summary: Staff were made aware of an incident involving two residents. It was reported that one resident kissed the other without permission.

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: 1/27/2023
Date Received by DCCECE: 1/27/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type:
Incident Type: Dual
Report Description: call : # Allegation of Sexual Misconduct Residents
Name/DOB: - DOB: ? Victim - DOB: ?
Perpetrator Date/Time of incident: 01/25/2023, around 2115 Staff made aware by on
1/26 that on the previous night, made an unwelcomed romantic advance towards
her as evidenced by kissing. Residents known to be friendly. gave account of event on
1/26 to staff member. call made on 1/26, report not accepted. Reference #
Corrective Action Plan: processed with therapist on peer-to-peer boundaries,
reiterate no touching by residents to each other on the unit, residents room assignment
changed for safety. The Following persons notified: DHS (AR) Alicia Crihfield Cassie
Sowder, CEO Ana Salazar , DON Erin Duvall APRN Madeline Spence Clinical Director
Felicia.Harrris@dhs.arkansas.gov Kris Stewart & Reagan Stanford and Ashlyn Whelchel
Disability Rights of AR Chelsea Vardell and Kendra Rice DHS Rebecca Thomas Perimeter
Interim Action Narrative: Resident moved to different rooms to prevent further sexual
acting out behaviors. Therapist educated AO on boundaries and processed with both
residents regarding the incident.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Maltreatment Narrative: Staff made aware by on 1/26 that on the previous night,
made an unwelcomed romantic advance towards her as evidenced by kissing.
Residents known to be friendly. gave account of event on 1/26 to staff member.
Licensing Narrative: The residents have been moved to different rooms to prevent further
sexual acting out. There have been no other reported incidents since intervention has been
in place. call was screened out. 5/3/2023- call was not screened out but
overturned and accepted for investigation. The case has now been closed by the investigator
as unsubstantiated.


state: AR

facility_name: Perimeter Behavioral of the Ozarks

summary: A resident used their fingernails to self-harm.

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: 1/27/2023
Date Received by DCCECE: 1/31/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: o Name: , DOB: , Guardian: DHS
(TX) - notified o Incident: 01/27/23 approximately at 0745 o Precaution safety plan: Self-
Harm, Constant LOS o Police were called: N/A o On 1/27/23 @ approximately 0745,
resident was seen using their fingernails to create scratch on inner forearm. Resident was
intervened by staff and taken out to nurses' station where RN noted a new abrasion on inner
left forearm. Area was cleaned and covered; no first aid required. Resident to be on self-
harm precautions with constant line of sight for the next 7 days as a result of this event.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 2/1/23- Program Coordinator spoke to the CEO, Cassie Sowder, and
discussed why the incident was reported late to the licensing unit per the current Corrective
Action Agreement. The CEO reported that a floor nurse quit without notice so the ADON,
who typically reports incidents, had to work the floor and was unable to report the incident
in a timely manner. The Program Coordinator informed the CEO that licensing will be
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

issuing a technical assistance for 109.1.f for all six incidents reported to us on 1/31/23 but
moving forward any reports that do not meet the requirements of the corrective action
agreement will be cited. Inspection # 058831 02/03/2023-- Specialist Sutton completed a
buildings and grounds visit. Resident was within LOS of staff at time of visit. There is a
standing order in place to cut and trim the nails of all residents as needed, and staff are
monitoring this. No additional licensing follow up required at this time.

doc_type: Notice of 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: 1/27/2023
Date Received by DCCECE: 1/31/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: o Name: , DOB: , Guardian: DHS (MT) -
notified o Incident: 01/27/23 approximately at 0745 o Precaution safety plan: Self-Harm,
Constant LOS o Police were called: N/A o On 1/27/23 @ approximately 0745, resident was
seen using their fingernails to reopen scabs on their forearms and hands. Resident was very
overstimulated and taken off unit to comfort room where she was able to process with staff
and prevent further injury. Resident took AM meds and RN cleaned and covered reopened
wounds on forearms and hands. No new injuries sustained, no first aid required. Resident
continues to remain on current self-harm precaution safety plan with constant line of sight
until safe behavior is observed.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 2/1/23- Program Coordinator spoke to the CEO, Cassie Sowder, and
discussed why the incident was reported late to the licensing unit per the current Corrective
Action Agreement. The CEO reported that a floor nurse quit without notice so the ADON,
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

who typically reports incidents, had to work the floor and was unable to report the incident
in a timely manner. The Program Coordinator informed the CEO that licensing will be
issuing a technical assistance for 109.1.f for all six incidents reported to us on 1/31/23 but
moving forward any reports that do not meet the requirements of the corrective action
agreement will be cited. Inspection # 058831 02/03/2023--Licensing visit completed by
specialist Sutton. Resident was discharged to a more appropriate level of care due to the
severity of her 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: 1/27/2023
Date Received by DCCECE: 1/31/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: o Name: , DOB: , Guardian:
- notified o Incident: 01/27/23 approximately at 0900 o Precaution safety plan: Self-
Harm, Constant LOS o Police were called: N/A o On 1/27/23 @ approximately 0900, AR
asked RN to cover an abrasion on their left forearm. Resident admitted to using their
fingernails to create the abrasion. The area was cleaned and covered at the nurse?s station;
no first aid required. The resident will be placed on self-harm precautions with constant line
of sight for the next 7 days.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 2/1/23- Program Coordinator spoke to the CEO, Cassie Sowder, and
discussed why the incident was reported late to the licensing unit per the current Corrective
Action Agreement. The CEO reported that a floor nurse quit without notice so the ADON,
who typically reports incidents, had to work the floor and was unable to report the incident
in a timely manner. The Program Coordinator informed the CEO that licensing will be
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

issuing a technical assistance for 109.1.f for all six incidents reported to us on 1/31/23 but
moving forward any reports that do not meet the requirements of the corrective action
agreement will be cited. Inspection # 058831 02/03/2023 Licensing specialist Sutton
completed a buildings and grounds visit this date. Resident was within LOS of staff at time
of visit. Standing order to cut and trim fingernails as needed. No additional licensing follow
up required at this time.


summary: A resident self-harmed with their fingernails.

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: 1/27/2023
Date Received by DCCECE: 1/31/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: , DOB 6, Guardian: DHS (MT) - notified
o Incident: 01/27/23 approximately at 1619 o Precaution safety plan: Self-Harm o Police
were called: N/A o On 1/27/23 at approximately 1619, RN responded to unit where was
dysregulated and using their fingernails to self-harm on their hands and forearms. Staff
attempted to use verbal de-escalation and blocking techniques but were unsuccessful. A
brief physical hold was initiated per provider?s orders to prevent further self-injury.
Afterwards, RN assessed for injury and noted a new abrasion on their left forearm created
by fingernails. RN cleaned and covered the wound at the nurse?s station; no first aid
required. The resident will continue to be on their self-harm precaution safety plan with
constant line of sight until safe behavior is observed.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 2/1/23- Program Coordinator spoke to the CEO, Cassie Sowder, and
discussed why the incident was reported late to the licensing unit per the current Corrective
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Action Agreement. The CEO reported that a floor nurse quit without notice so the ADON,
who typically reports incidents, had to work the floor and was unable to report the incident
in a timely manner. The Program Coordinator informed the CEO that licensing will be
issuing a technical assistance for 109.1.f for all six incidents reported to us on 1/31/23 but
moving forward any reports that do not meet the requirements of the corrective action
agreement will be cited. Inspection # 058831 02/03/2023 Licensing specialist Sutton
completed a buildings and grounds. This resident has been discharged due to a more
appropriate setting due to the severity of her self-harm behaviors.


summary: A resident used her fingernails to self-harm.

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: 1/26/2023
Date Received by DCCECE: 1/27/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: o Name: , DOB , Guardian: DHS (TX) -
notified o Incident: 01/26/23 approximately at 1617 o Precaution safety plan: Self-Harm,
Constant LOS o Police were called: N/A o On 1/26/23 at approximately 1617, became
dysregulated on the unit and began using fingernails in an attempt to self-harm on forearm.
Staff attempts with verbal de-escalation and blocking for safety were unsuccessful. Resident
was escalating and began hitting themselves in the head and attempted to hit head on the
walls. A brief physical hold was initiated to maintain safety and prevent further self-injury.
Therapist was retrieved to assist in therapeutic communication with resident. Resident was
released from hold when calmed and safe behaviors exhibited. Resident was taken to
nurses' station where reopened scab on left forearm was cleaned and covered, no first aid
required. Resident placed on a self-harm precaution safety plan with constant line of sight
for 7 days as a result of this event.
Interim Action Narrative:
Maltreatment Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: 02/3/23--Licensing specialist Sutton completed a buildings and
grounds visit at facility. Resident was observed within LOS of staff in the hallway. She
has processed with therapist about this incident. Standing order to cut and trim resident's
fingernails as needed. CEO stated that facility is in the process of educating staff about
different de-escalation interventions and is continuing to work on programmatic changes to
keep residents engaged during the day.


summary: A resident used a piece of rubber off a composition notebook to self-harm.

