAIN CONTROL OF

(5)(12)) SHE WAS PLACED INTO SEVERAL

ICAL RESTRAINT HOLDS MM ADVISED WHILE WA OLD THE NURSE ADMINISTERED A
SEDATIVE SHOT TO HER AND ELEASING THE 2) BIT ON THE RIGHT
FOREARM. OFFICERS OBSERVED WHAT APPEARED TO BE A LARGE BRUI MA\ GBARM THE Bite

DID NOT BREAK THE SKIN.

REFUSED MEDICAL TREATMENT WHILE ON SCENE AND ADVISED SHE WOULD SEEK MEDICAL ATTENTION AT
ER TIME.

rei ADVISED OFFICERS SHE WAS GOING TO PRESS CHARGES AGAINST [J OFFICERS ADVISED Jj TO
ACT THE PROSECUTING ATTORNEY'S OFFICE TO SEEK WARRANTS.

NO FURTHER POLICE ACTION REQUIRED
MVR/BWC IN USE.

COMMUNICATIONS MADE A DUPLICATE INCIDENT REPORT NUMBER SEE #2023-122962

Page 5 of 6

INCIDENTNUMBER 2023-122070 Report Copfarasnbvenileidpflormation Report generated: 10/27/2023 8:38 AM

ADDITIONAL HOMICIDE CIRCUMSTANCES (Chinn Sih bcl's alien [J Criminal resisted arrest
[_](A) Criminal attacked police officer, that officer killed criminal [_]@) Criminal attempted flight from a crime [© Unable to determine /
[_]@) Criminal attacked police officer, criminal killed by other officer [_]) Criminal killed in commission of a crime not enough information

RELATED CASE NUMBER(S)

CAR JACKING? [_]YES [V]NO DRIVE-BY? [ ]YES [V¥|NO GANG RELATED? [_]YES [V|NO

HATE/BIAS RELATIONSHIP: [V](88)None [_] YES, SEE BELOW
RACIAL (Anti-) RELIGIOUS (Anti-) ETHNICITY / NATIONAL ORIGIN (Anti-) SEXUAL (Anti-)

(11) White (21) Jewish [_] G2) Hispanic [_](41) Male Homosexual (Gay)

(12) Black (22) Catholic [_] (3) Other Ethnicity [_](42) Female Homosexual (Lesbian)
-— (13) American Indian / (23) Protestant . [_](43) Homosexual (Gay and Lesbian)
L_I Alaskan Native (24) Islamic (Muslim) SSE) [_](44) Heterosexual

(14) Asian / Pacific Islander (25) Other Religion [_] G1) Physical Disability [_](45) Bisexual

[_](15) Multi-Racial Group [_](26) Multi-Religious Group [_] (2) Mental Disability
[_](27) Atheist/A gnostic

Page 6 of 6


summary: Officers made contact with a juvenile victim who reported that they had been beaten up by two peers.

