summary: A resident was transported to Arkansas Children’s Hospital for evaluation of a left wrist injury caused by punching a door window.

raw_content:
Placement and Residential Licensing Unit
P.O. Box 1437, Slot S140, Little Rock, AR 72203-1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 024388
Date of Incident: 9/29/2024
Date Received: 9/30/2024
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Incident Type: Licensing
Report Description: X Serious injury requiring outside medical attention ? Resident?s
attempted suicide ? Allegation of abuse/neglect related to a restraint ? Resident?s death ?
AWOL/Elopement ? Allegation of sexual/physical abuse ? Sexual Misconduct ? Other
Patient/Resident Name/DOB: Date/Time of incident: 09/29/24
at 09:00 Patient Insurance: Name of Perimeter Staff Making
Notification Date Time Name of Person Notified DHS Charriot Sales, Director of Risk
Management 09/30/24 10:00 Felicia Harris, Chelsea Vardell, Kendra Rice, Jarred Parnell
OLTC Charriot Sales, Director of Risk Management 9/30/24 10:00
Jeff.rosenbaum@dhs.arkansas.gov Disability Rights Center, Inc. Charriot Sales, Director of
Risk Management 09/30/24 10:00 incidentreporting@disabilityrightsar.org Perimeter
Charriot Sales, Director of Risk Management 09/30/24 10:00 Skyler Barnes, Shawna Stover,
Chris Perry, Brandy Pfeifer, Carey Ouzts, Rebecca Thomas Guardian/Caseworker Keith
Bohannon, RN 09/29/24 18:25 Charriot R. Sales, Director of Risk
Management 09/30/24 Signature and title of staff completing this form Date: Name of
Facility: Perimeter Behavioral of the Ozarks Phone Number: 479-957-9857 ext. 108 Street
Address, City, State, Zip: 2466 S. 48th Street Suite B. Springdale, AR 72762 Please describe
the incident: On 09/29/24, was transported to the Arkansas Children?s Hospital
for evaluation for a left wrist injury. She reported to nursing staff that she punched the
window on the door. The resident was diagnosed the ER
physician and was prescribed 600mg Ibuprofen every six hours as needed for pain. She
returned to Perimeter at approximately 13:00. Actions Taken: ? Resident taken to the
Emergency Room. ? Resident was placed on self-harm precautions for 72 hours. ? Provider
consulted prior to transport and for aftercare follow-up. ? Guardian notified and approved
PRN pain medication.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 10/1/2024 - The provider reported incident was reviewed by the
licensing specialist. Licensing specialist will follow up with the facility for nursing notes or
discharge paper work. 10/1/2024 - ER paperwork received, reviewed, and uploaded to ELS.


state: AR

facility_name: Perimeter Behavioral of the Ozarks

summary: Officers were dispatched to the facility in response to 7-8 residents who were causing issues and attacking the staff.