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: 1/26/2023
Date Received by DCCECE: 1/30/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: o Name: , DOB: , Guardian: DHS (AR) -
notified o Incident: 01/26/23 approximately at 1800 o Precaution safety plan: Self-Harm,
Constant LOS o Police were called: N/A o On 1/26/23 at approximately 1800, staff reported
to event where was using a small piece of rubber that they ripped off their
composition notebook, rubbing the piece on her forearm in an attempt to self-harm.
Resident initially refused to give item to staff, but RN was able to retrieve item. Resident
was taken to nurses' station, 3 scabs noted to be opened up on left forearm from previous
self-harm events. Left forearm was cleaned and covered, no first aid required. Resident
placed on a self-harm precaution safety plan with constant line of sight for 7 days as a result
of this event.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Licensing specialist completed a buildings and grounds visit this date.
Resident was in line in the hallway within LOS of staff. Facility reported that resident
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

disclosed that she has been collecting and hiding contraband in the narrow gap between her
bedframe and the wall of her room and using a folder to retrieve items. The bed is bolted to
the floor and does not move, and the gap is too narrow to fit a hand inside. Staff used a rod
to remove contraband from this area and placed resident on a signed, individualized safety
contract that lists the following interventions: regular room searches, 1:1 when in the
classroom (source of most contraband items), "chicken fingers" when upset, grounding
activities with staff assist, and incentives for safe behavior.


raw_content:
AR KAN S A S&S
DEPARTMENT OF

4 HUMAN
<a\ SERVICES

Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot $140, Little Rock, AR 72203-1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550

Notice of Serious Incident

Date of Incident: 1/26/2023

Date Received by DCCECE: 1/27/2023

Facility Name: Perimeter of the Ozarks
Facility Number: 237

Facility Type: Residential

Incident Type: Licensing

Report Description: o Name: a: DOB gammy. Guardian:

- notified o Incident: 01/26/23 approximately at 1130 o Precaution safety plan: Self-Harm,
Constant LOS o Police were called: N/A o On 1/26/23 at approximately 1130, | was seen
at the end of the hallway on the unit picking at their left hand and wrist with their
fingernails. RN responded andj stated she was triggered by a peer attempting to self-
harm. Resident was taken to nurses' station where left hand and wrist were cleaned and
covered, no first aid required. Resident placed on a self-harm precaution safety plan with
constant line of sight for 7 days as a result of this event.

Interim Action Narrative:

Maltreatment Narrative:

Licensing Narrative: Licensing specialist Sutton completed a buildings and grounds visit
today. Resident was observed within LOS of staff (precautions end today). There is a
standing order to cut and trim nails as needed.

We Care. We Act. We Change Lives.
humanservices.arkansas.gov


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: 1/26/2023
Date Received by DCCECE: 1/31/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: o Name: , DOB: , Guardian: -
notified o Incident: 01/26/23 approximately at 1400 o Precaution safety plan: Self-Harm,
Constant LOS o Police were called: N/A o On 1/26/23 at approximately 1400, told RN
?I found a new way to self-harm?. Resident continued to explain that when they snap their
fingers close to their forearm and their middle finger will hit their forearm with enough force
at the right angle that the fingernail will make a scratch. RN assessed for injury and notes 2
superficial scratch to the resident?s upper left forearm. The area was cleaned and covered at
the nurse?s station. The resident will be on self-harm precautions with increased line of
sight for the next 7 days as a result of this event.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 2/1/23- Program Coordinator spoke to the CEO, Cassie Sowder, and
discussed why the incident was reported late to the licensing unit per the current Corrective
Action Agreement. The CEO reported that a floor nurse quit without notice so the ADON,
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

who typically reports incidents, had to work the floor and was unable to report the incident
in a timely manner. The Program Coordinator informed the CEO that licensing will be
issuing a technical assistance for 109.1.f for all six incidents reported to us on 1/31/23 but
moving forward any reports that do not meet the requirements of the corrective action
agreement will be cited. Inspection # 058831 02/03/23 Licensing specialist completed a
buildings and grounds visit this date. Resident was observed within LOS of staff at time of
visit. Standing order to cut and trim fingernails as needed. No additional licensing follow up
required at this time.


summary: The Corrective Action Agreement dated 6/9/2022 was extended for a minimum of 6 months due to additional support needed.

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
Corrective Action Agreement
Date: June 9, 2022
Update: January 25, 2023
To: Art Hickman
Owner Name: Woodridge Northwest, LLC
Facility Name: Perimeter Behavioral of the Ozarks
License #: 237
Mr. Hickman,
This document constitutes a formal Corrective Action Agreement (CAA) agreed upon by
Perimeter Behavioral of the Ozarks and the Department of Human Services, Division of Child
Care and Early Childhood Education, Placement and Residential Licensing Unit. This CAA will be
in effect for a minimum of six months (07/25/2023) from the date of signing by all parties. This
agreement may be extended beyond six months should DHS determine any non-compliance
with the CAA during the stated corrective action period.
UPDATE: Additional support is needed, therefore, CAA agreed upon on 6/9/2022 will be
extended for a minimum of six month up to one year.
The purpose of this agreement is to gain and maintain a high degree of compliance with
licensing requirements. The following non-compliance areas have been cited during the past six
months:
Minimum Licensing Standards (Residential): Section 103 Central Registry and Criminal
Records Checks
Perimeter Behavioral of the Ozarks has received citations on the following dates regarding
the staff Central Registry and Criminal Record Checks.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

103.8 Child Maltreatment Central Registry Checks and Arkansas State Police/FBI Criminal
Record Checks shall be initiated within ten (10) days of employment.
12/14/2022-
o
 Personnel record review revealed that 7 out of 8 personnel records
reviewed did not have all their regulatory checks conducted within ten
days of hire. The HR Director reports that multiple staff have been found
to have not had all required checks. The HR Director recently began work
at the facility and will keep the Licensing Unit updated on the status of all
staff still pending regulatory checks.
103.11 No person guilty of an excluded criminal offense pursuant to A.C.A. §9-28-409 shall be
permitted to have direct and unsupervised contact with children, except as provided in the
statute.
• Perimeter Behavioral of the Ozarks was cited on the following dates for allowing a
staff to work with prohibited charges.
6/9/2022-
o
 Staff was allowed to continue to work after the Agency was informed
that had a hit on the regulatory check.
UPDATE
Since the initiation of the CAA (June 2022), the facility was cited on the following date in
reference to noncompliance with section 103 Central Registry and Criminal Record Checks:
• 10/3/2022-A staff member was involved in an incident with a resident, did not have the
required regulatory checks completed as required by the Minimum Licensing Standards.
Minimum Licensing Standards (Residential): Section 910 – Grounds
• Perimeter Behavioral of the Ozarks was cited on the following dates regarding the
facility grounds.
910.1 The grounds of the facility shall be kept clean and free of safety hazards.
6/3/2022-
o
 Dayrooms and bedrooms were seen with trash on the floors.

 Facility cited a second time for 910.1 regarding an incident that occurred
on 5/31/22 in which a resident obtained glass and cut herself requiring
stitches to close the wound.
UPDATE
Since the initiation of the CAA (June 2022), the facility was cited the following on the date in
reference to noncompliance with section 910 Grounds:
• 12/29/2022- A resident obtained a razor from the makeup bag of a staff member who
had brought in makeup for the residents and used it to self-harm.
Minimum Licensing Standards (Residential): Section 911 - Buildings
Perimeter Behavioral of the Ozarks was cited on the following dates regarding the facility
buildings.
911.6 All buildings and furnishings shall be safe, clean, and in good repair.
3/1/2022-
o
 Several bedrooms were seen in disarray. Rooms had clothes laying on the
floor, drink containers, and multiple empty food wrappers.
3/8/2022-
o
 Dayroom and bedrooms on the blue unit were messy with debris and
used food wrappers on the floors. The orange unit was also seen in
disarray. Multiple Amazon boxes were found in the rooms and staff
report the girls use them as storage or trash cans. Profanity was seen on
the ceiling and trim was peeling from the wall in the dayroom of the
green unit. Water damage from a previous roof leak is being covered with
a board. Showers were seen to have missing tiles. Specialist discussed
how the tiles have had an order to be repaired for nearly one year. The
dining room area was seen to have a baseboard trim falling off the wall
and it was noted that the wall behind the trim was rotted out.
o
3/16/2022-
 Blue Hall had a dirty pile of towels on the floor in the walkway. Outlet on
the wall was missing its cover.
4/13/2022-
o

 Outlet cover was broken off in the hallway of the blue unit. Mold was
visible in the ceiling of the shower in room 303.
5/10/2022-
o
 Specialist viewed shower basins that have pulled up tiles which could be
used to cut or cause harm to residents.
 Facility cited a second time for 911.6 due to a resident cutting herself
with broken tile removed from a shower stall on 5/8/2022 requiring
seven stitches to her arm.
6/8/2022-
o
 Resident used shower tile to reopen a previously stitched wound on her
arm while in the shower using a tile from the shower.
911.15.f Areas used by children shall be designed, constructed, and furnished to reduce risk
of suicide and assault including, but not limited to: (f) Children’s personal items that contain
cords, pull-ties, strings, or other parts that could be used to inflict self-injury shall not be left
in the child’s room unless the dangerous component has been removed
3/1/2022-
o
 A ripped-up clothing item was found in a bedroom that had been cut into
a long strip that could be used as a ligature.
UPDATE
Since the initiation of the CAA (June 2022), the facility was cited the following dates in
reference to noncompliance with Section 911 Buildings:
• 7/20/2022- Ligatures were found in rooms 301, 302, and 303.
• 11/17/2022- A complaint from a resident revealed that the showers on the unit were
not draining properly causing them to flood. A Licensing Specialist turned on in a shower
and determined to not be draining properly. The resident complained of mold in the
dayroom and a black substance was found in the skylight on the blue unit. The resident
complained of an outlet with exposed wires and a screw in it behind a chair on the
orange unit, which was observed by the licensing specialist.
• 12/29/2022- Facility cited for 911.6 for loose outlet covers in the cafeteria, a protruding
screw in the window of a resident’s bedroom, and a broken light switch cover which was
used to self-harm by a resident.
• 1/19/2022- A resident used a broken sink countertop piece in her bedroom to create a
wound on her arm. This resident was already on “line of sight” self-harm precautions
and the Specialist requested this counter be fixed during a monitor visit on 1/9/23.