raw_content:
Report Contains Juvenile Information
INCIDENT NUMBER 2023-123176 JUVENILE INFORMATION Report generated: 10/23/2023 4:25 AM
Redact Before Release
NARRATIVE
OFFICERS WERE AT THE LISTED LOCATION FOR A PRIOR CALL (SEE INCIDENT 2023-123087) AND WERE ADVISED
BY COMMUNICATIONS THAT THEY HAD AN OPEN LINE DISTURBANCE AT THE LOCATION WHILE OFFICERS WERE
STILL ON SCENE. OFFICERS MADE CONTACT WITH THE CALLER, , WHO ADVISED THAT SHE HAD
SOME OF THE JUVENILES AT THE LOCATION FIGHTING. OFFICERS MADE CONTACT WITH JUVVIC1 AND WERE
ADVISED THAT THEY HAD BEEN BEATEN UP BY JUVSUS1 AND JUVSUS2. OFFICERS WERE ADVISED BY THE STAFF
THAT BOTH THE JUVSUS'S HAD TAKEN A WRISTBAND FROM A STAFF MEMBER THAT ALLOWED THEM TO UNLOCK
DOORS AND PROCEEDED TO ENTER THE DORM OF JUVVIC1 AND ASSAULTED THEM. OFFICERS OBSERVED A
LARGE BRUISE ON JUVVIC1'S FOREHEAD AND SCRATCHES ON THEIR NECK. JUVVIC1 REFUSED MEDICAL ON
SCENE. OFFICERS MADE CONTACT WITH JUVSUS1 AND WERE ADVISED THAT THEY REQUESTED MEMS TO THE
SCENE FOR A NECK INJURY. OFFICERS WERE ADVISED BY MEMS THAT THEY WOULD BE TRANSPORTING JUVSUS1
TO CHILDREN'S HOSPITAL FOR THEIR NECK INJURY. OFFICERS MADE CONTACT WITH JUVSUS2 AND GATHERED
THEIR INFORMATION. OFFICERS WERE ADVISED BY THE STAFF THAT THEY WOULD NOT BE SEEKING LEGAL
ACTION FOR THE JUVENILE'S ACTIONS. MVR AND BODY CAMERAS IN USE.
Page 8 of 9


summary: Officers responded to the facility for a disturbance call. Upon arrival, a resident advised that she wanted to harm herself, because she was tired of all the rules. Staff advised officers that the resident made several attempts to cut her wrist with a plastic object but was unsuccessful.

raw_content:
INCIDENT NUMBER 2023-122954 JUVENILE INFORMATION Report generated: 10/22/2023 10:01 PM
NARRATIVE
OFFICERS WERE DISPATCHED TO THE LISTED LOCATION IN REFERENCE TO DISTURBANCE CALL. CONTACT 1
ADVISED A STAFF MEMBER MADE HER MAD WHICH LED TO WANTING TO CAUSE HARM TO HERSELF
BECAUSE SHE WAS TIRED OF ALL THE RULES AND STAFF CHANGING THE RULES. STAFF ADVISED OFFICERS
CONTACT 1 HAD MADE SEVERAL ATTEMPTS TO CUT HER WRIST WITH A PLASTIC OBJECT BUT WAS
UNSUCCESSFUL.
CONTACT 1 STATED SEVERAL TIMES SHE WANTED TO KILL HERSELF SHE NO LONGER WANTED TO BE ALIVE. THE
FACILITY NURSE WAS ON SCENE AND MEDICALLY ASSESSED AND CLEARED CONTACT 1.
WHILE OFFICERS WERE GAINING CONTROL OF THE SITUATION ANOTHER STUDENT CONTACT 2 APPROACHED
OFFICERS AND TOOK AN AGGRESSIVE STANCE TOWARD OFFICERS ROGERS WAS CUSSING AND REFUSING TO
LISTEN TO VERBAL COMMANDS GIVEN BY OFFICERS. OFFICERS DETAINED CONTACT 2 AND PLACED HER IN A
PATROL UNIT.
UPON REMOVING CONTACT 2 FROM THE UNIT OFFICERS OBSERVED THE WIRES FROM THE REAR FACING
CAMERA HAD BEEN PULLED LOOSE AND WERE HANGING DOWN.
NO FURTHER POLICE ACTION REQUIRED
MVR/BWC IN USE.
Page 5 of 6


summary: Officers responded to the facility for a battery report. Upon arrival, a staff member advised officers that she wanted help escorting the residents back to their rooms.

raw_content:
LITTLE ROCK POLICE DEPARTMENT INCIDENT REPORT

[_]JUVENILE INFORMATION

INCIDENT

Report generated: 10/22/2023 9:49 PM

INCIDENT NUMBER

2023-123087

UNIT ASSIGNED

2X54

CALL DATE

CALL TIME

10/22/2023

19:25:00

TYPE OF CALL

BATTERY

INCIDENT DATE

LOCATION OF INCIDENT (ADDRESS / BUSINESS NAME)