raw_content:
Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
General Information
Case Number: 2024-00063013 Reporting Officer: 5272 - Moore, Jacob Reported 09/29/2024 19:48
Date/Time:
Location 2466 S 48TH ST B, Location PERIMETER OF THE OZARKS
County: Washington
Formatted: SPRINGDALE, 72762 Common Name:
Status: Closed Status Date: 10/02/2024 Disposition: Cleared by Arrest
Disposition Date: 10/02/2024 Occurred Incident Assault - Simple Occurred From 09/29/2024 19:46
Type: Date/Time:
Occurred To 09/29/2024 19:46
Scene Processed Significant Event:
Date/Time:
By:
Campus Code: Exceptional
Exceptional
Clearance Date:
Clearance:
Assigned Personnel
Solvability Factors
Solvability Factor: Total Solvability
Factor:
Modus Operandi
Offenses
# Statute Group Group Agency Crime Code Statute Description Offense Date
1 State 13B - Simple Assault 5-13-203a(1) BATTERY - 3RD DEGREE / PURPOSE OF 09/29/2024
CAUSING INJURY, CAUSES INJURY
Subjects
Number Type Name Address Contact Information Race Sex DOB
1 Suspect 2466 South 48th street, Black Female
Springdale , AR 72764
2 Suspect 2466 S 48th B, Springdale, AR White Female
72764
3 Victim TEED, KRISTOPHER M White Male
4 Victim BURKE, JAIBRIEL N Black Male
Properties
# Date Type Property Loss Type Description Name Subject Role
Vehicles
Contributing Officers
Officer: 5272 - Moore, Jacob Supervisor: 47 - Drake, Joshua Report 10/02/2024 18:20
Date/Time:
Report Type: Primary Approving User: fabiolama
Officer: 260 - French, Leland Supervisor: 47 - Drake, Joshua Report 10/02/2024 18:22
Date/Time:
Report Type: Supplement Approving User: fabiolama
Officer: 218 - Dickerson, Michael Supervisor: 47 - Drake, Joshua Report 10/02/2024 20:36
Date/Time:
Report Type: Supplement Approving User: fabiolama
Evidence
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
Status History
Case Status: In Field Status Date: 09/29/2024 Changed By: System
Date/Time 09/29/2024 22:57
Changed:
Case Status: Closed Status Date: 09/29/2024 Changed By: fabiolama
Date/Time 10/03/2024 09:09
Changed:
Case Status: Closed Status Date: 10/02/2024 Changed By: fabiolama
Date/Time 10/03/2024 09:10
Changed:
Disposition History
Disposition: Cleared by Arrest Disposition Date: 09/29/2024 Disposition fabiolama
Changed By:
Date/Time 10/03/2024 09:09
Changed:
Disposition: Cleared by Arrest Disposition Date: 10/02/2024 Disposition fabiolama
Changed By:
Date/Time 10/03/2024 09:10
Changed:
Supplemental Information
Action Taken: Reasons For No Purge Type:
Arrest:
Purge Date: Non-Fatal
Purge Review Shooting:
Date:
Associated Arrest Records
Arrest Information
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
General Information
Arrest Number: 2888 Case Number: 2024-00063013 Arrest Type: On-View Arrest
Location 2466 S 48TH ST B, Location PERIMETER OF THE OZARKS Arrest Status: Approved by Supervisor
Formatted: SPRINGDALE, 72762 Common Name:
Arrest Date/Time: 09/29/2024 21:29
Status Date/Time: 10/03/2024 00:00 Age at Arrest:
Basis for Caution:
Arrest Result Of: Resisted Arrest:
Arresting Officer
Multiple Count Arrest Arresting Officer: 218 - Dickerson, Michael Assignment:
Clearance
Arrestee Subject Juvenile Arrestee Name
Indicator:
Type: Formatted:
School Response No
Arrestee Primary Arrestee Date Of
Officer:
Contact: Birth:
Arrestee Location 2466 S 48th B, Springdale,
Arrestee License Arrestee License
Formatted: AR 72764
Number: State:
Arrestee Local Id
Arrestee Age: Arrestee Height:
Number:
Arrestee Race: White Arrestee Sex: Female
Arrestee License
Expiration Date: Arrestee Eye Arrestee Hair
Color: Color:
Arrestee Weight:
Arrestee Ethnic
Origin:
Additional Arrest Information
Statement Taken Officer Who Read Miranda
By: Miranda: Date/Time:
Fingerprinted By: Fingerprint Date: Statement Type:
Resident Type: City Resident Status: Resident Alcohol Influence:
Breath Analyzer Drug Influence: Clears Case:
Result:
School Name: Campus Code:
ID Procedure:
Juvenile Referred to Other
Disposition:
Arresting Officers
Primary: Yes Arresting Officer: 218 - Dickerson, Michael Assignment:
School Response No
Officer:
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
Charges
Offense/Charge 09/29/2024 22:00 Statute Group: State Statute/Violation: 5-13-203a(1)
Date/Time:
Statute BATTERY - 3RD DEGREE / Counts: 1
Statute Crime 13B - Simple Assault Description: PURPOSE OF CAUSING
Domestic Code:
Code: INJURY, CAUSES INJURY
Submit Offense: Yes
NCIC Code: Attempt/Commit: Completed
Disposition Date: 10/02/2024
Larceny Code: Plea:
Aiding/Abetting:
Other Agency: No Disposition: Referred to Other Auth
Drug Info Entries: 0
Scene Code: Clery Location:
Multiple Reason To
Clearance Commit:
Indicator:
Weapons
Weapon: Unarmed Feature:
Injury Information
Injury Types: Hospital: Extent Of Injury:
Transported By: Medical Condition:
Treatment:
Narratives
Entered By: 218 - Dickerson, Michael Date Entered: 10/02/2024 20:28
24-63013
BWC: Activated
On September 29th 2024, at approximately 7:48 PM I (Patrol First Class. M. Dickerson #415) was dispatched
to 2466 S 48th Street Suite B (Perimeter of the Ozarks) in reference to a disturbance. The caller advised
residents were threatening to attack the staff. The caller advised a resident had already attacked one of the
nurses thirty minutes before calling.
When I arrived on scene, Officers J. Moore #397 and L. French #367 were speaking with the staff and caller
attempting to gather information for the incident. I attempted to review footage of the incident with one of the
staff members when she began to run back toward the unit holding the children. Following the nurse back into
the containment unit I observed a white male staff member step outside of the unit with a torn shirt and red
face visibly distraught. The male individual advised he was just attacked and wanted to press charges on the
juvenile that attacked him. Entering into the containment unit I observed several female juveniles being
restrained by staff members and the male pointed to one and advised she was the one who
attacked the male staff member.
I advised the staff members to let go of her as she was actively resisting their efforts and myself and Officer L.
French #367 replaced the staff members and attempted to get the juvenile to walk out of the containment unit
with us. The juvenile verbally refused and demanded to be let go of, we then lifted her up by both arms and
waited for her to put her body weight on her legs. The juvenile never put her wight on her legs so we went
back to the ground. The juvenile then began to thrash her entire body and writhe on the ground attempting to
wrest free her hands from officer’s control. Myself and Officer L. French #367 then placed the juvenile’s hands
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
on the small of her back and placed her in handcuffs. Due to the juvenile continually writhing and ignoring
warning, I was unable to ensure the fit of the handcuffs but they were double locked. The juvenile was then
removed from the containment room where she began to kick at any individual nearby forcing me to catch her
legs and restrain them until she ceased lashing out. After everyone stepped away from the juvenile, she was
able to calm down a little and I stayed with her and attempted to figure out what had occurred. The juvenile
eventually identified herself as did not provide me with
any further information about what had occurred, only stating the male staff member had made her angry after
restraining her friend and she got mad. When asked about the incident further began to change the
subject. While sitting and talking with me began to struggle against her cuffs and even after being
warned several times, she was only going to cause abrasions to her skin, wrested her right hand from
the handcuffs. I finished taking the handcuffs off and advised her they could stay off if she controlled her
violent outbursts as we were in a controlled room and I did not want to risk injury of attempting to slip out of
handcuffs for a second time. required no medical treatment for the slight redness around her wrists.
Officer J. Moore #397 then confirmed there were charges for Battery 3rd and JDC had made the decision to
detain in light of the situation. I then explained the situation to and placed her in handcuffs
again, this time was more cooperative and the handcuffs were placed on in a manner where I was
able to check the fit and ensure they were double locked. For more information concerning the probable cause
and victim please refer to Officer J. Moore’s #397 narrative.
was then transported back to Washington County Juvenile Detention Center and handed over into the
intake officer’s custody.
PFC. M. Dickerson #415
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
Charges
Offense/Charge 09/29/2024 19:00 Statute Group: State Statute/Violation: 5-13-203
Date/Time:
Statute BATTERY - 3RD DEGREE Counts: 1
Statute Crime 13B - Simple Assault Description:
Domestic Code:
Code:
Attempt/Commit: Completed
Submit Offense: Yes
NCIC Code:
Plea:
Disposition Date: 09/30/2024
Larceny Code:
Disposition: Referred to Other Auth
Aiding/Abetting:
Other Agency: No
Clery Location:
Drug Info Entries: 0
Scene Code:
Reason To
Multiple Commit:
Clearance
Indicator:
Weapons
Weapon: Unarmed Feature:
Injury Information
Injury Types: Hospital: Extent Of Injury:
Transported By: Medical Condition:
Treatment:
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
Narratives
Entered By: 260 - French, Leland Date Entered: 09/30/2024 01:48
On September 29, 2024, I (Officer French 367) was dispatched to 2466 South 48th street for a disturbance
call. The caller stated 7-8 residents are causing issues and attacking the staff.
Upon arrival, I and Officer Moore 397 made contact with the caller Kristopher Teed
. Kristopher explained that the building is housing about thirty female juveniles. He stated about
seven of them are making threats and have attacked the staff before. Once inside the building, the female
juveniles are heard yelling and screaming. The juveniles are heard screaming profanities at the staff and
officers. The staff member that was attacked was identified as Jaibriel Burke . The
suspect juvenile is identified as .
Jaibriel stated was in the rec room and started breaking things and throwing stuff around. Jaibriel
stated he went in the room to remove and put her into solitary confinement. Jaibriel stated when he
opened the door to enter; started throwing punches and hitting him in the face and chest area.
Jaibriel and other staff members had to physically retrain but she continued to fight and hit Jaibriel. I
observed Jaibriel had abrasions under his right eye and had some of his bread missing from where she pulled
some of it out.
While speaking with Jaibriel, juveniles in the rec room started destroying property in the room. Staff members
went into the rooms and the juveniles started attacking the staff. Once female juvenile had to be restrained
due to attacking Kristopher. Kristopher stated he wanted to press charges so the female juvenile identified as
was detained. was already being restrained by staff
members. I and Officer Dickerson 415 took over by grabbing each of her arms. When attempting to pickup
to her feet, she dropped her weight. When she dropped her weight; officers assisted her to the ground
gently. While officer Dickerson moved her hands to the small of her back, I placed her in handcuffs. Once in
handcuffs, myself and Officer Moore performed a two on one escort out of the room and placed her in a chair.
While Officer Moore was speaking with staff members and Officer Dickerson was dealing with I
contacted Washington juvenile detention center. I spoke to the intake officer and I advised her of the situation
for both juveniles. The intake officer provided me with court dates for . was given
a court date of September 30, 2024 at 0800 hours. was given a court date of September 30, 2024 at
0815 hours. I transported to the Washington county juvenile detention center. She was released to
the care of the intake officers. Please see Officer Moore and Officer Dickerson narrative for more information.
End narrative. 367
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
Summary Narrative
Report Narratives
Name: Narrative Author: 5272 - Moore, Jacob Supervisor: 47 - Drake, Joshua Date Created: 09/29/2024 22:57
Description:
SPD CASE 2024-63013
***NARRATIVE***
***AXON BODY-CAM ACTIVATED***
On 09/29/2024 at approximately 1951 hours I was dispatched to the Perimeter of the Ozarks located at
2466 S 48th St B in regard to a disturbance. The caller, who was later identified as Kris Teed
) advised that there were juvenile residents at the location that were threatening staff members.
Teed further advised that one of the juveniles had assaulted one of the staff members approximately thirty
minutes prior to calling the Springdale Police Department.
As I arrived on scene, I made contact with Teed in the parking lot. While speaking with Teed, he
advised that several of the juveniles were acting very aggressive inside of the facility. I then advised for them
to escort myself and Officer French #367 into the facility to make contact with the victim of the assault. While
inside of the facility, I made contact with Jaibriel Burke who advised that a juvenile
had punched him the day prior on 09/28/2024, causing him physical injury. While speaking with Burke, I
observed that he had a laceration on his face. Upon asking him how he got this laceration, he advised that a
juvenile who was later identified as had punched him. He further
advised that during the incident, had pulled his beard to the point that it tore hair off of his face and
scratched his side. I then observed a scratch mark on his side. Due to his visible injuries, I asked him if he
wanted to press charges, to which he advised that he did. I began taking photos of Burke’s injuries and
uploaded them to the Springdale Police Department’s Axon Photo Library. I then began speaking with
who was in an enclosed area of the facility. Upon pulling her out of the enclosed area, she advised that she
did not do anything wrong. I explained to her that several people had stated that this incident happened, and
that there were physical injuries on Burke. While speaking with another incident started to unfold in a
separate enclosed area of the facility, where another staff member, who I identified as Teed, had gotten
assaulted. While Teed was walking out of the enclosed area of the facility, I observed that the shirt that he
was wearing prior had been torn and ripped. Due to this, I advised to return to the enclosed area where
she was originally at and I entered a separate enclosed portion of the facility to assist Officer French and
Officer Dickerson #415.
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
Upon entering the enclosed area of the facility, I observed a juvenile that I later identified as
detained and in handcuffs. With the assistance of Officer French, I
helped stand up and escorted her out of the enclosed portion of the facility. While escorting her out,
went limp and did not assist herself with walking. Once Officer French and I escorted her out, myself
and the other officers attempted to get to calm down. Once had calmed down, I made
contact with Teed who advised that he wanted to press charges against
I then made contact with Burke in the meeting area of the facility. Burke advised that he would
complete a witness statement form regarding the incident that had occurred with While speaking with
Burke, he also provided video surveillance footage of the incident. In this footage, I observed throw
several punches at Burke, causing him physical injury. I then returned to my patrol vehicle to retrieve witness
statement forms and Burke and another staff member began completing the witness statement forms. While
they were completing these written statement forms, I returned to Teed and asked him what had happened.
Teed advised that several juveniles were damaging property in a separate enclosed area of the facility, and in
an attempt to de-escalate the situation, had grabbed onto him from behind and hit him in the face. I
observed that he had physical redness and bruising on his face, along with the shirt that was ripped. At this
point, Teed had changed shirts so I advised him to retrieve the shirt that he was originally wearing. Once he
had retrieved the shirt, I began taking photos of his injury along with the ripped shirt. I then had Teed complete
a written statement regarding the incident. The photos have been uploaded to the Springdale Axon Photo
Library.
While the victims were completing written statements, Officer French contacted the Washington
County Juvenile Intake Department and advised them of the incident. While speaking with Juvenile Intake
Officers, they advised that they would be detaining both of the juveniles and requested that officers transport
them to the Washington County Juvenile Detention Center. I then advised Officer Dickerson of this, who was