Minimum Licensing Standards (Residential): Section 912- Bathrooms
Perimeter Behavioral of the Ozarks has received citations on the following dates regarding
the conditions of the resident’s bathrooms.
912.4- The bathroom shall be clean and sanitary.
3/1/2022-
o
 Several bathrooms were seen in poor conditions. Bathrooms had hair in
the sinks, discarded toilet paper on the floors and on the back of toilets.
Two toilets in rooms 204 and 301 were visibly clogged with feces. Room
301 toilet was overflowing onto the floor. The toilet in room 303 was
seen to have a small leak around the base of the toilet with standing
water on the floor.
3/8/2022-
o
 Bathrooms in the bedrooms were seen in poor condition with toilet
paper on the floor, a used tampon on the back of a toilet, and hair on the
sinks. The toilet in room 105 was clogged and there was visible mold seen
in the bottom of the shower in room 305.
3/16/2022-
o
 Trash was seen on the floor of the restroom in room 103.
5/10/2022-
o
 Paper trash sacks are being used as garbage receptacles in bathrooms.
Some of these trash sacks were seen to be overflowing onto the floors of
the bathrooms.
UPDATE
Since the initiation of the CAA (June 2022), the facility was cited the following date in reference
to noncompliance Section 912 Bathrooms:
• 7/20/2022- Bathroom by seclusion room was dirty.
Minimum Licensing Standards (Residential): Section 907 Ratio and Supervision

Perimeter Behavioral of the Ozarks has received citations on the following dates regarding
ratio and supervision concerns.
907.2- Child caring staff shall be responsible for providing the level of supervision, care, and
treatment necessary to ensure the safety and well-being of each child at the facility, taking
into account the child’s age, individual differences and abilities, surrounding circumstances,
hazards and risks.
3/1/2022-
o
 Two staff failed to provide the level of care necessary to ensure the
safety and well-being of a resident while she was being attacked by
several peers on 2/27/2022.
4/13/2022-
o
 Camera review of an incident showed two residents left alone in a calm
down room in which one resident took off her pants. The staff could be
seen in the main room outside of the calm down room on his cellphone.
907.3 Staff/child ratio shall be at least 1:6 during waking hours and 1:8 during sleeping hours.
4/13/2022-
o
 Staff was seen out of ratio on the blue unit ten residents to one staff.
Staff reported that no other staff was scheduled on the unit for the day
and one staff is “always” assigned to the unit.
 Staff was seen out of ratio on the green unit nine residents to one staff.
Staff reported that no other staff was scheduled to the unit due to the
facility being short staffed.
6/3/2022-
o
 A unit was seen out of ratio fourteen residents to two staff. Staff
reported that there were only two scheduled for this unit, but they have
a floater working who comes in if they need help.
UPDATE
Since the initiation of the CAA (June 2022), the facility was cited on the following dates in
reference to noncompliance with Section 907 Ratio and Supervision:
• 6/22/2022- Staff viewed out of ratio with residents on the Green Unit one staff and
eight residents.

• 10/3/2022- Staff viewed out of ratio with residents on the Green Unit one staff and ten
residents.
• 11/3/2022- The facility was cited for staffs’ failure to provide adequate supervision to a
resident who accessed a broom on the unit, took it to another resident’s room and used
it to damage a fire sprinkler causing the fire alarm to sound. The residents then left their
assigned units to fight staff and elope from the facility. The police were called to the
scene after staff called stating a riot had occurred and for the department to send
“everyone they have.” Multiple law enforcement officers and medical personnel
responded to the scene to assist. Four residents and one staff had to be taken for
emergency medical treatment.
• 11/23/2022- The facility was cited for staffs’ failure to adequately supervise two
residents during a trip to the emergency room department. It was reported that during
the trip to the emergency room on 11/21/22, a male staff member allowed the two
female residents to vape. The contents of the vape are unknown as it was never
recovered after a search of the facility grounds.
• 12/29/2022- The facility was cited for lack of staff supervision when a resident obtained
a razor from a staff makeup bag and used it to self-harm.
• 12/29/2022- The facility was cited for lack of staff supervision when a resident obtained
a staff key and used it to self-harm.
• 1/19/2023- The facility cited for lack of staff supervision after a resident on “line of
sight” self-harm precautions was able to use a broken sink countertop piece in her
bedroom to self-harm. The Licensing Specialist had addressed this broken sink with the
facility during a monitor visit on 1/9/2023. The resident self-harmed with it on
1/16/2023.
In addition to the non-compliance of the Minimum Licensing Standards listed above, new
areas of non-compliance have also developed through the course of the current Corrective
Action Agreement including the following:
Minimum Licensing Standards (Residential): Section 109 Unprofessional Conduct
Perimeter Behavioral of the Ozarks has received citations on the following dates regarding
unprofessional conduct.
109.1.f- Failing to comply with any stipulation or agreement with the board involving
probation or a settlement of any disciplinary matters.
12/27/2022-
o
 Five incidents viewed in the incident log the previous week were
determined to have not been reported to the licensing unit as per the
Corrective Action Agreement. The facility was cited five times for 109.1.f

110.12- The agency shall notify the Licensing Unit by the next business day when a report of
child maltreatment is accepted by the child abuse hotline against the owner, operator,
employee, foster parent, volunteer, child, or other person in a child welfare agency.
8/12/2022-
o
 The facility cited after they failed to
call to the Licensing Unit by the next business day.
8/16/2022-
o
 The facility cited after they failed to
call to the Licensing Unit by the next business day.
10/5/2022-
o
 The facility cited after they failed to report the acceptance of a
call to the Licensing Unit by the next business day.
110.14- The agency shall take steps to prevent harm or retaliation against the child while an
allegation of child maltreatment is being investigated.
6/20/2022-
o
 The facility cited after a staff member verbally retaliated against a
resident in front of other residents and staff regarding the resident’s
110.17- The agency shall notify the Licensing Unit by the next business day of serious injuries
requiring emergency medical treatment, agency vehicle accidents, arrests, elopements,
suicide attempts, or deaths and maintain documentation of the incident and notification.
8/12/2022-
o
 Agency failed to report the arrest of a resident by the next business day.
10/7/2022-
o
 The facility cited after they failed to report the attempted suicide of a
resident to the Licensing Unit by the next business day.
The agency was required to complete the following in the previous Correction Action
Agreement dated June 2022.
• Perimeter Behavioral Health of the Ozarks shall send documentation to the Licensing
Unit that all current staff have received all required regulatory checks in accordance
with the Minimum Licensing Standards. ( The Agency ensured that a backlog of staff
Regulatory checks were submitted incorrectly was cleared). Additionally, notification

of any new staff hired, during the course of this Corrective Action Agreement, shall be
sent to the Licensing Unit upon their hire with proof of their regulatory checks being
initiated. (Required as a part of the new CAA).
• The Agency’s facility management shall continue to conduct a minimum of once per
week walkthroughs of the agency to determine what repairs need immediate attention.
These repairs shall be documented and sent to the Licensing unit monthly.
(Walkthroughs were verbally communicated of completion, incidents have continued
to occur. Documentation will be required as a part of the new CAA).
• The Agency shall continue their Emergency Safety Procedures provided to the Licensing
Unit on 6/7/2022 regarding the use of showers at the facility until all repairs are made
to the bathrooms to ensure the safety of all residents. All staff should be trained on the
new Emergency Safety Procedure immediately and a list of all staff trained shall be
provided to the Licensing Unit by 6/24/2022. (Completed)
• In addition to all required incident reporting, the agency shall report all cases of self-
harm by residents to the Licensing Unit by the next business day for the duration of this
Corrective Action Agreement. (In compliance)
• The Licensing Unit will provide intent training to the facility regarding the 900 Section of
the Minimum Licensing Standards. All facility staff shall be required to attend and a sign
in sheet will be provided to the Licensing Unit. (Completed. In addition, the Licensing
Unit also provided Intent Training on sections 107, 108, 109, 110, and a second
training on the 900 Section of the Minimum Licensing standards on 12/20/22 and
12/21/22).
The Perimeter Behavioral Health of the Ozarks is now required to complete the following
revised corrective actions:
• By the last business day of every month, the facility shall send notification to the
Licensing Unit of any new staff hired that month for the course of this Corrective Action
Agreement. (Amended from previous CAA).
• Perimeter Behavioral Health of the Ozarks management shall continue to conduct a
minimum of once per week walkthroughs of the agency to ensure compliance with the
Minimum Licensing Standards. These walkthroughs shall be documented and provided
to Licensing upon request. (Amended from previous CAA).
• In addition to all required incident reporting, the agency shall report all cases of self-
harm by residents to the Licensing Unit by the next business day for the duration of this
Corrective Action Agreement.
• Perimeter Behavioral Health of the Ozarks shall ensure that any new staff submitting
regulatory checks receives training from the DCCECE Regulatory Check Unit.

doc_type: Corrective Action Agreement


summary: A resident self-harmed with her fingernails.