10/22/2023 7:25:14 PM

6501 W 12TH ST

OFFENSE

INCIDENT OFFENSE TYPE

[_]@) Drugs

VI Unknown

(N) Not Applicable /

TYPE OF CRIMINAL ACTIVITY:

(1®) Buying / Receiving
[_]@ Exploiting Children

[_](©) Cultivate / Manufacture / Publish
[_]©) Operating / Promoting / Assisting

[_]CE) Transport / Transmit / Import [_]@©) Using / Consuming

[_]®) Distributing / Selling

[_]@) Possessing / Concealing

OFFENSE STATUS
HHH
5H 6H 7H 4
GANG RELATED INFO:
[10 Juvenile Gang

[1@ Otter Gang
[_]@) None / Unknown

LOCATION CODE:

[](01) Air / Bus / Train Terminal
(02) Bank / Savings & Loan

(03) Bar / Night Club

(04) Church / Synagogue / Temple
[_](05) Commercial / Office Building
(06) Construction Site

(07) Convenience Store

(08) Department / Discount Store
(09) Drug Store / DR Office / Hospital
[_](10) Field / Woods

[_](11) Government / Public Building
(12) Grocery / Supermarket

(13) Highway / Road / Alley

(14) Hotel / Motel / Etc

[_](15) Jail / Penitentiary

[_](16) Lake / Waterway

[_]7 Liquor Store

[_](18) Parking Lot / Garage

[_](9) Rental / Storage Facility

(20) Residence / House

[_](21) Restaurant

[_](22) School / College

[_](23) Service / Gas Station

[_](24) Specialty Store (TV, Fur, Etc)
[_](25) Other / Unknown

[_]@7) Abandoned/Condemned Structure
[_]G8) Amusement Park

(39) Arena / Stadium / Fairgrounds
[_](40) ATM Separate from Bank
(41) Auto Dealership New / Used
[_](42) Camp / Campground

[_](44) Daycare Facility

[_ (45) Dock / Wharf / Freight Terminal
[_]@6) Farm Facility

[_](47) Gambling / Casino / Racetrack
[_]48) Industrial Site

[_](49) Military Installation

[_](60) Park / Playground

[_](1) Rest Area

[_] (52) School - College / University

[_] (53) School - Elementary / Secondary!
[_] 4) Shelter - Mission / Homeless
[_]©5) Shopping Mall

[_] ($6) Tribal Lands

[_](S7) Community Center

WEAPON FORCE:
(_]Q) Firearm (Unknown)
(_]@2) Handgun
(3) Rifle
[_]@4) Shotgun
[_] C5) Other Firearm

[_] 20) Knife / Cutting Instr (Axe, etc)

(FOR BURGLARY ONLY)

NUMBER OF PREMISES ENTERED

METHOD OF ENTRY:

C] @®) Forcible

[_]@) No Force

[_] G0) Biunt Object (Club, etc)
[_]G5) Motor Vehicle (as weapon)
[_] 0) Personal Weapons (hands, etc)

(on 11-15, an "A" denotes Automatic or Semi-Automatic)

[_ ](50) Poison
L_|(60) Explosives

(65) Fire / Incendiary Device
(70) Narcotics / Drugs /
Sleeping Pills

(85) Asphyxiation

(90) Other

(95) Unknown

(99) None

NOOO

NARCAN USED: | No

Yes

Other

ENTRY DATE REPORTING OFFICER ORIGINAL APPROVING SUPERVISOR .
10/23/2023 02:28:57 | JOSHUA THOMAS - CHAD GLOVER -{j MVR in use

LRPD Form 5501-01 Rev. RMS-2019-01-23

Page 1 of 4

INCIDENT NUMBER 2023-123087

[_] JUVENILE INFORMATION

Report generated: 10/22/2023 9:49 PM

OTHER PERSONS - PERSON REPORTING

NAME (Last, First, Middle)

6501 W 12TH ST LITTLE ROCK AR 72205

HOME PHONE:
5013528509

WORK PHONE:

MOBILE PHONE:

OTHER PHONE:

SEX: [_]@™) Male
[© Unk.