still speaking with . Once Officer French completed his phone call with the Juvenile Intake Officer,
we escorted to a quiet portion of the facility. Officer Dickerson then placed under arrest for
Battery – 3rd Degree. Once Officer Dickerson arrested he walked her to his patrol vehicle and
began transporting her to the Washington County Juvenile Detention Center. Officer French and I then made
contact with and Officer French placed her under arrest for Battery – 3rd Degree. Officer French then
walked her to his patrol vehicle and began transporting her to the Washington County Juvenile Detention
Center. The Juvenile Intake Officer advised Officer French that had a court date of 09/30/2024 at 0800
hours and had a court date of 09/30/2024 at 0830 hours, both at 855 Clydesdale Dr. I collected the
written statements and returned to the Springdale Police Department to begin on a juvenile preliminary report
form.
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
Once I arrived at the Springdale Police Department, I completed a juvenile preliminary report form for
both of the juveniles. After getting the preliminary report form completed, a supervisor approved it and I then
forwarded it to Officer Dickerson and Officer French.
All paperwork has been stapled and placed in the Squad B Nights Complete Paperwork Box.
Please refer to Officer French and Officer Dickerson’s case supplements for further information
regarding the incident.
At this time, I have nothing further to note.
///JM397///
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
Name: Narrative Author: 260 - French, Leland Supervisor: 47 - Drake, Joshua Date Created: 09/30/2024 01:42
Description:
On September 29, 2024, I (Officer French 367) was dispatched to 2466 South 48th street for a
disturbance call. The caller stated 7-8 residents are causing issues and attacking the staff.
Upon arrival, I and Officer Moore 397 made contact with the caller Kristopher Teed
Kristopher explained that the building is housing about thirty female juveniles. He stated about
seven of them are making threats and have attacked the staff before. Once inside the building, the female
juveniles are heard yelling and screaming. The juveniles are heard screaming profanities at the staff and
officers. The staff member that was attacked was identified as Jaibriel Burke . The
suspect juvenile is identified as
Jaibriel stated was in the rec room and started breaking things and throwing stuff around.
Jaibriel stated he went in the room to remove and put her into solitary confinement. Jaibriel stated
when he opened the door to enter; started throwing punches and hitting him in the face and chest
area. Jaibriel and other staff members had to physically retrain but she continued to fight and hit
Jaibriel. I observed Jaibriel had abrasions under his right eye and had some of his bread missing from where
she pulled some of it out.
While speaking with Jaibriel, juveniles in the rec room started destroying property in the room. Staff
members went into the rooms and the juveniles started attacking the staff. Once female juvenile had to be
restrained due to attacking Kristopher. Kristopher stated he wanted to press charges so the female juvenile
identified as was detained. was already being
restrained by staff members. I and Officer Dickerson 415 took over by grabbing each of her arms. When
attempting to pickup to her feet, she dropped her weight. When she dropped her weight; officers
assisted her to the ground gently. While officer Dickerson moved her hands to the small of her back, I placed
her in handcuffs. Once in handcuffs, myself and Officer Moore performed a two on one escort out of the room
and placed her in a chair.
While Officer Moore was speaking with staff members and Officer Dickerson was dealing with
I contacted Washington juvenile detention center. I spoke to the intake officer and I advised her of the situation
for both juveniles. The intake officer provided me with court dates for . was given
a court date of September 30, 2024 at 0800 hours. was given a court date of September 30, 2024 at
0815 hours. I transported to the Washington county juvenile detention center. She was released to
the care of the intake officers. Please see Officer Moore and Officer Dickerson narrative for more information.
End narrative. 367
Name: Narrative Author: 218 - Dickerson, Supervisor: 47 - Drake, Joshua Date Created: 10/02/2024 20:26
Michael
Description:
24-63013
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
BWC: Activated
On September 29th 2024, at approximately 7:48 PM I (Patrol First Class. M. Dickerson #415) was dispatched
to 2466 S 48th Street Suite B (Perimeter of the Ozarks) in reference to a disturbance. The caller advised
residents were threatening to attack the staff. The caller advised a resident had already attacked one of the
nurses thirty minutes before calling.
When I arrived on scene, Officers J. Moore #397 and L. French #367 were speaking with the staff and caller
attempting to gather information for the incident. I attempted to review footage of the incident with one of the
staff members when she began to run back toward the unit holding the children. Following the nurse back into
the containment unit I observed a white male staff member step outside of the unit with a torn shirt and red
face visibly distraught. The male individual advised he was just attacked and wanted to press charges on the
juvenile that attacked him. Entering into the containment unit I observed several female juveniles being
restrained by staff members and the male pointed to one and advised she was the one who
attacked the male staff member.
I advised the staff members to let go of her as she was actively resisting their efforts and myself and Officer L.
French #367 replaced the staff members and attempted to get the juvenile to walk out of the containment unit
with us. The juvenile verbally refused and demanded to be let go of, we then lifted her up by both arms and
waited for her to put her body weight on her legs. The juvenile never put her wight on her legs so we went
back to the ground. The juvenile then began to thrash her entire body and writhe on the ground attempting to
wrest free her hands from officer’s control. Myself and Officer L. French #367 then placed the juvenile’s hands
on the small of her back and placed her in handcuffs. Due to the juvenile continually writhing and ignoring
warning, I was unable to ensure the fit of the handcuffs but they were double locked. The juvenile was then
removed from the containment room where she began to kick at any individual nearby forcing me to catch her
legs and restrain them until she ceased lashing out. After everyone stepped away from the juvenile, she was
able to calm down a little and I stayed with her and attempted to figure out what had occurred. The juvenile
eventually identified herself as did not provide me with
any further information about what had occurred, only stating the male staff member had made her angry after
restraining her friend and she got mad. When asked about the incident further began to change the
subject. While sitting and talking with me began to struggle against her cuffs and even after being
warned several times, she was only going to cause abrasions to her skin, wrested her right hand from
the handcuffs. I finished taking the handcuffs off and advised her they could stay off if she controlled her
violent outbursts as we were in a controlled room and I did not want to risk injury of attempting to slip out of
handcuffs for a second time. required no medical treatment for the slight redness around her wrists.
Officer J. Moore #397 then confirmed there were charges for Battery 3rd and JDC had made the decision to
detain in light of the situation. I then explained the situation to and placed her in handcuffs
again, this time was more cooperative and the handcuffs were placed on in a manner where I was
able to check the fit and ensure they were double locked. For more information concerning the probable cause
and victim please refer to Officer J. Moore’s #397 narrative.
was then transported back to Washington County Juvenile Detention Center and handed over into the
intake officer’s custody.
PFC. M. Dickerson #415
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Case Report
Detail
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:19
Agency #: AR0720200
Login Id: SPRD\baileyjo Page 14 of 14

doc_type: Police Report


summary: The fire department was called for a female who had cut herself with a piece of wood at the facility. The juvenile was transported to Arkansas Children’s Hospital with non-life-threatening injuries.

raw_content:
Incident Details
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:21
Agency #: AR0720200
General Information
Incident Number: 2024-00062866 Incident Type: Fired Call Date/Time: 09/29/2024 01:11
Location 2466 S 48TH ST, Location OZARK GUIDANCE CENTER Originating Call
Formatted: SPRINGDALE, 72762 Common Name: Number:
Nature Of Call: Status: In Progress Priority: 3
Source: Admin Phone Line
Units/Personnel
Unit: 415 Primary Unit: No Call Date/Time: 09/29/2024 01:13
Personnel: 218 - Dickerson, Michael Primary: Yes
Unit: 386 Primary Unit: Yes Call Date/Time: 09/29/2024 01:13
Personnel: 265 - Springston, Alyshia Primary: Yes
Vehicles
Subjects
Role: Caller Primary Caller: No Non-Disclosure: No
Subject Type: Adult Name Formatted: Location
Formatted:
Primary Contact Date of Birth:
Information: Local Id Number:
License State:
License Number: License Expiration
Weight Range
Date:
Height Range Lower:
Lower: Race:
Ethnic Origin:
Sex: Female Hair Color:
Eye Color:
Disposition
Disposition: Complaint Only Count: 1 Unit:
Date/Time: 09/29/2024 01:30
Evidence
Call Log
Date/Time: 09/29/2024 01:11 User: andreawa Action: Call Created
Description: New call created. Call Type:
>New Call<, Location:
<UNKNOWN>
Date/Time: 09/29/2024 01:12 User: andreawa Action: Address Verified
Description: Call Location Changed from
Unverified To Verified
Date/Time: 09/29/2024 01:12 User: andreawa Action: Location
Description: Call Location Changed from
<UNKNOWN> to 2466 S
48TH ST, SPRINGDALE
User: andreawa Action: Location
Login Id: SPRD\baileyjo Page 1 of 5

Incident Details
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:21
Agency #: AR0720200
Date/Time: 09/29/2024 01:12
Description: Cross streets updated,
SPRINGHOUSE DR / PRIVATE
DR, ATCHISON AVE
Date/Time: 09/29/2024 01:12 User: testing, cad - system Action: Alerts Retrieval
Description: Alerts Were Successfully
Gathered For Location At
Address 2466 S 48TH ST
Date/Time: 09/29/2024 01:12 User: andreawa Action: Agency Context Added
Description: Police Call Type Added. Call
Type: Suicide, Status: Not In
Progress, Priority: 2
Date/Time: 09/29/2024 01:12 User: andreawa Action: Call Type
Description: Police Call Type Changed
From Suicide To Call Type:
Fired, Status: In Progress,
Priority: 3
Date/Time: 09/29/2024 01:13 User: andreawa Action: Location
Description: Call Location Changed from
2466 S 48TH ST,
SPRINGDALE to 2466 S 48TH
ST, SPRINGDALE (OZARK
GUIDANCE CENTER)
Date/Time: 09/29/2024 01:13 User: andreawa Action: Location
Description: Cross streets updated,
SPRINGHOUSE DR / PRIVATE
DR, ATCHISON AVE
Date/Time: 09/29/2024 01:13 User: testing, cad - system Action: Alerts Retrieval
Description: Alerts Were Successfully
Gathered For Location At
Address 2466 S 48TH ST
Date/Time: 09/29/2024 01:13 User: andreawa Action: Narrative Added
Description: FD ASSIST FOR A FEMALE
WHO HAD CUT HERSELF
WITH A PIECE OF WOOD AT
THE FACILITY
Date/Time: 09/29/2024 01:13 User: karlaes Action: Unit Status Action
Description: Unit 386 Dispatched
Date/Time: 09/29/2024 01:13 User: karlaes Action: Unit Location
Description: Unit 386 Secondary Location:
Secondary Location Cleared
Date/Time: 09/29/2024 01:13 User: karlaes Action: Incident Created
Description: Added Incident Number, ORI:
AR0720200, Number: 2024-
00062866
Login Id: SPRD\baileyjo Page 2 of 5

Incident Details
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:21
Agency #: AR0720200
Date/Time: 09/29/2024 01:13 User: karlaes Action: Call Ready for Dispatch
Description: Call marked ready for
dispatch
Date/Time: 09/29/2024 01:13 User: karlaes Action: Unit Location
Description: Unit 415 Secondary Location:
Secondary Location Cleared
Date/Time: 09/29/2024 01:13 User: karlaes Action: Unit Status Action
Description: Unit 415 Dispatched
Date/Time: 09/29/2024 01:13 User: andreawa Action: Narrative Added
Description: FEMALE CUT TO THE
ARM NO BLEEDING NOW
Date/Time: 09/29/2024 01:14 User: karlaes Action: Unit Status Action
Description: Unit 386 Responding
Date/Time: 09/29/2024 01:14 User: karlaes Action: Unit Status Action
Description: Unit 415 Responding
Date/Time: 09/29/2024 01:19 User: karlaes Action: Unit Status Action
Description: Unit 415 On Scene
Date/Time: 09/29/2024 01:23 User: karlaes Action: Unit Status Action
Description: Unit 386 On Scene
Date/Time: 09/29/2024 01:30 User: jasminne Action: Person Added
Description: Person Added: Last Name -
Date/Time: 09/29/2024 01:30 User: jasminne Action: Narrative Added
Description: 415/
WAS TRANSPORTED TO ACH
WITH NON LIFE
THREATENING INJURIES
Date/Time: 09/29/2024 01:30 User: karlaes Action: Disposition Changed
Description: Added: Complaint Only
Count 1
Date/Time: 09/29/2024 01:30 User: karlaes Action: Narrative Added
Description: 415/T98 DISPO ON 2
Date/Time: 09/29/2024 01:30 User: karlaes Action: Unit Status Action
Description: Unit 415 Available
Date/Time: 09/29/2024 01:30 User: karlaes Action: Unit Status Action
Description: Unit 386 Available
Date/Time: 09/29/2024 01:30 User: karlaes Action: Call Cleared
Description: Close Call
Login Id: SPRD\baileyjo Page 3 of 5

Incident Details
Agency: Springdale Police Department Print Date/Time: 10/22/2024 10:21
Agency #: AR0720200
Narratives
Entered By: andreawa Date Entered: 09/29/2024 01:13
FD ASSIST FOR A FEMALE WHO HAD CUT HERSELF WITH A PIECE OF WOOD AT THE FACILITY
Entered By: andreawa Date Entered: 09/29/2024 01:13
FEMALE CUT TO THE ARM NO BLEEDING NOW
Entered By: jasminne Date Entered: 09/29/2024 01:30
WAS TRANSPORTED TO ACH WITH NON LIFE THREATENING INJURIES
Entered By: karlaes Date Entered: 09/29/2024 01:30
415/T98 DISPO ON 2
Login Id: SPRD\baileyjo Page 5 of 5


summary: The Springdale Police Department was called to the facility due to a resident assaulting multiple staff. The resident was arrested and taken to JDC.

raw_content:
Placement and Residential Licensing Unit
P.O. Box 1437, Slot S140, Little Rock, AR 72203-1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 024389
Date of Incident: 9/29/2024
Date Received: 9/30/2024
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Incident Type: Licensing
Report Description: ? Serious injury requiring outside medical attention ? Resident?s
attempted suicide ? Allegation of abuse/neglect related to a restraint ? Resident?s death ?
AWOL/Elopement ? Allegation of sexual/physical abuse ? Sexual Misconduct X Other,
Arrest Patient/Resident Name/DOB: Date/Time of incident:
09/29/24 at 21:30 Patient Insurance: Name of Perimeter Staff Making
Notification Date Time Name of Person Notified DHS Charriot Sales, Director of Risk
Management 09/30/24 18:00 Felicia Harris, Chelsea Vardell, Kendra Rice, Jarred Parnell
OLTC Charriot Sales, Director of Risk Management 9/30/24 18:00
Jeff.rosenbaum@dhs.arkansas.gov Disability Rights Center, Inc. Charriot Sales, Director of
Risk Management 09/30/24 18:00 incidentreporting@disabilityrightsar.org Perimeter
Charriot Sales, Director of Risk Management 09/30/24 18:00 Skyler Barnes, Shawna Stover,
Chris Perry, Brandy Pfeifer, Carey Ouzts, Rebecca Thomas Guardian/Caseworker Sabrina
McLellen, LPN 09/29/24 23:57 Charriot R. Sales, Director of
Risk Management 09/30/24 Signature and title of staff completing this form Date: Name of
Facility: Perimeter Behavioral of the Ozarks Phone Number: 479-957-9857 ext. 108 Street
Address, City, State, Zip: 2466 S. 48th Street Suite B. Springdale, AR 72762 Please describe
the incident: On 09/29/24, the Springdale Police Department was called on
On 09/28/24, the resident assaulted multiple staff and was exhibiting the same aggression
that evening. She was taken to the Juvenile Detention Center and was scheduled for court
on 09/30/24 at 08:00. She returned to Perimeter on 09/30/24 at approximately 14:00. Actions
Taken: ? Called the Springdale Police Department. ? Resident taken to the Juvenile
Detention Center. ? Court appointment on 30 Sep 24 at 08:00. ? Guardian notified.
Interim Action Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Maltreatment Narrative:
Licensing Narrative: 10/1/2024 - The provider reported incident was reviewed by the
licensing specialist. Licensing specialist will follow up with facility if there is camera footage
for review and if the resident received a citation. 10/1/2024 - Citation information received,
reviewed, and uploaded to ELS. 10/3/2024 - A visit was conducted at the facility to review
video footage for the reported incident. Timestamp for the video 9/29/2024 at 7:05 PM from
7:05PM to 7:13. Residents can be seen becoming dysregulated while yelling out of the door.
At 7:13 PM another resident from another unit was outside of the door of the blue unit.
When residents in the blue unit saw the other resident outside they became more physical.
The staff can be seen utilizing body blocks and trying to verbally calm residents. Police
contact at 7:19PM because the environment was becoming more unsafe. The residents
continue to posture and instigate until the police arrive with no further incident. 10/7/2024 -
Licensing specialist sent correspondence inquiring and requesting documentation about
preventative implementations being utilized to deescalate before restraints or police
intervention is needed. 10/7/2024 - 1. De-escalation Training All staff members undergo
regular training in crisis prevention and intervention via Handle with Care, with a strong
emphasis on verbal de-escalation techniques. This includes recognizing early signs of
agitation and employing strategies such as verbal de-escalation, calming techniques, and
environmental modifications to support regulation. 2. Therapeutic Interventions and
Programming We have increased the availability of therapeutic programming, including
group and individual therapy sessions, to address emotional regulation, conflict resolution,
and coping skills. By focusing on these skills in a structured manner, we aim to reduce
underlying stressors and improve residents' ability to handle challenging situations. 3.
Trauma-Informed Care Approach We continue to use a trauma-informed care framework,
which emphasizes understanding the root causes of behavior, considering trauma histories,
and using empathy to guide our interactions with residents. This approach helps reduce
triggers and build trust between staff and residents, mitigating tensions. 4. Leadership
Review of Emergency Safety Interventions (ESIs) In addition to these preventative
measures, all Emergency Safety Interventions (ESIs) are reviewed by leadership to ensure
that best practices are being followed. This review process includes analyzing the
circumstances that led to the intervention, evaluating whether preventative strategies were
properly applied, and identifying areas for improvement. By conducting these thorough
reviews, we aim to reduce the frequency of incidents requiring restraints or outside
intervention and to further refine our de-escalation protocols. We are committed to
maintaining a safe and supportive environment for all residents and staff and continue to
review and refine our practices to meet these goals. If you have any additional suggestions

or would like to discuss our strategies further, we are more than happy to set up a time for a
deeper conversation.

doc_type: Notice of Incident


summary: The Springdale Police Department was called to respond to an incident at the facility. During their visit, a resident attacked and assaulted several staff. The resident was taken to JDC.

raw_content:
Placement and Residential Licensing Unit
P.O. Box 1437, Slot S140, Little Rock, AR 72203-1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 024390
Date of Incident: 9/29/2024
Date Received: 9/30/2024
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Incident Type: Licensing
Report Description: ? Serious injury requiring outside medical attention ? Resident?s
attempted suicide ? Allegation of abuse/neglect related to a restraint ? Resident?s death ?
AWOL/Elopement ? Allegation of sexual/physical abuse ? Sexual Misconduct X Other,
Arrest Patient/Resident Name/DOB: Date/Time of
incident: 09/29/24 at 21:30 Patient Insurance: Name of Perimeter Staff Making
Notification Date Time Name of Person Notified DHS Charriot Sales, Director of Risk
Management 09/30/24 18:00 Felicia Harris, Chelsea Vardell, Kendra Rice, Jarred Parnell
OLTC Charriot Sales, Director of Risk Management 9/30/24 18:00
Jeff.rosenbaum@dhs.arkansas.gov Disability Rights Center, Inc. Charriot Sales, Director of
Risk Management 09/30/24 18:00 incidentreporting@disabilityrightsar.org Perimeter
Charriot Sales, Director of Risk Management 09/30/24 18:00 Skyler Barnes, Shawna Stover,
Chris Perry, Brandy Pfeifer, Carey Ouzts, Rebecca Thomas Guardian/Caseworker Sabrina
McLellen, LPN 09/29/24 23:30 Charriot R. Sales, Director of
Risk Management 09/30/24 Signature and title of staff completing this form Date: Name of
Facility: Perimeter Behavioral of the Ozarks Phone Number: 479-957-9857 ext. 108 Street
Address, City, State, Zip: 2466 S. 48th Street Suite B. Springdale, AR 72762 Please describe
the incident: On 09/29/24, the Springdale Police Department was called to respond to an
incident on scene. During their visit, resident attacked and assaulted
several staff. She was taken to the Juvenile Detention Center and was scheduled for court on
09/30/24 at 08:10. She returned to Perimeter on 09/30/24 at approximately 14:00. Actions
Taken: ? Called the Springdale Police Department. ? Resident taken to the Juvenile
Detention Center. ? Court appointment on 30 Sep 24 at 08:10. ? Guardian notified.
Interim Action Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Maltreatment Narrative:
Licensing Narrative: 10/1/2024 - The provider reported incident was reviewed by the
licensing specialist. Licensing specialist will follow up with facility for camera footage of if
the resident received a citation. 10/1/2024 -Citation information received, reviewed, and
uploaded to ELS. 10/3/2024 - A visit was conducted at the facility to review camera footage
for the report incident. Timestamp for the video footage was 9/29/2024 - at 8:18 PM - 10
staff present for the incident. Residents can be seen in different positions in the sun room.
Resident can be seen standing on a chair and removing a light fixture cover in the sun
room. Staff can be seen walking into the unit and initiates a restraint on The
staff and resident struggle for a moment, can be seen assisting and takes
over the restraint, removes himself from the restraint and is assisted by
another staff. Resident is restrained by staff person for approximately 30
seconds to one minute. Police arrive at 8:20PM and remove to the milieu and then
transport the resident JDC. Licensing discussed preventative measures the facility is taking
in order to deescalate resident before restraints and police intervention is required. 1. De-
escalation Training All staff members undergo regular training in crisis prevention and
intervention via Handle with Care, with a strong emphasis on verbal de-escalation
techniques. This includes recognizing early signs of agitation and employing strategies
such as verbal de-escalation, calming techniques, and environmental modifications to
support regulation. 2. Therapeutic Interventions and Programming We have increased the
availability of therapeutic programming, including group and individual therapy sessions, to
address emotional regulation, conflict resolution, and coping skills. By focusing on these
skills in a structured manner, we aim to reduce underlying stressors and improve residents'
ability to handle challenging situations. 3. Trauma-Informed Care Approach We continue to
use a trauma-informed care framework, which emphasizes understanding the root causes of
behavior, considering trauma histories, and using empathy to guide our interactions with
residents. This approach helps reduce triggers and build trust between staff and residents,
mitigating tensions. 4. Leadership Review of Emergency Safety Interventions (ESIs) In
addition to these preventative measures, all Emergency Safety Interventions (ESIs) are
reviewed by leadership to ensure that best practices are being followed. This review process
includes analyzing the circumstances that led to the intervention, evaluating whether
preventative strategies were properly applied, and identifying areas for improvement. By
conducting these thorough reviews, we aim to reduce the frequency of incidents requiring
restraints or outside intervention and to further refine our de-escalation protocols. We are
committed to maintaining a safe and supportive environment for all residents and staff and
continue to review and refine our practices to meet these goals. If you have any additional

suggestions or would like to discuss our strategies further, we are more than happy to set up
a time for a deeper conversation.


summary: A resident reported that a staff member left bruises on her after a restraint. The complaint was UNFOUNDED by Licensing.

raw_content:
Placement and Residential Licensing Unit
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
R
Notice of Serious Incident
Case Number: 024415
Date of Incident: 9/28/2024
Date Received: 10/1/2024
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Incident Type: Dual
Report Description: ? Serious injury requiring outside medical attention ? Resident?s
attempted suicide X Allegation of abuse/neglect related to a restraint ? Resident?s death ?
AWOL/Elopement ? Allegation of sexual/physical abuse ? Sexual Misconduct ? Other
Patient/Resident Name/DOB: Date/Time of incident:
09/28/24 at 19:54 Patient Insurance: Texas Medicaid Name of Perimeter Staff Making
Notification Date Time Name of Person Notified DHS Charriot Sales, Director of Risk
Management 10/01/24 14:00 Felicia Harris, Chelsea Vardell, Kendra Rice, Jarred Parnell
OLTC Charriot Sales, Director of Risk Management 10/01/24 14:00
Jeff.rosenbaum@dhs.arkansas.gov Disability Rights Center, Inc. Charriot Sales, Director of
Risk Management 10/01/24 14:00 incidentreporting@disabilityrightsar.org Perimeter
Charriot Sales, Director of Risk Management 10/01/24 14:00 Skyler Barnes, Shawna Stover,
Chris Perry, Brandy Pfeifer, Carey Ouzts, Rebecca Thomas Guardian/Caseworker Jonathon
Arnett, Case Manager 10/01/24 10:55 Monica Cortez, Caseworker Charriot R. Sales, Director
of Risk Management 10/01/24 Signature and title of staff completing this form Date: Name
of Facility: Perimeter Behavioral of the Ozarks Phone Number: 479-957-9857 ext. 108 Street
Address, City, State, Zip: 2466 S. 48th Street Suite B. Springdale, AR 72762? Please describe
the incident: On 09/30/24, wrote a grievance that stated, ? put bruises
on me.? A was submitted and accepted. On 10/01/24, the Director of Risk
Management interviewed and she reported it happened Saturday out in the Milieu
while she was in a restraint; does have bruising on both arms. Camera was
reviewed for that incident and was in a restraint; however, was not the staff
involved in the hold. Justification and execution of the restraint aligns with state, facility,
and Handle with Care regulation. Actions Taken: made 9/30/24; referral
. and SIR submitted. Staff member suspended.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Interim Action Narrative: Employee suspended.
Maltreatment Narrative:
is a resident of Perimeter Behavioral of the Ozarks and
is a staff member. On 9/30/24, staff received a grievance form stating, "
put bruises on me. " For context, this resident has been involved in four restraints since
9/26/24 with various staff members. Each restraint was reviewed by camera by multiple
leadership personnel and no misconduct was noted. Additionally, was medically
assessed after each incident and did not present with bruising.
Licensing Narrative: 10/2/2024 - The complaint was reviewed by the licensing specialist.
Licensing will reach out to he investigator for permission and inquire about video footage,
nursing notes, and restraint packet information. The two staff involved in the hold is
and . 10/3/2024 - A visit was conducted to review video footage.
Time stamp 9/28/2024 - 7:53 PM- can be seen walking in the millieu. Staff
and . opens the door to the blue unit and resident
immediately begins attacking . initiates "primary restraint technique,
restraining the residents arms at the shoulder. Then the resident is escorted to the seclusion
room by and 4 other staff. The resident is struggling for entire escort. There is a
struggle in the door way. The resident is put into seclusion room at 7:55PM. There is
restraint packet signed by Doctor Hiatt for the restraint. At time stamp 7:57 PM - Resident
. can be seen in the milieu with staff . and at 7:57:40 grabs
the arm of . At 7:58 PM can be seen body blocking At 7:59 places
a hand on resident as resident falls to the floor 7:59:30. Time stamp 9/29/2024 at 7:15 PM
7:16PM- and can be seen in the milieu with . trying to
escort the resident to the seclusion room. enters the milieu and assists. The
resident can be holding a door frame. grabs the residents to release from the door
frame and the two staff escort the resident into the seclusion. There is a restraint packet
signed by Doctor Hiatt. 10/4/2024 - Staffed with Supervisor C. Vardell - follow up visit
scheduled for 10/24/2024. 10/7/2024 - Signed 521 received and uploaded to ELS.
10/23/2024 - maltreatment findings are unsubstantiated and ICA was lifted.


summary: A resident was taken to Arkansas Children’s Hospital after appearing to be shaking and very pale and collapsing on the floor.

raw_content:
Placement and Residential Licensing Unit
P.O. Box 1437, Slot S140, Little Rock, AR 72203-1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 024254
Date of Incident: 9/24/2024
Date Received: 9/25/2024
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Incident Type: Licensing
Report Description: ? Serious injury requiring outside medical attention ? Resident?s
attempted suicide ? Allegation of abuse/neglect related to a restraint ? Resident?s death ?
AWOL/Elopement ? Allegation of sexual/physical abuse ? Sexual Misconduct X Other,
Emergency Room Treatment Patient/Resident Name/DOB:
Date/Time of incident: 09/24/24 at 18:25 Patient Insurance:
Perimeter Staff Making Notification Date Time Name of Person Notified DHS Charriot
Sales, Director of Risk Management 09/25/24 16:00 Felicia Harris, Chelsea Vardell, Kendra
Rice, Jarred Parnell Disability Rights Center, Inc. Charriot Sales, Director of Risk
Management 09/25/24 16:00 incidentreporting@disabilityrightsar.org Perimeter Charriot
Sales, Director of Risk Management 09/25/24 16:00 Skyler Barnes, Shawna Stover, Chris
Perry, Brandy Pfeifer, Carey Ouzts, Rebecca Thomas Guardian/Caseworker Charriot Sales,
Director of Risk Management 09/24/24 18:55 Charriot R. Sales,
Director of Risk Management 09/25/24 Signature and title of staff completing this form
Date: Name of Facility: Perimeter Behavioral of the Ozarks Phone Number: 479-957-9857
ext. 108 Street Address, City, State, Zip: 2466 S. 48th Street Suite B. Springdale, AR 72762?
Please describe the incident: On 09/24/24, reported to staff that she wasn?t
feeling well. She appeared to be shaking and very pale. During her assessment, she stood up
and immediately collapsed on the floor, becoming lethargic and bradycardic. EMS was
called and the resident was taken to the Arkansas Children?s Hospital. was
stabilized, and was prescribed cephalexin. She
returned to Perimeter at 23:20. Actions Taken: Resident taken to the Emergency Room.
Resident was line of sight last evening for increased observation. Provider consulted during
incident and for aftercare follow-up. Follow-up phone call with guardian on 9/25/24 at
10:37.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 9/26/2024- The provider reported incident was reviewed by the
licensing specialist. Licensing specialist will follow up with the facility for nursing notes and
hospital discharge paperwork. 10/1/2024 - ER notes received, reviewed, and uploaded to
ELS.


summary: A visit was conducted to review personnel records. No deficiencies cited.

raw_content:
~ ARK AN GC AS
© OEPARTMENT OF

) <7 HUMAN
» “et 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: Jarred Parnell
Person In Charge:

Record Visit Date: 9/12/2024
Home Visit Date: 9/12/2024

Purpose of Visit: Personnel Records

Regulations Out of Compliance:

Regulations Needing Technical Assistance:

Regulation Not Applicable:

Regulations Not Correctable:

Narrative:

9/12/2024 - A visit was conducted to review personnel records.

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

Records were reviewed for the following personnel:

Licensing spoke with the facility concerning training for Restraints documentation for The staff
person does not participate in holds.

Provider Comments:

CCL Staff Signature : 4 —hPe Date: 9/13/2024
Provider Signature : Date: 9/13/2024
VO”
os

www.arkansas.gov/dhs

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

doc_type: Compliance Report


summary: A complaint received states that a facility nurse made a statement indicating that black techs should only deal with black residents. According to the complaint, several black techs and residents were questioned by the Risk Coordinator, and nothing was done about the statement. The complaint was UNFOUNDED by Licensing.

raw_content:
Placement and Residential Licensing Unit
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
R
Notice of Serious Incident
Case Number: 025645
Date of Incident: 9/11/2024
Date Received: 11/20/2024
Facility Name: Perimeter of the Ozarks
Facility Number: 237
Incident Type: Licensing
Report Description: Nurse made a comment that black techs should only deal with black
residents. Several black techs and residents were questioned by Risk Coordinator, and
nothing was done about the statement. The D.O.N thought it was funny and told him not to
say that around staff. Several residents have complained but they were put on restrictions to
the unit.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: Licensing specialist contacted the reporter. The reporter states nurse
made the statements that black techs should deal with black residents. This
statement was allegedly heard by staff and residents. The reporter states the following
residents would confirm the comments and A visit was conducted at the
facility interview staff and residents regarding the incident. Residents and
who were named by the reporter. Interview documentation has been uploaded to ELS.
Licensing specialist followed up with facility risk manager concerning allegations made by
the reporter. Risk manager C. Sales has inquired with other staff and did not obtain
information to substantiate that had made racist statements or treated
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

residents based on race, age, or gender. 1/8/2025 - Findings 521 send to the facility for
signature. 1/15/2025 - The complaint is unfounded by licensing.


summary: This document constitutes a formal Corrective Action Agreement (CAA) agreed upon by Perimeter Behavioral of the Ozarks and the Department of Human Services, Placement and Residential Licensing Unit.

doc_type: Corrective Action Agreement