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: 1/25/2023
Date Received by DCCECE: 1/26/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: o Name: , DOB: , Guardian: DHS (MT) -
notified o Incident: 01/25/23 approximately at 0900 o Precaution safety plan: Self-Harm, 1:1
observation o Police were called: N/A o On 1/25/23 at approximately 0900, RN responded
to unit where was attempting to use fingernails to self harm. Staff had been present with
resident for several minutes after initial self harm act of scratching on the arm. Verbal
redirection and blocking techniques were unsuccessful and attempted to bite
themselves on the knees and thighs. Resident was placed in a brief physical hold until she
was able to regulate emotions and contract for safety. RN noted scabs from previous self-
harm incident on forearms were reopened, no first aid required. Arms were cleaned and
covered. 's current safety plan with constant line of sight for self-harm to be extended
until safe behaviors are exhibited.
Interim Action Narrative:
Maltreatment Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: Resident has been discharged to a more appropriate level of care due
to the severity of her self-harm 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: 1/25/2023
Date Received by DCCECE: 1/26/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: o Name: , DOB: , Guardian: DHS (TX) -
notified o Incident: 01/25/23 approximately at 1300 o Precaution safety plan: Self-Harm,
Constant LOS o Police were called: N/A o On 1/25/23 at approximately 1400, became
dysregulated on the unit and began using fingernails to re-open scab on their right forearm.
Resident was taken to nurses' station where arm was cleaned and covered, no first aid
required. Resident placed on a self-harm precaution safety plan with constant line of sight
for 7 days as a result of this event.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 02/3/23--Licensing specialist Sutton completed a buildings and
grounds visit at facility. Resident was observed within LOS of staff in the hallway. She
has processed with therapist about this incident. Standing order to cut and trim resident's
fingernails as needed. CEO stated that facility is in the process of educating staff about
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

different de-escalation interventions and is continuing to work on programmatic changes to
keep residents engaged during the day.


summary: Licensing visited the facility to conduct a buildings and grounds walkthrough and to follow up on provider reported incidents. No deficiencies were cited.

raw_content:
ARKANSAS
DEPARTMENT OF

> HUMAN
~=a' 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

521 Visit Compliance Report

Licensee: Perimeter of the Ozarks

Facility Number: 237

Licensee Address: 2466 SOUTH 48TH STREET
SPRINGDALE AR 72766

Licensing Specialist: Michele Sutton
Person In Charge: Sarah Kroon
Record Visit Date: 1/24/2023

Home Visit Date: 1/24/2023

Purpose of Visit: Monitor Visit;Self Report Visit;Subsequent Building and Grounds

Regulations Out of Compliance:

Regulations Needing Technical Assistance:

Regulation Not Applicable:

Regulations Not Correctable:

Narrative:

Licensing specialist completed a buildings and grounds and follow up on provider reported incidents over the
weekend.

www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 1 of 2

Ratio--Classroom 12:11,Classroom 24:12, hallway2:1,cafeteria1:2--all units within ratio.

Buildings/Grounds: Licensing specialist viewed blue, orange, and green units, classrooms, cafeteria and
grounds. The grounds are currently not in use due to roofing being completed on building and the presence of
sharp metal, nails, and screws on the grounds. Bedrooms were clean and no visible contraband/self-harm
implements were seen during visit.

Bathrooms in 305 and 205 have tiles that need to be replaced but they had been secured and did not present a
safety hazard time of visit. 521 revised to take original buildings and grounds citation for this off of the report.
Facility was advised by licensing specialist that moving forward, anything that needs maintenance
upkeep/attention will be discussed with facility during walk throughs to ensure facility is well-maintained, but
non-safety issues will not be cited under buildings and grounds as long as the furnishing and materials are
functional and do not pose a risk to the physical or psychological comfort or safety of the children in care.

Licensing specialist asked to view documentation of any activity or therapy groups completed over the
weekend. There were no formal groups completed as therapist was completing individual therapy over the
weekend. However, there was a tie dye shirt making group led by MHTs. Licensing specialist saw shirts that
were made on the units.

Licensing specialist viewed safety plans for 4 residents with more than one self-harm attempt over the last 5
days. Current safety plans were in place for all 4 and facility was following the safety plans at time of
visit--each resident was within LOS/proximity of staff at time of visit. Each resident has documentation of an
individual therapy visit within 24 hours of incident(s), and one of the residents has been referred for discharge
due to lack of progress in the program. Licensing specialist observed 2 staff following the individualized
behavior plan with resident || in the hallway--they were processing with her and utilizing her noise
cancelling headphones and weighted blanket.

Provider Comments:

CCL Staff Signature : Date: 1/24/2023
Provider Signature : Date: 1/24/2023
www.arkansas.gov/dhs

Serving more than one million Arkansans each year Page 2 of 2

doc_type: Compliance Report


summary: A resident self-harmed by repeatedly hitting herself in the nose.

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: 1/24/2023
Date Received by DCCECE: 1/24/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: DOB , Guardian: (AR)
- notified Incident: 01/24/23 approximately at 1200 (Comfort/Seclusion Room) Precaution
safety plan: Self harm precautions for an additional 7 days, LOS constant Police were called:
N/A On 01/24/2023, resident was hitting herself in the nose repeatedly, stating she wanted
to "see her own blood." She was unable to produce bleeding in relation to the hits to her
nose and staff intervention to block hits to her face. She then preceded to pick at a scab on
her left arm in an attempt to produce blood. She was unsuccessful but was able to process
with RN and lead to keep her mind off self-harm thoughts. No first aid/medical attention
required. Resident regulated and returned to class without further incident. Resident will
have an extension on her current self-harm precaution safety plan until safe behaviors are
exhibited.
Interim Action Narrative:
Maltreatment Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: 02/03/23 Licensing specialist completed a buildings and grounds visit
this date. Resident was observed within LOS of staff at time of visit. Standing order to cut
and trim fingernails as needed. No additional licensing follow up required at this time.


summary: A resident self-harmed by using her fingernails to scratch herself.

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: 1/24/2023
Date Received by DCCECE: 1/24/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: o Name: , DOB: , Guardian: DHS (MT) -
notified o Incident: 01/24/23 approximately at 1345 o Precaution safety plan: Self-Harm, 1:1
observation o Police were called: N/A o On 1/24/23 at approximately 1315, became
dysregulated and refused to go to class and take afternoon medication. MHT lead sat and
attempted to process and deescalate to no avail. Resident began using fingernails to scratch
and self-harm on their left hand. Verbal de-escalation was unsuccessful. Staff used physical
blocking to prevent self-injurious behaviors but was not successful. Resident then began
biting themselves on their knees. Physical hold was initiated to maintain the safety of the
resident until they were able to regulate emotions and contracted for safety. When removed
from physical hold, resident was assessed for injury from self-injurious behaviors. Scratch
with redness noted on left wrist with several bite marks present on knees. No first aid
required. Resident processed with staff and was able to regulate emotions and go to class
without further incident. Residents current self-harm precaution safety plan extended until
safe behaviors are displayed.
Interim Action Narrative:
Maltreatment Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: Resident has been discharged from the facility to a more appropriate
setting due to the severity of her behaviors.


summary: A resident self-harmed by banging her head on the wall.

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: 1/24/2023
Date Received by DCCECE: 1/25/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: DOB: , Guardian: DHS (TX) -
notified Incident: 01/24/23 approximately 1838 Precaution safety plan: Self-Harm, for 7 days
LOS constant Police were called: N/A On 01/24/23 approximately 1838, resident began
banging her head on the wall on the unit, which began dysregulating other residents.
Resident was taken off the unit in an attempt to regulate and provide a calmer environment
but continued to hit head on the wall in the comfort room. Verbal de-escalation attempts
failed, and resident was placed in a physical hold to prevent further injury. Once resident
was displaying safe behaviors, physical hold was released, and resident was able to process
with staff to regulate emotions. No injuries were noted in relation to the restraint. Self-harm
precautions with constant LOS continued until safe behaviors are displayed.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Resident is on an individualized behavior management plan.
Licensing specialist observed staff using treatment modalities listed in plan during visit on
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

01/24/23. No further incidents have been reported since 1/26/23, and resident was observed
within LOS and close proximity of staff at 2/3/23 visit.


summary: A resident used their fingernails to self-harm on their forearm.

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: 1/23/2023
Date Received by DCCECE: 1/23/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: , DOB: , Guardian: DHS (MT) - notified
Incident: 01/23/23 approximately at 1230 Precaution safety plan: Self-Harm, LOS constant,
1:1 Police were called: N/A On 01/23/23 at 1230 was using their fingernails to self-harm
on their right forearm. Verbal redirection was unsuccessful. Staff members used blocking
techniques to prevent further behaviors. reopened wounds that they previously inflicted
on themselves. The wound bed was irritated and bleeding. agreed to exit unit and
process with RN. First aid was provided to cleanse area and prevent infection. will
continue to be on self-harm precautions for 7 days.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Licensing specialist looked in resident's room today. No contraband
was seen in the room at time of visit. Licensing specialist viewed safety plan--constant LOS-
-and confirmed that resident was within LOS of staff during visit. Resident has received
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

therapy since this incident occurred and currently the facility is working with MT DHS on a
discharge plan due to limited progress being made with tx in that setting.


summary: A resident reported that she tied clothing around her neck while in the bathroom in an attempt to self-harm.

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: 1/23/2023
Date Received by DCCECE: 1/24/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: DOB: , Guardian:
(AR) - notified Incident: 01/23/23 approximately at 1800 (Green Unit) Precaution safety
plan: Suicide precautions for 7 days LOS constant Police were called: N/A On 01/23/2023,
resident reported to RN that while she was in the bathroom, she tied an article of clothing
around her neck. Slightly reddened marks noted around neck that quickly dissipated. No
nursing care was rendered. CSSRS preformed, resident placed on suicide precautions with
constant line of sight for the next 7 days.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Licensing visit this date. All residents were observed within LOS of
staff at time of visit. No additional incidents of self-harm have been reported for this
resident at this time. No additional licensing follow up required for this case.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


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: 1/22/2023
Date Received by DCCECE: 1/23/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: , DOB: , Guardian: DHS (MT) - notified
Incident: 01/22/23 approximately at 1700 Precaution safety plan: Self-Harm, LOS constant
Police were called: N/A Responded to the unit on 01/22/23 at approximately 1700. was
self -harming in their room with their finger nail to their left forearm. The resident was not
responding to staff attempts to regulate and became increasingly agitated and attempted to
bite themselves numerous times and attempted to hit their head on the wall and ground. To
prevent injury a physical restraint was initiated at 1711. The resident continued to struggle
against the restraint but eventually fatigued and was able to process with staff. After the
resident agreed to safe behaviors they were released from the restraint at 1751. RN assessed
the resident for injury and found a superficial wound of scratched off skin approximately 2
inches long and 1/2 in wide. The resident was taken to the nurse's station and the nurse
cleaned the affected area and covered it and previous injuries with gauze and tape. Resident
continued to process with staff member off unit without further incident.
Interim Action Narrative:
Maltreatment Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: Licensing specialist viewed therapy notes, nursing notes, safety plans,
and referrals for this resident. Resident received crisis intervention counseling from an
MHP the day after the incident. Resident is on a constant line of sight safety plan and was
within LOS of staff during licensing visit today. The facility has provided MT DHS with a
discharge notice and requested she be discharged by 2-3-23 due to lack of fit in facility and
lack of progress. It is noted that CPS is looking into other options for placement currently.


summary: A resident tied scrubs around her neck in an attempt to self-harm.

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: 1/22/2023
Date Received by DCCECE: 1/23/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: , DOB: , Guardian: Ward of State (AR) -
notified Incident: 01/22/23 approximately at 1230PM Precaution safety plan: Suicide Risk ,
for 7 days LOS constant Police were called: N/A It was reported by staff to this RN that the
resident became dysregulated at approximately 1230 in the cafeteria. It was reported that
she became upset that she ate chicken so she sat in the corner of the dining room behind
the TV. Staff attempted to regulate the resident but she remained uncooperative. ran
and attempted to jump through the cafeteria window to the kitchen. Staff was able to
prevent the resident from entering the kitchen. returned to their unit after this incidence
but attempted to run off the unit when other residents were returning. had a rip in their
paper scrub shirt and was taken off the unit for a new pair of paper scrubs. was
changing in the seclusion room and used the scrubs to tie around her neck. RN removed
the material from ?s neck. began to calm down and was able to process with staff.
RN assessed for injury and noted a small bruise on the right side of ?s neck, no first aid
was required .C-SSRS suicide risk assessment done with resident, scored high risk. They
will remain on suicide precautions for the next 7 days.
Interim Action Narrative:
Maltreatment Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: Resident is on a safety plan (licensing specialist viewed). Resident was
observed to be within LOS during licensing visit today on 01-24-23. Resident received
individual therapy within 24 hours of incident occurring.


summary: A resident self-harmed by scratching her wrist and neck with keys.

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: 1/21/2023
Date Received by DCCECE: 1/23/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: , Guardian: Ward of State (AR) -
notified Incident: 01/21/23 approximately at 1300 Precaution safety plan: Suicide Risk , for 7
days LOS constant Police were called: N/A I?m writing to inform you that earlier today,
became dysregulated on the unit, stating she was suicidal. She began scratching at wrist
and the side of her neck. She then took a staff keys and put the lanyard around her neck and
used keys to further scratch her neck. Staff intervened quickly to maintain safety. Resident
was able to regulate emotions and no further incident occurred. Superficial scratches noted
and assessed by RN on wrist/side of neck. No first aid/medical intervention needed. C-
SSRS preformed, she scored high risk. will be placed on a suicide and self-harm
precaution safety plan with constant line of sight for the next 7 days.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Spoke with DON Sarah Kroon and therapist Madelyn Spence, who
stated that resident pulled a break away lanyard off of a staff member's neck and the lanyard
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

has a key attached to it. CEO Cassie Sowder stated she is looking into getting away from
using lanyards and exploring options. For now, resident is on a safety plan (licensing
specialist viewed). Resident was observed to be within LOS during licensing visit today on
01-24-23. Resident received individual therapy within 24 hours of incident occurring.


summary: A resident self-harmed by scratching her arms and attempting to hit her head against the wall and floor.

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: 1/21/2023
Date Received by DCCECE: 1/23/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: DOB: , Guardian: DHS (MT) - notified
Incident: 01/20/23 approximately at 2100 Precaution safety plan: Self-Harm, LOS constant
Police were called: N/A ON 01/20/23 approximately became upset on the unit and
began to scream, scratch arms repeatedly, and attempted to hit head against the wall and
the floor. A nurse and two staff members were able to process with and was able to
calm after some time. Superficial scratch marks were observed on forearms but required no
medical treatment.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Licensing specialist viewed therapy notes, nursing notes, safety plans,
and referrals for this resident. Resident received crisis intervention counseling from an
MHP the day after the incident. Resident is on a constant line of sight safety plan and was
within LOS of staff during licensing visit today. The facility has provided MT DHS with a
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

discharge notice and requested she be discharged by 2-3-23 due to lack of fit in facility and
lack of progress. It is noted that CPS is looking into other options for placement currently.


summary: A resident self-harmed with a foil wrapper she took from breakfast.

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: 1/21/2023
Date Received by DCCECE: 1/23/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: , DOB , Guardian: Mother (AR) -
notified Incident: 01/21/23 approximately at 1045 Precaution safety plan: Self-Harm, for 7
days LOS constant Police were called: N/A On 01/21/23 at 1045, used the tin foil
wrapper she stole from breakfast to create several superficial scratches on her left wrist. Staff
intervened; contraband was retrieved. Superficial scratches noted and assessed by RN on
wrist. No medical intervention/first aid required. Because of this event, the current self
harm precaution safety plan will be extended until safe behavior is observed.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 02/03/23 Licensing specialist completed a buildings and grounds visit
this date. Resident was observed within LOS of staff at time of visit. Standing order to cut
and trim fingernails as needed. No additional licensing follow up required at this time.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident self-harmed by punching themselves in the nose.

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: 1/20/2023
Date Received by DCCECE: 1/23/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: DOB: 7, Guardian: Mother (AR) -
notified Incident: 01/20/23 approximately at 1604 Precaution safety plan: Self-Harm, for 7
days LOS constant Police were called: N/A On 01/20/23 at approximately 1600 became
dysregulated and was not responding to staff?s attempts to process with them. A physical
restraint was initiated per physician orders to prevent injury when began punching
themselves in the nose. agreed to safe behaviors and the physical restraint was released.
was taken off the unit to process with RN in the seclusion/quiet room and began
punching themselves again. Staff responded and a physical restraint was initiated to prevent
injury. After agreeing to safe behaviors processed with a staff member without further
incident. The resident was taken to the bathroom to wash hands/face and was assessed for
injury. No injuries were found, and no first aid was required. We will be extending ?s
self-harm precautions for the next 7 days.
Interim Action Narrative:
Maltreatment Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: was seen to be within close proximity of staff during
licensing visit today--ratio was 1:2 in the cafeteria. She was working on schoolwork away
from the classroom with an MHT and another student. Licensing specialist viewed
resident's chart today and viewed safety plan--constant LOS, therapy notes--was seen within
24 hours of incident.


summary: A resident became dysregulated and attempted to self-harm by hitting their head on the floor and bed frame.

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: 1/20/2023
Date Received by DCCECE: 1/23/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: , DOB: , Guardian: Mother (AR) -
notified Incident: 01/20/23 approximately at 1844 Precaution safety plan: Self-Harm, for 7
days LOS constant Police were called: N/A On 01/20/23 approximately 1844 staff
responded to ?s unit after they became dysregulated and began punching themselves in
the face and attempted to hit their head on the floor and bed frame. A physical restraint was
initiated by staff per physician orders to prevent injury. remained dysregulated and
continued aggressive behaviors while in the physical restraint and was not responsive to
staff?s attempts to re-regulate. An emergency medication was ordered by the physician and
administered intra-muscularly to . After a few more minutes was cooperative and
agreed to safe behaviors and the physical restraint ended. was assessed by nursing staff
for injury and none were found and no first aid was required. was taken off the unit to
process with staff. remains on self-harm precautions for the next 7 days.
Interim Action Narrative:
Maltreatment Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: was seen to be within close proximity of staff during
licensing visit today--ratio was 1:2 in the cafeteria. She was working on schoolwork away
from the classroom with an MHT and another student. Licensing specialist viewed
resident's chart today and viewed safety plan--constant LOS, therapy notes--was seen within
24 hours of incident.


summary: A resident self-harmed with a staple she found.

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: 1/20/2023
Date Received by DCCECE: 1/23/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: DOB: , Guardian: DHS (AR) -
notified Incident: 01/20/23 approximately at 2100 Precaution safety plan: Self-Harm, for 7
days LOS constant Police were called: N/A On 01/20/23 approximately 2100, after taking
evening medications, went into room and found a staple and then proceeded to self-
harm on left forearm. After multiple attempts from several staff to process and redirect ,
took an exit to the comfort room with two staff and was able to process and become
calm and gave up the staple to staff. Superficial cuts were observed on left forearm which
were cleaned and bandaged before returning to the unit.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Licensing specialist visited today and observed to be within LOS
of staff in the classroom at time of visit. Licensing specialist did not see any contraband in
resident's room at time of visit. Specialist viewed resident's safety plan and therapy notes--
resident is on constant LOS and received therapy within 24 hours of her self-harm incidents.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident self-harmed with her fingernails on her forearm.

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: 1/19/2023
Date Received by DCCECE: 1/19/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: , DOB , Guardian: DHS (TX) -
notified Incident: 01/19/23 approximately at 1000 (Classroom) Precaution safety plan: Self-
Harm, LOS constant Police were called: N/A On 01/19/23 at 1134, was reported to
be self-harming with fingernails on her right forearm on an area of skin that had a scab.
was taken to nurses' station to clean affected area with solution. No first aid
needed. placed on self-harm precautions for 7 days as a result of this event.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Licensing specialist observed the facility following the individualized
behavior treatment protocol during facility visit today. Resident was in hallway with nurse
and MHP with noiseless headphones and weighted blanket processing.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: Officers received a report from Arkansas State Police that a resident was inappropriately touched by a peer.

raw_content:
Case Report

Detail

Agency: Springdale Police Department Print Date/Time: 01/23/2023 07:41
Agency #: ARO720200

General Information

Case Number: 2023-00003672 Reporting Officer: 171 - Satterfield, Vicki
Occurred 2466 S 48TH ST B, SPRINGDALE Reported Date: 01/19/2023 08:27
Location: Incident Type: Sex Offenses

Status: Closed Occurred From: 01/19/2023 08:00
Status Date: 01/19/2023 Occurred Through:

Disposition: Inactive Exceptional Clearance:

Disposition Date: 01/19/2023 Exceptional Clearance

Scene Processed eae

By: Significant Event

Campus Code: County:

Assigned Personnel: = 33 - Cardenas, Eric Assigned By: 214 - Wyles, James
Assignment Type: Lead Investigator Assigned Date/Time: 01/19/2023 09:33
End Date:
Description: Weight:
Modus Operandi
“Offenses
# Statute Group GroupAgency Crime Code Statute Description Offense Date
1 State 11D - Forcible Fondling 5-14-125{a)(1) SEXUAL ASSAULT 2ND / FORCIBLE 01/19/2023
FONDLING

Number Type Name Address Contact Information Race Sex DOB
1 Suspect
2 Victim

Properties
# Date Type Property Loss Type Description Name Subject Role

Number Role Type Make/Model Color Plate/Registration Year State

Contributing Officers

Number Report Date/Time Officer Supervisor Approving User Report Type

Counter Evidence Type Code Description Current Location Date Received Make/Model

Login Id: sprd\shaleais Page 1 of 4

Case Report
Detail

Agency: Springdale Police Department Print Date/Time: 01/23/2023 07:41
Agency #: ARO720200

Case Status Status Date Changed By Date/Time Changed
Open 01/19/2023 vickisa 01/19/2023 08:32
Closed 01/19/2023 EricCa 01/19/2023 15:37
Disposition Disposition Date Changed By Date/Time Changed
Inactive 01/19/2023 EricCa 01/19/2023 15:37

Supplemental Information

Actions Taken Reasons For No Arrest Purge Type Purge Date Purge Review Date Non-Fatal Shooting

Name: Hotline Narrative Author: 171 - Satterfield, Vicki © Supervisor: Date Created: 01/19/2023 08:49

Description:
On 01/19/2023 a report was received from Arkansas State Police Investigator Deidre Uselton in regards to new report.

DHS snapshot was reviewed and the following is a summary of the report.

AV is EE residing in Perimeter Behavioral Health facility with AO EE It was reported that I was tickling | |
and then began touching her inappropriately moved her hand to vagina on top of her clothes, BEA continucusty told | stop
but did not listen and only continued touching her) stated tha has a crush on her.

VLS/610

Name: 405 Investigation Author: 33 - Cardenas, Eric Supervisor: Date Created: 01/19/2023 15:06
Description:

On January 19, 2023 Investigator Uselton and |, went to Perimeter Behavioral Health and made contact vi( I 2 7 _

Investigator Uselton interviewed | | | recorded the interview with my cell phone.

Cardenas 405

Login Id: sprd\shaleais Page 2 of 4

Case Report
Detail

Agency: Springdale Police Department Print Date/Time: 01/23/2023 07:41
Agency #: ARO720200

Name: Victim Interview Author: 33 - Cardenas, Eric Supervisor: Date Created: 01/19/2023 15:08
Description:

On January 19, 2023, CACD Investigator Deidra Uselton interviewed a: Perimeter Behavioral Health. The following is a summary of Inv.
Useltons interview with :

Inv. Uselton conducted a recorded forensic interview with | began by talking about her interests and why she is at Perimeter and then
discussed her famil HB ws asked why Inv. Uselton, and Det. Cardenas were here to speak with her today and she said because a girl sexually
assaulted | was asked to talk about what happened from beginning to end HE said that she came to Perimeter on January 4th. She said
she met a girl named Bethe was also a resident at Perimeter, and they began talking Jseia they later became roommates and that was ok
with her. said that_on Tuesday night they were in their room hanging out coloring and talking. said she was talking about a sibling of hers
tickling her and then came up and began ticklin her aa said ‘ne sen at her waist/hip area and was working her hands down to her
who ha {pointed at vagina) but denied ‘hall touched her vagina. said that also touched her boobs on the clothes while
tickling her] said that before the tickling incident began had told her she liked her and wanted them to be girlfriends.
her head she was thinking “no way” but did not tell that because she did not want to hurt her feelings. said that when the incident
happened, she was sitting on the bed and was standing up in front of her and was moving closer to her as she was tickling her! said she
told to stop, and she said, “no | like it.” aici cia stop because she pushed her away and stood up {A said at this point she
changed the subject and said let's color or go to bed and they ended up going to bed. said she woke up first in the morning and went and told

a staff member and she was moved out of room around lunch denied that asked | | to touch her anywhere on her body and
she denied that [J touched her te she does still see in class but as not had any issues and does not want to be her
friend anymore. Inv. Uselton went over the other forms of maltreatment and did not make a disclosure. J said she would tell her parents,
school counselor, principal or SRO if something happened that was not ok.

said that in

Eric Cardenas 405

Login Id: sprd\shaleais Page 3 of 4

Case Report

Detail
Agency: Springdale Police Department Print Date/Time: 01/23/2023 07:41
Agency #: ARO720200
Name: Case Status Author: 33 - Cardenas, Eric Supervisor: Date Created: 01/19/2023 15:14

Description:
On January 19, 2023 CACD Investigator Uselton and | made contact with i! at Perimeter Behavioral Health in
Springdale. Inv. Uselton interviewed} ani not disclose any sexual assault allegations during her interview. stated the alleged

juvenile offender stopped tickling her when asked to stop. The alleged offender grazed her “boob” with her hand, and tickled her above her private
area, but did not come in contact with her vagina.

The alleged offender is also a patient at Perimeter and is in foster care. We did not make contact with the alleged juvenile offender. Based on i

disclosure, there is no evidence that a crime occurred, This case will be placed as inactive. | attached a copy of the recorded interview to the Tyler Case
file.

lam forwarding this case to my supervisor for review.

Cardenas 405

Login Id: sprd\shaleais Page 4 of 4

doc_type: Police Report


summary: Licensing conducted an unannounced visit to follow up on several self-reported incidents and complete a buildings and grounds walkthrough. Technical assistance was provided for 910.1.

raw_content:
521 Visit Compliance Report

Licensee: Perimeter of the Ozarks

Facility Number: 237

Licensee Address: 2466 SOUTH 48TH STREET
SPRINGDALE AR 72766

Licensing Specialist: Michele Sutton
Person In Charge: Ana Salazar
Record Visit Date: 1/19/2023

Home Visit Date: 1/19/2023

ARKANSAS
) DEPARTMENT OF

> HUMAN
~a' 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

Purpose of Visit: Self Report Visit;Subsequent Building and Grounds

Regulations Out of Compliance:

Regulations Needing Technical Assistance:

Regulation Number: 9. 910. 1

Regulation Description: The grounds of the facility shall be kept clean and free of safety hazards.

Findings Description:

Action Due Date:

Action Due Description:
Comply Date:

Sub Regulation Description:
Regulation Number: 9. 909. 8

Regulation Description: The facility shall ensure each child in care is provided with opportunities for regular

recreational activities and exercise.

Findings Description:

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

Page 1 of 3

Action Due Date:
Action Due Description:
Comply Date:

Sub Regulation Description:

Regulation Not Applicable:

Regulations Not Correctable:

Narrative:

Unannounced licensing visit completed this date. Licensing specialist followed up on several self-reported
incidents, completed a buildings and grounds, and spoke with residents involved in serious occurrences over
the weekend involving peer-to-peer sexual touching.

Buildings and Grounds: CEO stated there are plans to renovate the mileu area of the facility--re-painting
walls, adding inspirational messages, and adding wallpaper around nurse's station. All units in ratio (blue--in
cafeteria at time of visit--2:8, orange--4:9, green 2:10, milieu 2:1). 5 MARS were reviewed with no
locked per regulatory requirements.

Viewed all units. Repairs have been made to room 201. No broken pieces of wood noted on baseboards or
doorframes of any unit, no dangerous materials/contraband seen in rooms. Viewed the isolation rooms--no
hazards noted. Viewed grounds of facility. A piece of sharp sheet metal from the roof was immediately visible
near the door. DON advised that residents are not currently allowed to use the courtyard, grounds, or gym
while the roofers are completing their work on the building. Licensing specialist recommended that leaves
piled around the fence in the yard are removed after workers finish to ensure there are no dangerous materials
in the yard debris.

Follow up on self-reported incidents:

Spoke with CEO Cassie Sowder who stated that individualized behavior plans are being created for residents
who exhibit frequent self-harm behaviors. She stated resident || has the first plan that has been
implemented and it includes identifying signs/symptoms of escalation, implementing specific interventions
(noise cancelling headphones, weighted vest,etc.) and requires staff working with resident to sign off that they
understand the plan. The facility's plan is to create this for other residents as needed with a target completion
date of 2/14/23. CEO also plans to increase therapy and educational groups on the unit. CEO stated staff is
receiving training on supervision requirements--specifically what true 1:1 looks like, close proximity needed
for constant LOS, etc.

4 children involved in serious occurrences were interviewed. One child stated that "staff do their job and help
us and stuff" and verified that the corrective action plan provided by the facility was being implemented.

www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 2 of 3

Another child stated that her biggest concern over the weekend was that they (residents) don't have anything
to do since not being able to use the grounds or the gym. She stated that the facility has implemented a policy
to lock resident's puzzles and books in a closet in their room and only allow one book at a time to prevent
clutter since "DHS told them they had to do that." She said they mostly watch TV or listen to music on the
TVs and "the only thing we have to do is fight, so there are a lot of fights." A third resident stated that she is
upset that she was moved from her room to a different unit instead of the resident who allegedly touched her.
Licensing specialist asked her if she was on any precautions that she was aware of and she stated that she was
on suicide precautions. She stated that there is "nothing different" about being on suicide and line of sight
precautions and not and stated she is not in LOS of staff at all times. The fourth resident refused to answer any
questions stating that she did not wish to talk about the events that occurred over the weekend, and that she
has already talked to someone.

No citations in areas viewed--facility will receive technical assistance for standard 909.8--the facility will
ensure that each child in care is provided with opportunities for regular recreational activities and
exercise--facility CEO stated they will re-visit the policy of locking recreational materials in the closets with
residents. Licensing specialist provided clarification that DHS does not require this. While gym and yards are
inaccessible, please ensure the residents have group recreational activities indoors during the week and on the
weekends--all three residents interviewed stated they are watching TV in the units during the weekends.

Facility will receive technical assistance for standard 901.1--please ensure that the grounds have been
examined thoroughly for self-harm implements when construction is completed. Licensing recommends
removing leaves and yard debris for a better view of the facility grounds when construction work is
completed.

Provider Comments:

CCL Staff Signature : Date: 1/19/2023
Provider Signature : Date: 1/19/2023
www.arkansas.gov/dhs

Serving more than one million Arkansans each year Page 3 of 3


summary: A resident self-harmed with her fingernails.

raw_content:
AR KAN S A S&S
DEPARTMENT OF

4 HUMAN
<a¥ SERVICES

Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot $140, Little Rock, AR 72203-1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550

Notice of Serious Incident

Date of Incident: 1/19/2023

Date Received by DCCECE: 1/19/2023

Facility Name: Perimeter of the Ozarks
Facility Number: 237

Facility Type: Residential

Incident Type: Licensing

Report Description: Name: a. DOB: PY Guardian: DHS (MT) - notified
Incident: 01/19/23 approximately at 1000 (Comfort/Seclusion Room) Precaution safety
plan: Self-Harm, LOS constant Police were called: N/A On 01/19/23 at 1000, was
reported to be self-harming with fingernails on her right forearm. After processing with staff,
Dallas allowed nurse to clean affected area with solution. No first aid needed. BE placed
on self-harm precautions for 7 days as a result of this event.

Interim Action Narrative:

Maltreatment Narrative:

Licensing Narrative: Licensing specialist viewed safety plans, therapy notes, and discharge
referrals for resident today and confirmed that she was within LOS from staff as per her
safety plan in the classroom. Resident has received therapy since these incidents and facility

is working on a discharge plan for her due to limited progress in the facility.

We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident self-harmed with pieces of her fidget.

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: 1/18/2023
Date Received by DCCECE: 1/19/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: , Guardian: DHS (AR) -
notified Incident: 01/18/23 approximately at 07:00pm (blue Unit) 1:1 Precaution safety plan:
Self-Harm, Police were called: N/A It was reported by Cassie S., our CEO, on 01/18/23
approximately 07:00pm resident was found by another staff member (MHT) on her unit
(blue unit) after to self-harm with an object. Cassie immediately intervened and processed
1:1 with the resident, already had some dry blood and superficial cuts on both arms,
after processing with our CEO was able to turn in the object she was using to self-harm. It
was 2 little pieces of material from her fidget she was hiding under her bra. Cuts were
cleaned and no further medical attention needed. No other incidents reported after this.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Visited facility today. Viewed resident treatment plan. Resident has
been receiving crisis therapy following her self-harm incidents. Resident was within LOS of
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

staff in the classroom as per her tx plan at time of visit. Resident room was viewed--no
visible contraband or self-harm implements at time of visit.


summary: Officers received a report from Arkansas State Police of an allegation of abuse between residents that occurred at the facility.

raw_content:
Case Report

Detail
Agency: Springdale Police Department \ Print Date/Time: 01/23/2023 07:41
Agency #: ARO720200
Case Number: 2023-00003261 Reporting Officer:
Occurred 2466 S 48TH ST B, SPRINGDALE Reported Date: 01/17/2023 08:20
Location: Incident Type: Sex Offenses
Status: Closed Occurred From: 01/17/2023 08:19
Status Date: 01/18/2023 Occurred Through: 07/17/2023 08:19
Disposition: Inactive Exceptional Clearance:
Disposition Date: 01/18/2023 Exceptional Clearance
Scene Processed Bate
By: Significant Event
Campus Code: County:

Assigned Personnel: — 81 - Helms, Hunter Assigned By: 214 - Wyles, James
Assignment Type: Lead Investigator Assigned Date/Time: 01/17/2023 09:28
End Date:

Solvability Factors

Description: Weight:
Modus Operandi
Offenses
# Statute Group Group Agency Crime Code Statute Description Offense Date
1 State 11D - Forcible Fondling —5-14-125(a)(1) SEXUAL ASSAULT 2ND / FORCIBLE 01/17/2023
FONDLING

Number Type Name Address Contact Information Race Sex DOB
1 Suspect
2 Victim

Properties

# Date Type Property Loss Type Description Name Subject Role

Vehicles

Number Role Type Make/Model Color Plate/Registration Year State

Contributing Officers
Number Report Date/Time Officer Supervisor Approving User Report Type

Counter Evidence Type Code Description Current Location Date Received Make/Model

Login Id: sprd\shaleais Page 1 of 3

Case Report
Detail

Agency: Springdale Police Department Print Date/Time: 01/23/2023 07:41
Agency #: ARO720200

Case Status Status Date Changed By Date/Time Changed
Open 01/17/2023 mariamo 01/17/2023 08:43
Closed 01/18/2023 hunterhe 01/18/2023 12:15
Disposition Disposition Date Changed By Date/Time Changed
Inactive 01/18/2023 JamesWy 01/19/2023 07:55
Actions Taken Reasons For No Arrest Purge Type Purge Date Purge Review Date Non-Fatal Shooting
Meat <b SAW aD Es ERA EN ralveS Spe LL whe Dis Cw, ld Ze

Name: hotline Author: 131 - Moreno, Maria Supervisor: Date Created: 01/17/2023 08:52
Description:

On 1/17/23 a report was received from Arkansas State Police Investigator Ying Merritt in regards to a new report.

The DHS snapshot was reviewed and the following is a summary of the report.

AV Ss PY is currently in the custody of Texas DHS and is currently a resident at Perimeter Behavioral Health of the
Ozarks in Springdale, AR. The AO is a fellow resident i has indicated that during a hug grabbed her butt. It is
believed that did this for sexual purposes. The contact was not wanted by [EEE A date for the incident is unknown. It is unknown how

WE reacted to the incident. Until recently J andi lived in the same unit at Perimeter, however, after being made aware of the
incident, the two have been moved to i we In a separate incident, El licked and sucked on another <r ia

neck. This incident occurred on 1/14/2023] is believed to have done this for sexual purposes. This contact was not wanted by

MLM/624

Login Id: sprd\shaleais Page 2 of 3

Case Report
Detail

Agency: Springdale Police Department Print Date/Time: 01/23/2023 07:41

Agency #: ARO720200
Name: Victim Interview Author: 81 - Helms, Hunter Supervisor: 214 - Wyles, James Date Created: 01/18/2023 10:20
Description:

| received the hotline at 0900 hours on January 17th. | made contact with Investigator Ying with State Police and we agreed to meet at the Perimeter
Behavioral Unit at 1300 hours to meet with the victim,

Forensic Interviewer Ying conducted the interview in the conference room at the Perimeter Center. The victim,

stated that a girl named I touched her butt. real name is and is a female that identifies as a male so for the rest of the
report she will be identified as a male named stated that it happened on Saturday because| did something to somebody else too.
stated that gavel. hickey and it made her mad {i stated that she was going to beat up|

Ying asked (WEB touched her under or over her clothes and she stated “over”. Ying asked her what said andl stated, “he rubbed my butt
over my shorts as he walked by me and just said "goodnight". Ying asked fi did anything else and she stated "no". Ying asked if she said
anything back to f and she stated "no, | was to freaked out to say anything.” | asked if she was in a relationship with Hen she stated
“yes | am. The interview was ended, and she was sent back to her room.

Ying also erie she talked about J coming up to give her a hug and she sucked and bit her neck. stated that she

pulled away from and left the room. Ying recorded both interviews and this is a summary of those interviews.

There was not enough disclosed to press charges against fl based off their statements.

Name: Case Status Author: 81 - Helms, Hunter Supervisor: 214 - Wyles, James Date Created: 01/18/2023 10:56

Description:

This case can be closed, there is not enough for charges at this time.

Login Id: sprd\shaleais Page 3 of 3


summary: A resident self-harmed by punching herself in the face and head.

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: 1/17/2023
Date Received by DCCECE: 1/18/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: DOB: , Guardian: DHS (AR) - notified
Incident: 01/17/23 approximately at 0927 (orange Unit) Precaution safety plan: Self-Harm,
for 7 days LOS constant Police were called: N/A On 01/17/23, was aggitated and
began punching herself in the face and head. Physical restraint initiated to prevent further
injury to self. Resident released from physical restraint promptly, when deemed safe. Self-
harm precaution safety plan initiated with constant LOS for 7 days as a result of this event.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Resident is on self-harm precautions and constant LOS as noted
above. Facility CEO stated during unannounced visit today that the staff have been
educatied on supervision requirements including that true LOS includes proximity to
resident.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident self-harmed by punching herself in the nose repeatedly.

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: 1/17/2023
Date Received by DCCECE: 1/18/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: DOB:0 , Guardian: ,
guardian - notified Incident: 01/17/23 approximately at 1427 (Blue Unit) Precaution safety
plan: Self-Harm, for 7 days LOS constant Police were called: N/A On 01/17/23, Heidi was
agitated and began punching herself in the nose repeatedly. Physical restraint initiated to
prevent further injury to self. Resident released from physical restraint promptly, when
deemed safe. Self-harm precaution safety plan initiated with constant LOS for 7 days as a
result of this event.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Per CEO, Facility plans to create an individualized behavior plan for
this resident to address frequency of self-harm behaviors. In the meantime, they have
resident on constant LOS and increased supervision.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident reported that a peer grabbed her breasts.

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: 1/16/2023
Date Received by DCCECE: 1/17/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Dual
Report Description: ? Allegation of sexual misconduct Residents Name/DOB:
? Perpetrator Date/Time of incident:
reports that she ?could not remember? the exact day the event occurred this past
week. reported that ?grabbed her breasts.? Immediate Actions Taken: Corrective
Action Plan includes Therapeutic group to be conducted by therapist on peer to peer
boundaries, implement no touching by residents to each other on the unit, residents
separated onto different units for safety, re-educate staff on appropriate supervision,
residents who were impacted will process with their therapist. Additional Information:
placed: Documented only, no report taken. Reference Notified:
Caseworker Cassie Sowder, CEO Ana Salazar, DON Erin Duvall APRN Madeline Spence
Clinical Director Felicia.Harris@dhs.arkansas.gov Kris Stewart & Reagan Stanford and
Ashlyn Whelchel Disability Rights of AR Chelsea Vardell and Kendra Rice DHS Rebecca
Thomas, Perimeter
Interim Action Narrative:
Maltreatment Narrative: Screened out by
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: Licensing specialist spoke with this resident today regarding this
incident. Resident stated it happened while she was in line for dinner. She stated she has
been moved to a different unit and would have preferred for the AO to have been moved to
the different unit. No other concerns or issues noted related to this incident. She confirmed
that the interventions listed above have been implemented.


summary: A resident self-harmed by hitting their head against the wall.

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: 1/16/2023
Date Received by DCCECE: 1/16/2023
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Facility Type: Residential
Incident Type: Licensing
Report Description: Name: DOB: , Guardian:
Corpus Christi, TX ( Ward of the state)- notified Precaution safety plan: Self-Harm, for 7
days LOS constant Police were called: N/A Incident : 01/16/23 , at 0945 and 0900 This
morning was in the unit hallway hitting their head against the wall. Though numerous
staff attempted to process with them they continued to hit their head against the wall in the
same spot. Because of the existing wound, the slight but repetitive pressure of the hits
caused the wound to reopen. s therapist was able to removed them from the unit and
process with them. After minimal first aid was utilized to clean area of blood. Because of
this will continue to be on self harm precautions for 7 more days.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: See narrative for incident 001193--resident has been placed on an
individualized behavior plan
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A resident self-harmed with pieces of wood she ripped off the sink liner. The facility was cited 911.6 and 907.2 as a result of this incident.

raw_content:
AR KAN S A S&S
DEPARTMENT OF

4 HUMAN
<a\ SERVICES

Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot $140, Little Rock, AR 72203-1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550

Notice of Serious Incident

Date of Incident: 1/16/2023

Date Received by DCCECE: 1/17/2023

Facility Name: Perimeter of the Ozarks
Facility Number: 237

Facility Type: Residential

Incident Type: Licensing

Report Description: Name: Re: wes 6 60ti(<té‘éi*@Sds Guardian: DHS (AR) -
notified Incident: 01/16/23 approximately at 2130 (orange Unit) Precaution safety plan: Self-
Harm, for 7 days LOS constant Police were called: N/A On 01/16/2023 approximately 2130
residents went into a peer's room on orange unit (room 201) and ripped pieces of the sink?s
wooden liner off and used it to create superficial cuts on L-arm. The wounds were cleaned
by the RN, no further medical treatment required.

Interim Action Narrative:

Maltreatment Narrative:

Licensing Narrative: See 521--facility will be cited for R911.6 and technical assistance will be
provided for R907.2

We Care. We Act. We Change Lives.
humanservices.arkansas.gov

ARKANSAS
) DEPARTMENT OF

> HUMAN
~a' 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

521 Visit Compliance Report

Licensee: Perimeter of the Ozarks

Facility Number: 237

Licensee Address: 2466 SOUTH 48TH STREET
SPRINGDALE AR 72766

Licensing Specialist: Michele Sutton
Person In Charge:

Record Visit Date: 1/19/2023

Home Visit Date: 1/19/2023

Purpose of Visit: Monitor Visit

Regulations Out of Compliance:

Regulation Number: 9. 911. 6

Regulation Description: All buildings and furnishings shall be safe, clean, and in good repair.
Findings Description:

Action Due Date:

Action Due Description:

Comply Date:

Sub Regulation Description:

Regulation Number: 9. 907. 2

Regulation Description: Child caring staff shall be responsible for providing the level of supervision, care, and
treatment necessary to ensure the safety and well-being of each child at the facility, taking into account the child’s
age, individual differences and abilities, surrounding circumstances, hazards and risks.

Findings Description:
Action Due Date:

Action Due Description:

www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 1 of 2

Comply Date:
Sub Regulation Description:

Regulations Needing Technical Assistance:

Regulation Not Applicable:

Regulations Not Correctable:

Narrative:

On 01-16-23 Resident ma used a wooden piece from broken sink counter in Room 201 to self-harm and
create superficial wound to arm. Facility will be cited for standard 911.6--all buildings and furnishings shall
be safe, clean, and in good repair. Technical assistance was provided during licensing walkthrough on
01-09-23 to ensure this area was repaired with a note made that repairs were pending. This incident occurred
one week later on 01-16-2023. Please ensure that all repairs are completed timely, especially when a broken
furnishing could potentially be used as a self-harm implement. If there is a delay in getting replacement
materials, please ensure the safety of the area while repairs are pending--e.g. increased supervision, limited
access, etc.

Facility will also be cited for standard 907.2--childcare staff shall be responsible for providing the level of
supervision, care, and treatment necessary to ensure the safety and well-being of each child at the facility,
taking into account the child's age, individual differences and abilities, surrounding circumstances, hazards,
and risks. Please ensure there is increased supervision in any area with identified safety hazards and please
ensure that children who are on constant LOS/self-harm precautions are supervised heavily in areas with
identified safety hazards.

Licensing viewed room 201 during unannounced buildings and grounds visit on 01-19-2023 and found that
the sink area in Room 201 has been repaired and the lining has been secured.

Provider Comments:

CCL Staff Signature : Date: 1/19/2023
Provider Signature : Date: 1/19/2023
www.arkansas.gov/dhs

Serving more than one million Arkansans each year Page 2 of 2