[V]©® Female

ETHNICITY: [_](DHispanic
[V](@N) Non-Hispanic [—](U) Unk.

RACE: [¥](W) White [_](B) Black [_]@ American Indian
(]@) Asian / Pacific Islander [_](U) Unknown

DATE OF BIRTH
05/08/1985

RES. STATUS:

[V7](®) Resident

[_]@) Nonresident [](U) Unknown

MENTALLY AFFLICTED?

LJ) Yes [VJQ)No [](U) Unk.

| OCCUPATION / EMPLOYER:

AGE:
Exact Age:
Range:

COMPLEXION:
L_](1) Light

(2) Medium
[_]@) Dark
(4) Acne
[_](5) Freckled
(6) Ruddy
(7) Other
(8) Unknown

HAIR LENGTH:

(Ja) Long
(2) Medium
[_]@) Short

(4) Bald(ng)
(5) Other
(6) Unknown

38

[_] @B) 7-364 Days Old

HAIR STYLE:
| ](01) Afro
[_](02) Wavy
[_]@03) Straight
[](04) Curly

(05) Braided
(06) Ponytail
(07) Military
(08) Processed
(09) Wig/Toupee
(10) Other
(11) Unknown

(1) Light

(2) Medium
(3) Heavy
(4) Muscular
L_](5) Unknown

(NN) Under 24 Hrs. Old [/] (99) Over 98 Years Old

(NB) 1-6 Days Old [_] 0) Unknown

HAIR COLOR:
[_]q) Black
[_](2) Blonde
[_]@) Brown
[_](4) Grey
[_|(5) Red
L_]@ Sandy
[_](7) Other
[_](8) Unknown

EYE COLOR:

[_]() Blue

[ ]@) Brown
[_]@) Grey
[_](4) Green
[_](5) Hazel
[_]© Other
[_](7) Unknown

DL. / ID No. (STATE) WEIGHT:
Lbs

FACAIL HAIR:

C] (01) Clean Shaven
[| (02) Unshaven
[_](03) Full Beard
[_] (04) Must. (hvy)
[_]@5) Must. (thin)
[_] (06) Brows (hvy)
[_] 7) Brows (thin)
[__](08) Side Burns
[_](09) Goatee
[_](10) Other
[_](11) Unknown

DEMEANOR:

[_](01) Angry
[_](02) Apologetic
[_](@3) Calm
[__](04) Irrational
[_](5) Nervous

[_] (06) Polite
[_](07) Professional
[_]@8) Stupor
[__](09) Violent

[_] (0) Drunk / High
[_](11) Other
[_](12) Unknown

CLOTHING DESCRIPTION

SCAR / MARK:

[_]@1) Head
[_](02) Neck

[_] (03) Hand (xt)
[_] (04) Hand (if)
[_] 5) Arm (rt)
[_] (06) Arm (ift)
[_] 7) Body

[_] 8) Leg (xt)
[_] (09) Leg (aft)
[_] (10) Other
[_](11) None
[_](2) Unknown

TATTOO:

[_](1) Designs
[_](2) Initials
[_]G) Names
[_](4) Pictures
[_](5) Words
[_]@ Numbers
[_](7) Insignia
[_|(8) None

[| (9) Unknown

TATTOO LOC:

[_] 01) Am (ft)
[_] 02) Arm (1)
[_](03) Leg (ft)
[_] 04) Leg (1)
[_] (05) Hand (ft)
[_] (06) Hand (rt)
[_](07) Face
[_](8) Neck

[_] (09) Finger(s)
[_](10) Chest
[_](11) Back

Page 2 of 4

INCIDENT NUMBER 2023-123087 JUVENILE INFORMATION

Report generated: 10/22/2023 9:49 PM

NARRATIVE

OFFICERS WERE DISPATCHED TO THE LISTED LOCATION FOR A BATTERY REPORT. UPON ARRIVAL OFFICERS
MADE CONTACT WITH WANTED OFFICERS TO HELP ESCORT THEIR RESIDENTS

BACK TO THEIR ROOMS. DID NOT WANT TO MAKE A REPORT, BUT JUST WANTED
OFFICERS TO ASSIST. N ICE ACTION WAS TAKEN. BWC WAS IN USE.

Page 3 of 4

INCIDENT NUMBER 2023-123087 [_]JUVENILE INFORMATION Report generated: 10/22/2023 9:49 PM

ADDITIONAL HOMICIDE CIRCUMSTANCES (Chinn Sih bcl's alien [J Criminal resisted arrest
[_](A) Criminal attacked police officer, that officer killed criminal [_]@) Criminal attempted flight from a crime [© Unable to determine /
[_]@) Criminal attacked police officer, criminal killed by other officer [_]) Criminal killed in commission of a crime not enough information

RELATED CASE NUMBER(S)

CAR JACKING? [_]YES [V]NO DRIVE-BY? [_]YES [V|NO GANG RELATED? [_]YES [V|NO

HATE/BIAS RELATIONSHIP: [V](88)None [_] YES, SEE BELOW
RACIAL (Anti-) RELIGIOUS (Anti-) ETHNICITY / NATIONAL ORIGIN (Anti-) SEXUAL (Anti-)

(11) White (21) Jewish [_] G2) Hispanic [_](41) Male Homosexual (Gay)

(12) Black (22) Catholic [_] (3) Other Ethnicity [_](42) Female Homosexual (Lesbian)
-— (13) American Indian / (23) Protestant . [_](43) Homosexual (Gay and Lesbian)
LI Alaskan Native (24) Islamic (Muslim) SSE) [_](44) Heterosexual

(14) Asian / Pacific Islander (25) Other Religion [_](51) Physical Disability [_](45) Bisexual

[_](15) Multi-Racial Group [__](26) Multi-Religious Group [__] (52) Mental Disability
[_](27) Atheist/A gnostic

Page 4 of 4


summary: A resident was transported for acute care after exhibiting destructive and assaultive behaviors.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 10/22/2023
Date Received by DCCECE: 10/23/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On October 22, 2023, client ( DOB: ) was
transported to Acute (Pinnacle) for unsafe behavior. Client displayed behaviors such as
property destruction and assaultive behaviors during staff interventions. DHS is the
guardian of the client and was notified of the transfer.
Interim Action Narrative: Resident was transported to acute care.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. 10/30/2023, Licensing Specialist followed-up with facility to see if resident has
returned. Licensing Specialist informed that resident has not returned to the facility.
11/1/2023, facility informed Licensing Specialist that resident returned to the facility.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was transported to Arkansas Children’s Hospital after she was kicked in the back of the head by a peer.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 10/22/2023
Date Received by DCCECE: 10/23/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On October 22, 2023 client DOB:
stated that she was kicked in the back of the head by another client.
stated that she felt her neck pop and became lightheaded.
was transported by EMS to Arkansas Childrens Hospital and was seen by Dr. Bailey. An x-
ray was taken of the spine and no abnormalities were found. was
transported back to the Centers by Centers staff. Discharge paperwork advised to take
as needed.
Interim Action Narrative: Resident was assessed by the nurse and sent to FCMC for an
assessment/x-ray. Residents were separated.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. Licensing Specialist will inquire about safety precautions for the residents and
resident's guardianship. 10/24/2023, Licensing Specialist informed of resident's guardian.
Residents were placed on separate dorms and do not have any contact in the classrooms.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident was transported to Arkansas Children’s Hospital after she began vomiting blood.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
R
Notice of Serious Incident
Case Number: 016965
Date of Incident: 10/20/2023
Date Received by DCCECE: 10/23/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On October 20, 2023, an incident occurred at Elizabeth Mitchell
Adolescent Center. Client, began vomiting blood.
was transported to Arkansas Childrens Hospital where she was seen by Dr.
Pushparajah. was diagnosed with acute gastritis. was released from
Arkansas Childrens Hospital and prescribed Famotidine, and sucralfate.
Interim Action Narrative: Resident was transported to ACH for an evaluation.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. Licensing Specialist will inquire about guardianship. 10/24/2023, Licensing
Specialist informed of guardianship.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: Licensing visited the facility to conduct a buildings and grounds walkthrough. No deficiencies cited.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203-1437
P: 501.508.8910 F: 501.683.6060 TDD: 501.682.1550

Elizabeth Mitchell Centers Kendra Rice
6501 W 12TH ST Donaghey Plaza
LITTLE ROCK AR 72204-1511 P.O. Box 1437

Little Rock, AR. 72203
Facility Visit Compliance Notice

Facility#: 157

Date of Visit: 10/18/2023

Visit Type(s): Subsequent Building and Grounds
Time: 12:15 AM - 1:18 PM

Visit Comment :
Time of visit: 12:15 pm to 1:15 pm
Census: 57

Licensing Specialist completed buildings and grounds on EMAC and EMCC. The following areas were
observed: grounds, dining room, administration hall, dorms, parking lot, classrooms, and courtyard.

Licensing Specialist was escorted by Ms. | fF Director of Residential.

Walking to the building, Licensing Specialist observed parked cars and vans on the parking lot. The lawn was
well maintained. The courtyard was free of debris. Ms. JJ informed Licensing Specialist of the last
tornado drill, 9/26/2023.

EMAC -— Classroom 1, ratio 3:8, Classroom 2, ratio 2:7, and Classroom 3, ratio 2:8. Licensing Specialist
observed the dorms: One, Two, Three, and Four. Dorm 2, ratio 1:1. All bedrooms observed were clean and
organized. Dorm 4 housekeeping were working during the walkthrough. Dorm 3, there was a speech therapy
session taking place, ratio 1:1.

Page 1 of 2

EMCC -— Residents were eating lunch when Licensing Specialist completed the walkthrough ratio 5:28.
Licensing Specialist observed a resident eating outside of the dining room with a staff member close by.
Licensing Specialist also observed residents coming from the bathroom and another resident entering. It
appeared that the residents were using the bathroom before returning to class.

Licensing Specialist observed the dorms at EMCC: North, South, East, and the New Dorm. All bedrooms and
bathrooms observed were clean and organized. Licensing Specialist observed housekeeping working on the
administration hall. Licensing Specialist observed the following documentation on the walls: weekend
schedule, emergency escape plan, client’s rights, and the zone of regulations.

Ms. RY informed Licensing Specialist of the Halloween festivities planned for the residents next week.

CCL Staff Signature : Date: 10/18/2023
M\\y K 7 ||
Provider Signature : Date: 10/18/2023
VV |Movnls

Your Signature indicates that this form has been reviewed with you; it does not imply your agreement with
it.

Right to Appeal: For more information on how to appeal these findings, refer to the minimum Licensing
Requirements or contact your Licensing Specialist.

Page 2 of 2


summary: A resident was transported for acute care after destroying property and exhibiting assaultive behaviors.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Date of Incident: 10/2/2023
Date Received by DCCECE: 10/3/2023
Facility Name: Elizabeth Mitchell Centers
Facility Number: 157
Incident Type: Licensing
Report Description: On October 1, 2023, client DOB: was
transported to Acute (Pinnacle) for unsafe behavior. Client displayed behaviors such as
property destruction and assaultive behaviors during staff interventions. DHS is the
guardian of the client and was notified of the transfer.
Interim Action Narrative: Resident was sent to acute care.
Maltreatment Narrative:
Licensing Narrative: Licensing Specialist reviewed provider reported incident for licensing
concerns. Facility received intent training on 10/2/2023 on reporting incidents. Licensing
Specialist will follow-up with facility to see if resident has returned. 10/9/2023, Licensing
Specialist followed-up with facility to see if resident has returned. Licensing Specialist
informed that resident has not returned to the facility. 10/10/2023, Licensing Specialist
informed that resident returned to the facility from acute care on yesterday (10/9/2023)
afternoon.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov