summary: A resident reported her roommate touched her private area under her shirt while she was sleeping. 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: 025016
Date of Incident: 10/27/2024
Date Received: 10/28/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Dual
Report Description: On 10.27.24,
reported to 3-11 supervisor ShaKendra Dunbar. Her roommate
went under her shirt while she was sleeping and touched her boob.
woke up and asked "What the fuck are you doing" replied, "Shhhhh," and
returned back to her side of the bedroom. proceeded to get out of bed, walked into
the dayroom and spoke with the staff in ratio, and sat in a chair. The incident has been
Interim Action Narrative:
Licensing Narrative: Facility contacted Licensing regarding the complaint via telephone.
10/29/2024 Licensing Specialist Horton emailed the for permission to contact
the facility to request witness statements and safety plan. Licensing requested permission to
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

contact facility for witness statements and treatment plans. Permission was granted by
to contact facility. Facility reports the safety plan is already in place they are in
separate units. The facility provides the witness statement. Documentation has been
uploaded.

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: Little Creek Behavioral Health
Facility Number: 255
Licensee Address: 161 SKUNK HOLLOW
CONWAY AR 72032
Licensing Specialist: Kendra Slade
Person In Charge: Jlynn Price
Record Visit Date: 12/11/2024
Home Visit Date: 12/11/2024
Purpose of Visit: Complaint Visit
Regulations Out of Compliance:
Regulations Needing Technical Assistance:
Regulation Not Applicable:
Regulations Not Correctable:
Narrative:
No in-person licensing visit was completed on 12/11/2024.
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 1 of 2

Licensing received a complaint on 10/28/2024 for ELS Case #025016.
This complaint has beenUNFOUNDEDby Licensing.
Provider Comments:
CCL Staff Signature : Date: 12/11/2024
Provider Signature : Date: 12/11/2024
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 2 of 2


state: AR

facility_name: Little Creek Behavioral Health

summary: Officer received a call for service from the Crimes Against Children division in reference to a sexual offense that occurred at Little Creek.

raw_content:
FAULKNER COUNTY SHERIFFS OFFICE ** Juvenile Involved **

Incident Report Report Status: FILED INRECORDS
Case Number: 24003058 Case Status: ACTIVE
Page 1 of 3
Case#: 24003058 Report Date: 11/05/2024 13:56
Report By: Staff Sergeant. Timothy Johnson = (F5) Arrival Time:
Case Type: SEX CRIME UNDER 18 Reporting Zone: D
Business: Occurred From: 10/27/2024 17:00
Address: 161 SKUNK HOLLOW RD Occurred Through: 10/28/2024 08:00
Intersection: Reportable IBRS: Yes
City/State/Zip: CONWAY, AR 72032 School:
Lat/Long: Lat: 35,0682371 / Long: -92.3842116 Case Status: ACTIVE
Case Type: SEX CRIME UNDER 18 File / Cad ID:
Assigned To: _ Investigator. Mckenzie Taylor - (Cd9) Assigned Date: 11/07/2024
Cleared By: Cleared Date:
How Cleared:
IBR Clear Code: Clery Related: NO
UCR / Offenses
UCR: Forcible Fondling - [11D] Status: Completed
Charge: FORCIBLE FONDLING
Statute: Charge Code: 11D
Description: FORCIBLE FONDLING
Location: Other / Unknown
Weapon: None
Possibly Using: Not Applicable Criminal Activity: None/unknown
Bias: None Method Of Entry:
Gang Name: Home Invasion:
Victims

Victim Type: — Individual

——_— DOB:

Race/Sex: W/F

Address: 161 SKUNK HOLLOW ROAD Current Age: Height:
City/State: CONWAY, AR 72032 Age: Weight:
Email: Hair Color: Eyes:
Home Phone: Work: Cell: DL#:
Resident: RESIDENT Ethnicity: NOT HISPANIC OR LATINO
Occupation: Military:

Email: Narcan Dose: 0 SSN:
Employer:

Offender / Suspect

Name fF DOB | Race/Sex: W/F

FAULKNER COUNTY SHERIFFS OFFICE ** Juvenile Involved **

Incident Report Report Status: FILED INRECORDS
Case Number: 24003058 Case Status: ACTIVE
Page 2 of 3
Offender / Suspect
Address: 161 SKUNK HOLLOW ROAD Current Age: Height:
City/State: CONWAY, AR 72032 Age: Weight:
Resident: RESIDENT Hair Color: Eyes:
Ethnicity: HISPANIC OR LATINO Cell Phone: SSN:
Home Phone: Work Phone: DL#:
Occupation: Narcan Dose: 0
Employer:
Complainant
Name: ROBERTS, SUZIE DOB: Race/Sex: WI/IF
Address: 574 LOCUST ST Current Age: Height:
City/State: | CONWAY, AR 72034 Age: 0 Weight:
Email: Hair Color: Eyes:
Home: po Cell Phone: DL#:
Occupation: Work Phone:

Employer: CRIMES AGAINST CHILDREN

Narrative

On Tuesday, November 5, 2024, at approximately 1320 hours I received a call for service from the Crimes Against
Children in reference to a sexual offense.

| made contact with Ms, Suzie Roberts (Complainant) via telephone who advised me that there was a sexual offense
that occurred at 161 Skunk Hollow Road (Little Creek Behavioral Health). Mrs. Roberts stated JV1(A.V.) was
roommates with JV2 (E.S.) and alleged that on approximately October 27, 2024, they were sleeping in their room. Ms.
Roberts stated that JV1 alleged that JV2 came over to her bed and stuck her hand under clothing to touch her naked
person. Ms. Roberts stated that JV1 alleged that JV2 put her hand over her mouth when tried to say something and
left. Ms. Roberts was able to provide the ages of both JV1 and JV2. JV1’s approximate age isMlknd JV2’s
approximate age is Mrs. Roberts stated there was nothing that occurred following the touching of the breast area
by the hand of JV2.

| provided Ms. Roberts with this report number and told her how to obtain a copy of this report.

JOHNSON, TIMOTHY 11/5/2024, 3:10:08 PM

es be

Reporting Officer Approved By Officer
Staff Sergeant. Timothy Johnson - (F5) Sergeant. Zachary Cooley - (F6)
Reported On: 11/05/2024 13:56 Approved On: 11/09/2024 14:58

FILED INRECORDS

FAULKNER COUNTY SHERIFFS OFFICE ** Juvenile Involved **

Incident Report Report Status: FILED INRECORDS
Case Number: 24003058 Case Status: ACTIVE
Page 3 of 3

Case Status: ACTIVE Administrative Use Only - IBRS Date
143329

FAULKNER COUNTY SHERIFFS OFFICE

Call for Service Card

Page 1 of 1

Call Information

Received Date: 10/31/2024 11:08 Dispatch Date: 10/31/2024 11:30 EnRoute Date: 10/31/2024 11:36
Arrived Date: 10/31/2024 11:36 Completed Date: 10/31/2024 11:36 Call Canceled:

Disposition: HANDLED BY OFFICER-NO REPORT

CFS #: 24103658 Case #: Priority:

Nature: SEXUAL OFFENSE How Received: ADMIN LINE
Initial Nature: Alarm:

Call Taken By: JACKSON, MAKHAITLIN Dispatched By: BUTLER, TWYLA Fire Type:

Completed By: BRABHA\M, DIXIE ReOpened By: ReOpened Reason:

Site Dangers: NO K9 Used: NO Bill For Call: NO
Business Check: NO Toneout: Permit #:

Business:

caller adv this is in regard to a sexual abuse report at little creek

Incident Information

Common Name: Zone: SOUTH
Address: 161 SKUNK HOLLOW RD SubDivision:

CSZ: CONWAY, AR 72032 Intersection: ROBERT
ESN: 316 Lat/Lon: 35.0682371,

Caller Information

Name: ROBERT, SUSIE Address:
Phone #: (501) 472-7592 CSZ:
Notes
Entry Date Entry By Note Type Notes
10/31/2024 11:36:18 BRABHAM, DIXIE
10/31/2024 11:36:31 BRABHAM, DIXIE Complete all units. CALER ADVD THAT SHE WILL HAVE TO
CALL BACK
Total Notes: 2
Units
Unit Number Unit Name Department Mileage Start_ Mileage End Primary Unit
F34 RAGLAND, MAGGIE FCSO 0 0 YES
Dispatched Date: 10/31/2024 11:30 EnRoute Date: 10/31/2024 11:36 Arrived Date: 10/31/2024 11:36
Transport Start: Transport End: Completed Date: 10/31/2024 11:36
Disposition Date: Call Canceled: Back At Station:
Total Units: 1
Radio Traffic
Traffic Date Unit # Unit Name Traffic
10/31/2024 11:30 F34 RAGLAND, MAGGIE UNIT DISPATCHED
10/31/2024 11:36 F34 RAGLAND, MAGGIE UNIT ENROUTE

Total Radio Traffic: 2

Print Date: Nov 19 2024 - 10:58:06 FAULKNER COUNTY SHERIFFS OFFICE, 24103658
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FAULKNER COUNTY SHERIFFS OFFICE

Call for Service Card
Page 1 of 2

Call Information

Received Date: 11/05/2024 13:10 Dispatch Date: 11/05/2024 13:20 EnRoute Date: 11/05/2024 14:00

Arrived Date: 11/05/2024 14:00 Completed Date: 11/05/2024 14:00 Call Canceled:

Disposition: INC REPORT TAKEN

CFS #: 24110488 Case #: Priority:

Nature: ABUSE-JUVENILE How Received: ADMIN LINE
Initial Nature: Alarm:

Call Taken By: BRABHA\M, DIXIE Dispatched By: BRABHA\M, DIXIE Fire Type:

Completed By: BRABHA\M, DIXIE ReOpened By: ReOpened Reason:

Site Dangers: NO K9 Used: NO Bill For Call: NO
Business Check: NO Toneout: Permit #:

Business:

Incident Information
Common Name: Zone: SOUTH

Address: 161 SKUNK HOLLOW RD SubDivision:
CSZ: CONWAY, AR 72032 Intersection: ROBERTS
ESN: 316 Lat/Lon: 35.0682371,

Caller Information

Name: ROBERTS, SUSIE Address:
Phone #: (501) 472-7592 CSZ:
Notes

Entry Date Entry By Note Type Notes

11/05/2024 14:00:48 BRABHAM, DIXIE
11/05/2024 14:00:48 BRABHAM, DIXIE

11/05/2024 14:00:58 BRABHAM, DIXIE Complete all units.
11/05/2024 14:00:58 BRABHAM, DIXIE Complete all units.

Total Notes: 4
Units
Unit Number Unit Name Department Mileage Start_ Mileage End Primary Unit
F5 JOHNSON, TIMOTHY FCSO 0 0 YES
Dispatched Date: 11/05/2024 13:20 EnRoute Date: 11/05/2024 14:00 Arrived Date: 11/05/2024 14:00
Transport Start: Transport End: Completed Date: 11/05/2024 14:00
Disposition Date: Call Canceled: Back At Station:
F13 GILMORE, BLAKE FCSO 0 0 NO
Dispatched Date: 11/05/2024 13:20 EnRoute Date: 11/05/2024 14:00 Arrived Date: 11/05/2024 14:00
Transport Start: Transport End: Completed Date: 11/05/2024 14:00
Disposition Date: Call Canceled: Back At Station:

Total Units: 2
Print Date: Nov 19 2024 - 10:57:48 FAULKNER COUNTY SHERIFFS OFFICE, 24110488

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FAULKNER COUNTY SHERIFFS OFFICE

Call for Service Card
Page 2 of 2

Radio Traffic

Traffic Date Unit # Unit Name Traffic

11/05/2024 13:20 F5 JOHNSON, TIMOTHY UNIT DISPATCHED

11/05/2024 13:20 F13 GILMORE, BLAKE UNIT DISPATCHED

11/05/2024 13:49 F13 GILMORE, BLAKE UNIT DISPATCHED
re-dispatched to oldest call.

11/05/2024 13:49 F5 JOHNSON, TIMOTHY UNIT DISPATCHED
re-dispatched to oldest call.

11/05/2024 13:49 F5 JOHNSON, TIMOTHY UNIT DISPATCHED
re-dispatched to oldest call.

11/05/2024 13:49 F13 GILMORE, BLAKE UNIT DISPATCHED
re-dispatched to oldest call.

11/05/2024 14:00 F5 JOHNSON, TIMOTHY UNIT ENROUTE

11/05/2024 14:00 F13 GILMORE, BLAKE UNIT ENROUTE

Total Radio Traffic: 8

Case Numbers

Entry Date Case Number Department
11/05/2024 13:55:45 24003058 FAULKNER COUNTY SO
Print Date: Nov 19 2024 - 10:57:48 FAULKNER COUNTY SHERIFFS OFFICE, 24110488

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doc_type: Police Report


summary: A complaint was received alleging that multiple residents were overmedicated. According to the complaint, weight gain, sleepiness, slurred speech, visible shaking and trembling were observed among the residents listed. The facility was cited 905.11, 905.12, and 908.8 as a result of this complaint.

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: 024735
Date of Incident: 10/15/2024
Date Received: 10/15/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Dual
Report Description: AVs are
AO is unknown. AVs are
from who are residing at the Little Creek Behavioral Center.
The concern is that AVs are being over-medicated. The following was observed
has had a , she has had
substantial weight gain. She was observed to be in a sedated state, her
reported that she can?t refuse any of her medications or if she
does, they give her a shot. . had visible shaking of
her hands and was staring into space. She complained that she can?t stay awake during
school because of feeling sedated. . appeared to
be shaking and trembling, . is on Zyprexa and
Metformin, she expressed concern about the medication.
appeared very sedated and couldn?t keep his eyes open. He is unable to participate in
school because of sleepiness, appeared to be
sedated and had slurred speech, . appeared to
with hand shaking, . reported that her medication
makes her stomach hurt. She has had a 50lb weight gain, .
complained that her medication makes her sleepy. She appeared sleepy and in a
sedated state, . AVs were all observed during a visit
to the facility, they all have an extensive list of medications. AVs were all observed to be
sleepy and have slurred speech, they were described to be ?sedated.? AVs get medicated
every day.
Interim Action Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: 10/15/2024- Program Manager, Program Administrator, and Director
participated in a meeting with to discuss entry into the facility and aiding
Program Coordinator received an email from
and reviewed complaint. 10/16/2024- Program Coordinator spoke with
and she indicated that the residents were going to be interviewed
reported that the resident had discharged. Program
Coordinator and licensing specialist will visit the facility today to review chemical restraint
records and medication lists for all the residents named in this complaint. Program
Coordinator, Licensing Specialist Horton, and Nurse Melissa West, OLTC. Licensing
reviewed the MAR of residents listed in this complaint. restraint logs for September 2024
and October 2024, and physician orders. Licensing also walked the facility to see what the
residents were doing. Facility provided documentation on nursing documentation, post
psychotropic stat/emergency medication usage, PRTF Individiualized Behavioral
Contingencies, staff training requirements, Special Procedures Information Sheet, PRN

Medication Consent Form and possible side effects, physical escort policy, and personal
restraint. 10/17/2024, Licensing returned to the facility and observed residents in their
classrooms and observed 5 residents laying their heads on their desks. Licensing requested
copies of the nurses' licenses and background checks. The facility provided copies of the
Handle with Care training rosters for December 2023 and June 2024. Licensing reviewed
and gathered more documentation from the residents' files named in this complaint.
10/18/2024, Program Coordinator and Nurse West completed a walkthrough of the
educational hall and observed some residents who appeared sleep, nodding, or laying their
heads down. Facility provided the census that consist of each resident's name and the state
they are from. Nurse West spoke with the nurses at the nursing station and asked questions
regarding the med pass process. Documentation was provided. 10/21/2024, Program
Coordinator uploaded documentation for this complaint. 10/25/2024, Staffed with Program
Manager regarding background checks. Email sent to background to see if checks had been
ran. Program Coordinator requested contracts/agreements from states they provide services
to. 10/28/2024, facilty provided copies of out of state agreements. 10/29/2024, spoke with
Cinty and she reported 4 staff members backgrounds were not approved. Per Cindy,
background chesk were ran but not approved due to missing the maltreatment and HR and
to start over. Facility informed that staff members could not work until
their backgrounds were approved. 11/13/2024, facility reported that their HR representative
reported that staff members backgrounds were approved. Licensing will follow up with
Cindy. 11/14/2024, Cindy informed that all employees have been cleared to work via email.
11/15/2024, checked case is still pending.

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: Little Creek Behavioral Health
Facility Number: 255
Licensee Address: 161 SKUNK HOLLOW
CONWAY AR 72032
Licensing Specialist: Kendra Slade
Person In Charge: Jlynn Price
Record Visit Date: 12/9/2024
Home Visit Date: 12/9/2024
Purpose of Visit: Complaint Visit
Regulations Out of Compliance:
Regulation Number: 900.905.11
Regulation Description: Chemical restraints shall be used only if ordered by a physician. A chemical restraint is
an emergency behavioral intervention that uses pharmaceuticals by topical application, oral administration,
injection, or other means to modify a child’s behavior. Prescribed treatment medications that have a secondary
effect on the child’s behavior are not considered chemical restraint.
Finding Description: Chemical restraints were ordered but not signed off by the physician.
Action Due Date:
Action Due Description:
Comply Date:
Action Due Description:
Regulation Number: 900.905.12
Regulation Description: Seclusion, mechanical, or physical restraints shall be used only if ordered by a
physician.
Finding Description: Physical restraints ordered but not signed off by the physician.
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 1 of 3

Action Due Date:
Action Due Description:
Comply Date:
Action Due Description:
Regulation Number: 900.908.8
Regulation Description: The administering of all medications, including over-the-counter, shall be logged at the
time the medication is given, by the person administering the medication.
Finding Description: A chemical restraint was not logged on the MAR.
Action Due Date:
Action Due Description:
Comply Date:
Action Due Description:
Regulations Needing Technical Assistance:
Regulation Not Applicable:
Regulations Not Correctable:
Narrative:
No in-person licensing visit completed on 12/9/2024.
Licensing received a complaint on 10/15/2024 for ELS Case #024735.
Program Coordinator Slade, Licensing Specialist Horton, and Nurse West completed reviewed children
records and observed the residents on 10/16/2024, 10/17/2024, and 10/18/2024.
Licensing received the following documentation: incidents of WV residents for (September and October 2024,
census including the state of each resident, restraint logs for all residents (September and October 2024),
policies and procedures (chemical restraint and medication hold policy, restraint, medication, behavior
management procedure), documentation of medication changes, background checks, physician
orders/progress notes of WV residents, verification of qualification for nurses and therapists, and proof of
behavior management training.
After reviewing the documentation provided, the facility will be cited for the following standards:
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 2 of 3

908.8The administering of all medications, including over-the-counter, shall be logged by the person
administering the medication at the time the medication is given. A chemical restraint was not logged on the
MAR.
905.11Chemical restraints shall be used only if ordered by a physician. A chemical restraint is an emergency
behavioral intervention that uses pharmaceuticals by topical application, oral administration, injection, or
other means to modify a child’s behavior. Prescribed medications that have a secondary effect on the child’s
behavior are not considered chemical restraint. Chemical restraints were ordered but not signed off by the
physician.
905.12Seclusion, mechanical, or physical restraints shall be used only if ordered by a physician. Physical
restraints ordered but not signed off by the physician.
Provider Comments:
CCL Staff Signature : Date: 12/9/2024
Provider Signature : Date: 12/9/2024
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 3 of 3

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
January 7, 2025
To: Brady Serafin
Facility: Little Creek Behavioral Health
License #: 255
Address: 161 Skunk Hollow Rd. Conway, AR 72032
Mr. Serafin,
Pursuant to Minimum Licensing Standards for Child Welfare Agencies, a
compliance review was conducted on case 024735 and the 521-compliance report form
issued to your agency on 12/9/2024 included:
• A review of ten client’s incident reports, MARs for September 1, 2024, through
December 13, 2024, physician orders, and emergency safety
intervention/debriefings.
• The facility census, the facility September to October 2024 restraint log, medication
pass procedures, medication management procedures, physical restraint policy,
special procedures information sheet, medication hold policy, and chemical
restraint policy.
• A copy of the employed therapists licensing verification, Handle with Care Training
for staff, nursing license verifications, and verification of the psychiatrist’s licensure
were obtained.
• On site visits were conducted on 10/16/2024,10/17/2024,10/18/2024 and
12/13/2024. Case files were reviewed for 10 clients referred to as client’s #1-10 on
this report.
After review and reconsideration by the Placement and Residential Licensing unit,
the citations listed on the 521-compliance form dated 12/9/2024 stand. Furthermore, a
review of the records revealed additional areas of non-compliance with licensing

standards 905.16, 905.17, and 908.11. Please see below for further details regarding the
findings.
905.11 Chemical restraints shall be used only if ordered by a physician. A chemical
restraint is an emergency behavioral intervention that uses pharmaceuticals by
topical application, oral administration, injection, or other means to modify a child’s
behavior. Prescribed treatment medications that have a secondary effect on the
child’s behavior are not considered chemical restraint.
• This standard was not met as evidenced by:
Based on the review of records, the physician’s signature was absent for
o
chemical restraints ordered for client #6 and client #9.
• Client #6
The findings are: The emergency safety intervention and debriefing forms
o
collected on 10/16/2024 for chemical restraints ordered on 9/27/24 at 19:30,
10/11/2024 at 20:37 and 10/11/24 @ 22:04 do not have a signature by the
ordering physician present. Additionally, client #6’s physician orders were
reviewed that show a verbal order was received for the chemical restraints
administered on 9/27/2024 at 19:30, 10/11/2024 at 20:37 and 10/11/2024 at
22:04, but there is no physician signature.
• Client #9
The findings are: The emergency safety intervention and debriefing forms
o
collected on 10/16/2024 for chemical restraints ordered on 9/20/2024 at
14:44, 9/30/2024 at 17:35, and 10/2/2024 at 16:42 do not have a signature by
the ordering physician present. Additionally, client #9’s physician orders were
reviewed that show a verbal order was received for the chemical restraints
administered on 9/20/2024 at 14:44, 9/30/2024 at 17:35, and 10/2/2024 at
16:42, but there is no physician signature.
905.12 Seclusion, mechanical, or physical restraints shall be used only if ordered by a
physician.
• This standard was not met as evidenced by:
Based on the review of records, the physician’s signature was absent for
o
physical restraints ordered for client #6 and client #9.
• Client #6
The findings are: The emergency safety intervention and debriefing forms
o
collected on 10/16/2024 for the physical restraint ordered on 10/11/2024 at
20:26 did not have a signature by the ordering physician present.
Additionally, client #6’s physician orders were reviewed that show a verbal

order was received for the physical restraint administered 10/11/2024 at
20:26, but there is no physician signature.
• Client #9
The findings are: The emergency safety intervention and debriefing forms
o
collected on 10/16/2024 for the physical restraints ordered on 9/20/2024
at14:30, 9/30/2024 at17:32 and10/2/2024 at 11:18 did not have a signature
by the ordering physician present. Additionally, client #9’s physician orders
were reviewed that show a verbal order was received for the physical
restraints administered on 9/20/2024 at14:30, 9/30/2024 at17:32
and10/2/2024 at 11:18, but there is no physician signature.
905.16 Staff shall continually monitor each child in seclusion or restraints and shall
document.
• This standard was not met as evidenced by:
Based on the review of records, the facility failed to monitor each child in
o
seclusion or restraints and document for client #9.
• Client #9
The findings are: The emergency safety intervention and debriefing forms
o
collected on 10/16/2024 shows that client #9 was ordered a chemical
restraint on 10/2/2024 at 16:42. The restraint monitoring sheet of the
emergency safety intervention packet has been left blank with no details
regarding the monitoring of the resident after the chemical restraint was
administered.
905.17 Documentation of all restraints shall be maintained and shall include the
child’s name, date, time, reason, staff involved, and measures taken prior to restraint.
• This standard was not met as evidenced by:
Based on the review of records, the facility failed to maintain documentation
o
of the staff involved and measures taken prior to a restraint hold for client #9.
• Client #9
The findings are: The emergency safety intervention and debriefing forms
o
collected on 10/16/2024 shows that client #9 was given a chemical restraint
on 10/2/2024 at 16:42. The facility failed to document what nurse
administered the chemical restraint, the time the chemical restraint was
administered, and the measures taken prior to the chemical restraint.
908.8 The administering of all medications, including over the counter, shall be logged
by the person administering the medication at the time that the medication is given.

• This standard was not met as evidenced by:
Based on the review of records, the facility failed to log the time that
o
medication was administered to client #6 and client #7. Additionally, the
facility failed to log the administration of a chemical restraint given to client
#9.
• Client #6
The findings are: A review of the November 2024 MARs shows that the facility
o
failed to log the time that that medication Vistaril 50mg was provided to
client #6 on 11/11/2024.
• Client #7
The findings are: A review of the November 2024 MARs shows that the facility
o
failed to log the time that that medication Mylanta was provided to client #7
on 11/26/2024.
• Client #9
The findings are: A review of the October 2024 MARs shows that the facility
o
failed to log the administration of Haldol 10mg and Benadryl 100mg for client
#9 on their MARs log the date of 10/2/2024.
908.11 Any stimulant or psychotropic medicine requiring intra-muscular injection
shall be administered only by a physician, registered nurse, or LPN.
• This standard was not met as evidenced by:
Based on the review of records, the facility failed to ensure psychotropic
o
medicines requiring intra-muscular injections are administered by a
physician, registered nurse, or LPN for client #9.
• Client #9
The findings are: A review of the emergency safety intervention and debriefing
o
form shows that the facility failed to log the name of the person who
administered the intra-muscular psychotropic medications to client #9 on
10/2/2024.
***** Pursuant to A.C.A. § 9-24-406(e)(3-4): If you believe that the Department’s notice
of noncompliance is in error, you may ask for reconsideration. The request for
reconsideration must be in writing and delivered to the Department by certified mail
within twenty (20) business days of receipt of the notice of noncompliance. The
request must specify the parts of the notice that are alleged to be in error, explain why
you believe those parts are in error, and include documentation to support the
allegation of error. Once received the Department shall issue a decision on your
request within twenty (20) days after receipt of the request.

_______________________________________ _1_/_7_/2_0_2__4_______________
Sharra Singleton-Litzsey, PRLU Administrator Date

doc_type: Notice of Incident


summary: Officer made contact with an investigator from the Arkansas State Police who reported a complaint of sexual assault that allegedly occurred at the facility.

raw_content:
FAULKNER COUNTY SHERIFFS OFFICE ** Juvenile Involved **

re Incident Report Report Status: FILED INRECORDS
¥ Case Number: 24002783 Case Status: ACTIVE
~ Page 1 of 2
Case#: 24002783 Report Date: 10/07/2024 11:21
Report By: Deputy. Margaret Ragland - (F34) Arrival Time: 11:21
Case Type: SEX CRIME UNDER 18 Reporting Zone: D
Business: LITTLE CREEK BEHAVIORAL Occurred From: 09/22/2024 17:00
Address: 161 SKUNK HOLLOW RD Occurred Through: 10/07/2024 11:21
Intersection: Reportable IBRS: Yes
City/State/Zip: CONWAY, AR 72032 School:
Lat/Long: Lat: 35.0682371 / Long: -92.3842116 Case Status: ACTIVE
Case Type: SEX CRIME UNDER 18 File / Cad ID:
Assigned To: Investigator. Mckenzie Taylor - (Cd9) Assigned Date: 10/11/2024
Cleared By: Cleared Date:
How Cleared:
IBR Clear Code: Clery Related: NO
UCR / Offenses
UCR: Forcible Fondling - [11D] Status: Completed
Charge: SEXUAL ASSAULT IN 2ND DEGREE
Statute: Charge Code: 5=14=125
Location: Other / Unknown
Weapon: Personal Weapons
Possibly Using: Not Applicable Criminal Activity: None/unknown
Bias: None Method Of Entry:
Gang Name: Home Invasion:
Victims
Victim Type: Individual
Name: DOB: Race/Sex: U/F
Address: Current Age: Height:
City/State: Age: Weight:
Email: Hair Color: Eyes:
Home Phone: Work: Cell: DL#:
Resident: UNKNOWN Ethnicity: NOT HISPANIC OR LATINO
Occupation: Military:
Email: Narcan Dose: 0 SSN:
Employer:
Offender / Suspect

Name FP a Race/Sex: U/F

Address: Current Age: Height:

Rs S04, FAULKNER COUNTY SHERIFFS OFFICE ** Juvenile Involved **

xs es Incident Report Report Status: FILED INRECORDS
P| i Case Number: 24002783 Case Status: ACTIVE
— oe Page 2 of 2
Offender / Suspect
City/State: , ™ Age: 14 Weight:
Resident: UNKNOWN Hair Color: Eyes:
Ethnicity: NOT HISPANIC OR LATINO Cell Phone: SSN:
Home Phone: Work Phone: DL#:
Occupation: Narcan Dose: 0
Employer:

Complainant

Name: POWELL (AR STATE POLICE HOTLINE), SARAH DOB: Race/Sex: U/F
Address: Current Age: Height:
City/State: Age: 0 Weight:

Email: Hair Color: Eyes:

Home: CellPhone: (501) 804-2384 DL#:
Occupation: Work Phone:

Employer:

Narrative

ON 10/7/24 AT APPROXIMATELY 11:16 AM, I WAS DISPATCHED TO A CALL FOR SERVICE IN REFERENCE TO
JUVENILE ABUSE AT 122 SKUNK HALLOW ROAD (LITTLE CREEK BEHAVIORAL).

| MADE CONTACT WITH MS. LINDA POWELL (COMPLAINANT) WHO STATED SHE WAS AN INVESTIGATOR WITH
THE ARKANSAS STATE POLICE. MS. POWELL STATED ON 9/22/24, JO1 (OFFENDER) FORCEFULLY PUT HER
FINGERS IN JV1'S (VICTIM) VAGINA, MS. POWELL STATED THE INCIDENT WAS SAID TO OCCUR IN JV1'S ROOM AT
THE FACILITY. MS. POWELL STATED IT WAS REPORTED TO THE STAFF AND THEN THE STAFF REPORTED IT. MS.
POWELL GAVE A REPORT NUMBER OF

MS. POWELL STATED ALL PATIENTS FROM THE FACILITY ARE FROM OUT OF STATE AND THERE WAS LIMITED
INFORMATION GIVEN ABOUT THEM. | ADVISED MS. POWELL OF THE REPORT NUMBER AND HOW TO OBTAIN A
COPY.

RAGLAND, MAGGIE 10/7/2024, 11:37:54 AM

a Oe

Reporting Officer Approved By Officer
Deputy. Margaret Ragland - (F34) Sergeant. Zachary Cooley - (F6)
Reported On: 10/07/2024 11:21 Approved On: 10/07/2024 18:50

FILED INRECORDS

Case Status: ACTIVE Administrative Use Only - IBRS Date
143053

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Call Information

Received Date:
Arrived Date:

10/07/2024 11:11
10/07/2024 11:21

FAULKNER COUNTY SHERIFFS OFFICE

Call for Service Card

EnRoute Date:
Call Canceled:

Dispatch Date:
Completed Date:

10/07/2024 11:16
10/07/2024 11:45

Page 1 of 2

10/07/2024 11:21

Disposition: INC REPORT TAKEN
CFS #: 24100808 Case #: Priority:
Nature: ABUSE-JUVENILE How Received: ADMIN LINE
Initial Nature: Alarm:
Call Taken By: RODRIGUEZ, VINCENT Dispatched By: RODRIGUEZ, VINCENT Fire Type:
Completed By: RODRIGUEZ, VINCENT ReOpened By: ReOpened Reason:
Site Dangers: NO K9 Used: NO Bill For Call: NO
Business Check: NO Toneout: Permit #:
Business:
WOULD LIKE TO MAKE A REPORT

Incident Information
Common Name: — LITTLE CREEK BEHAVIORAL Zone: SOUTH
Address: 161 SKUNK HOLLOW RD SubDivision:
CSZ: CONWAY, AR 72032 Intersection: POWELL
ESN: 316 Lat/Lon: 35.0682371,
Caller Information
Name: POWELL, LINDA Address:
Phone #: (501) 804-2384 CSZ:
Notes
Entry Date Entry By Note Type Notes
10/07/2024 11:21:23 JACKSON, MAKHAITLIN
10/07/2024 11:45:54 RODRIGUEZ, VINCENT Complete all units.

Total Notes: 2
Units
Unit Number Unit Name Department Mileage Start_ Mileage End __ Primary Unit
F34 RAGLAND, MAGGIE FCSO 0 0 YES
Dispatched Date: 10/07/2024 11:16 EnRoute Date: 10/07/2024 11:21 Arrived Date: 10/07/2024 11:21
Transport Start: Transport End: Completed Date: 10/07/2024 11:45
Disposition Date: Call Canceled: Back At Station:

Total Units: 1

Radio Traffic
Traffic Date Unit # Unit Name Traffic
10/07/2024 11:16 F34 RAGLAND, MAGGIE UNIT DISPATCHED
10/07/2024 11:21 F34 RAGLAND, MAGGIE UNIT ENROUTE

Print Date: Oct 23 2024 - 10:51:40
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Total Radio Traffic: 2

FAULKNER COUNTY SHERIFFS OFFICE, 24100808

CAD_ Details

KASMUCK

ce Co, FAULKNER COUNTY SHERIFFS OFFICE

Call for Service Card

®,

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Case Numbers

Entry Date Case Number Department
10/07/2024 11:21:39 24002783 FAULKNER COUNTY SO
Print Date: Oct 23 2024 - 10:51:40 FAULKNER COUNTY SHERIFFS OFFICE, 24100808

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summary: Officer took a call for service regarding a sexual offense that occurred at Little Creek Behavioral Health. The Complainant with AR State Police Crimes Against Children informed officer that JV (Juvenile Victim) said that JO (Juvenile Offender) raped him from behind, sometime in mid-August.

raw_content:
Rs S04, FAULKNER COUNTY SHERIFFS OFFICE ** Juvenile Involved **

</ | Incident Report Report Status: FILED INRECORDS
g ¥ Case Number: 24002705 Case Status: ACTIVE
Rippig of Page 1 of 2

Case#: 24002705 Report Date: 09/30/2024 17:00
Report By: Deputy. Juan Rivas = (F26) Arrival Time: 16:57
Case Type: SEX CRIME UNDER 18 Reporting Zone: D
Business: LITTLE CREEK BEHAVIORAL Occurred From: 08/01/2024 00:00
Address: 161 SKUNK HOLLOW RD Occurred Through: 08/31/2024 00:00
Intersection: Reportable IBRS: No
City/State/Zip: CONWAY, AR 72032 School:
Lat/Long: Lat: 35,0893332 / Long: -92.4436122 Case Status: ACTIVE
Case Type: SEX CRIME UNDER 18 File / Cad ID:
Assigned To: __ Investigator. Brittany Harmon = (Cd5) Assigned Date: 10/04/2024
Cleared By: Cleared Date:
How Cleared:
IBR Clear Code: Clery Related: NO
UCR / Offenses
UCR: All Other Offenses - [90Z] Status: Completed
Charge: SEXUAL ASSAULT IN 4TH DEGREE
Statute: Charge Code: 5=14-127
Victims

Victim Type: Individual

Name: DOB: aaa Race/Sex: W/M
Address: Current Age: Height:
City/State: Age: a Weight:
Email: Hair Color: Eyes:
Home Phone: Work: Cell: DL#:
Resident: NON-RESIDENT Ethnicity: NOT HISPANIC OR LATINO
Occupation: Military:

Email: Narcan Dose: 0 SSN:
Employer:

Business Involved

Business Type: Society / Public

Business Name: State of ARKANSAS (Society)

Address:

City/State/Zip:

Phone: Email:

Rs S04, FAULKNER COUNTY SHERIFFS OFFICE ** Juvenile Involved **

xs es Incident Report Report Status: FILED INRECORDS
“i ‘ Case Number: 24002705 Case Status: ACTIVE
— oe Page 2 of 2
Offender / Suspect
Name fF | DOB: Race/Sex: W/M
Address: Current Age: Height:
City/State: Age: 0 Weight:
Resident: NON-RESIDENT Hair Color: Eyes:
Ethnicity: NOT HISPANIC OR LATINO Cell Phone: SSN:
Home Phone: Work Phone: DL#:
Occupation: Narcan Dose: 0
Employer:
Complainant
Name: ASP POWELL, LINDA DOB: Race/Sex: U/U
Address: 574 LOCUST STREET Current Age: Height:
City/State: | CONWAY, AR 72034 Age: 0 Weight:
Email: Hair Color: Eyes:
Home: (501) 804-2384 Cell Phone: DL#:
Occupation: Work Phone: (501) 328-3347

Employer: AR STATE POLICE CRIMES AGAINST

Narrative

On September 30th,2024, at approximately 5:00 P.M., I took a call for service regarding a sexual offense that occurred
at the Little Creek Behavioral Health on 161 Skunk Hollow Road.

| spoke to Ms. Linda Powell (Complainant) via cell phone. Ms, Powell stated she talked to JV1, and he said that JO1
raped him from behind, and the incident occurred sometime between mid-August. Ms. Powell stated that the boys
had clothes on, but JO "humped" him from behind.

Ms. Powell advised that was all the information she was given and provided me with her report number |
also provided Ms. Powell with our report number for her records.

RIVAS, JUAN 9/30/2024, 5:20:06 PM

ee Be ee

Reporting Officer Approved By Officer
Deputy. Juan Rivas - (F26) Corporal. William Lipsmeyer - (F9)
Reported On: 09/30/2024 17:00 Approved On: 10/01/2024 17:00
FILED INRECORDS
Case Status: ACTIVE Administrative Use Only - IBRS Date

142975

AHNER Co FAULKNER COUNTY SHERIFFS OFFICE
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“A “ Call for Service Card
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Call Information
Received Date: 09/30/2024 16:48 Dispatch Date: 09/30/2024 16:53 EnRoute Date: 09/30/2024 16:57
Arrived Date: 09/30/2024 16:57 Completed Date: 09/30/2024 17:02 Call Canceled:
Disposition: EXTINGUISHED-FIRE ONLY
CFS #: 24093609 Case #: Priority:
Nature: GENERAL INFORMATION How Received:
Initial Nature: Alarm:
Call Taken By: RODRIGUEZ, VINCENT Dispatched By: RODRIGUEZ, VINCENT Fire Type:
Completed By: BUTLER, TWYLA ReOpened By: ReOpened Reason:
Site Dangers: NO K9 Used: NO Bill For Call: NO
Business Check: NO Toneout: Permit #:
Business:
NEEDS A DEPUTY TO GIVE HER A CALL SO SHE CAN MAKE A REPORT
WORKS FOR ASP CRIMES AGAINST CHILDREN
Incident Information
Common Name: Zone:
Address: 801 LOCUST AVE SubDivision:
CSZ: CONWAY, AR 72034 Intersection: POWELL
ESN: 350 Lat/Lon: 35.0893332,
Caller Information
Name: POWELL, LINDA Address:
Phone #: (501) 804-2384 CSZ:
Notes
Entry Date Entry By Note Type Notes
09/30/2024 16:57:55 BUTLER, TWYLA
09/30/2024 17:02:44 BUTLER, TWYLA Complete all units.
Total Notes: 2
Units
Unit Number _ Unit Name Department Mileage Start_ Mileage End Primary Unit
F26 RIVAS, JUAN FCSO 0 0 YES

Dispatched Date: 09/30/2024 16:53

Transport Start:

EnRoute Date:
Transport End:

Arrived Date:
Completed Date:

09/30/2024 16:57 09/30/2024 16:57

09/30/2024 17:02

Disposition Date: Call Canceled: Back At Station:
Total Units: 1

Radio Traffic

Traffic Date Unit # Unit Name Traffic

09/30/2024 16:53 F26 RIVAS, JUAN UNIT DISPATCHED

09/30/2024 16:57 F26 RIVAS, JUAN UNIT ENROUTE

Print Date: Oct 25 2024 - 12:42:48
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Total Radio Traffic: 2

FAULKNER COUNTY SHERIFFS OFFICE, CFS: 24093609 GEN INFO
CAD_Details KASMUCK

ce Co, FAULKNER COUNTY SHERIFFS OFFICE

Call for Service Card

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Case Numbers

Entry Date Case Number Department
09/30/2024 16:58:04 24002705 FAULKNER COUNTY SO
Print Date: Oct 25 2024 - 12:42:48 FAULKNER COUNTY SHERIFFS OFFICE, CFS: 24093609 GEN INFO

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summary: A resident reported her peer forcibly placed her fingers into her vagina while in their bedroom. Both residents admitted to this incident occurring; however, the peer stated they were horseplaying.

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: 024184
Date of Incident: 9/22/2024
Date Received: 9/23/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Dual
Report Description: On 09.22.24, Risk received a phone call from the facility D.O.N. of a
sexual assault claim on the Guppies unit.
reported her peer
forcibly placed her fingers into vagina while in room. and both
admitted to this incident occurring; however, stated they were horseplaying, and
did ask her to stop, but she was laughing and joking, so she did not take her statement
seriously. Accepted by
Interim Action Narrative: Facility reported incident to the Residents were place on
separate dorms.
Maltreatment Narrative:
On yesterday 9/22/2024 a report was
made to an official that had been molested by stated forcefully put
her fingers into her vagina forcefully. This occurred in bedroom at the center. The
bedroom number is unknown currently. It is known that there is no pain or suffering to
Licensing Narrative: Licensing reviewed complaint for licensing concerns. Program
Coordinator checked . No has been assigned.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Program Coordinator will inquire about safety plan, nursing note, and witness statements.
Permission requested from to contact the facility. 9/24/2024, facility reported
that the resident verbally told the DON about the incident and provided documentation. Per
email, the residents were separated. The AV was moved to another unit. 9/26/2024,
Program Coordinator reviewed provided documentation and interview reports.
The A/O does admit to this incident occurring, but believed the A/V was joking when she
kept saying to stop. This occurred in the middle of the day in a bedroom the two residents
share. No video footage of the dayroom or the bedroom were available for review. The
incident reportedly happened very quickly between supervision checks. 10/7/2024, per
case is pending. 10/11/2024, per pending. 10/21/2024, case is still pending
per 10/25/2024, Program Coordinator contacted the for an update. Per
this case is still pending. informed Licensing that the assigned
. 10/26/2024, per case is still pending.
11/6/2024, per case found TRUE. Program Coordinator will request a safety plan
for peer fo be in a single room for the remainder of her stat at facility. Per facility, the peer
discharged on 9/30/2024. 11/7/2024, Case approved. 11/25/2024 Facility provided
documentation via email. Witness statements, patient observation sheets, and nurse's note
were uploaded to the case. The case has been closed as unfounded by licensing as a lack of
supervision could not be determined.


summary: A resident was injured during a restraint after becoming combative with staff.

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: 023608
Date of Incident: 8/29/2024
Date Received: 8/29/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Dual
Report Description: On 08.29.24, took his peers' snacks during classroom
snack time. The staff asked to place all the extra snacks on the teacher's desk and
return to the classroom during break time. became combative with the staff and
pushed the staff while the staff was attempting to retrieve the snacks. threw all the
extra snacks toward the wall and staff, took off his shoes, and began to charge toward the
supervisor in the hallway. For safety reasons, was placed in a physical restraint.
During the restraint, was injured due to the continued combativeness on the floor
with the staff. was placed in a splint and sent to the local ED for further evaluation.
Interim Action Narrative: Resident was assessed by the nurse and taken to the ER for an
evaluation. Staff placed on leave pending investigation.
Maltreatment Narrative: AV is in long-term treatment at Little
Creek Behavioral Health. AO is a behavioral health associate supervisor at
Little Creek. On 8/29/2024, took a peer?s snack. When asked him to return
the snack, got aggressive. put him in a restraint. While in the restraint, he
kept saying, ?My wrist is hurting. Pop it back into place.? He said ?My wrist is hurting?
about three times. Later, a nurse looked at his wrist and saw that it was swollen. The nurse
ordered an X-ray. Reporter has not seen the X-ray and cannot say if ?s wrist is
dislocated. He has no visible bruises, but his skin is dark, and they might be hard to see.
was placed on leave for today (8/29/2024).
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: Licensing was informed of incident via telephone. Program
Coordinator reviewed camera footage and requested documentation. Program Coordinator
received an email from the about the complaint and visiting the facility.
8/30/2024, facility reported resident has a closed fracture with a follow up appointment on
Tuesday. Facility was reminded about providing documentation (witness statements,
nursing note, restraint packet, ER discharge summary). 9/3/2024, facility reported that
resident had a follow up appointment with Ortho today. 9/5/2024, Director of Risk inquired
about ICA. 9/6/2024, facility informed that ICA was approved. Per camera footage review, it
could not be determined how the resident injured his wrist. Staff member mentioned will be
working with maintenance and will not have any interactions with the residents. Facility
provided documentation for this complaint. 9/26/2024, per still pending. 10/7/2024,
pending per 10/11/2024, per pending. inquired if
anything came about of this incident. 10/14/2024, inquired about the
ICA for the staff member. Program Coordinator requested training documentation for the
staff member. Per case found unsubstantiated. 10/15/2024, facility inquired if ICA
could be lifted. 10/17/2024, Program Coordinator consulted with Program Manager
regarding the ICA being lifted. Facility informed that ICA could be lifted. 10/18/2024, case
completed.


summary: Fire alarm. False alarm.

raw_content:
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Call Information

Received Date:
Arrived Date:

08/29/2024 13:56

FAULKNER COUNTY SHERIFFS OFFICE

Call for Service Card

EnRoute Date:
Call Canceled:

Dispatch Date:
Completed Date:

Page 1 of 2

08/29/2024 14:02

Disposition: DISREGARD CALL
CFS #: 24083646 Case #: Priority:
Nature: FIRE ALARM How Received: ADMIN LINE
Initial Nature: Alarm:
Call Taken By: BRABHA\M, DIXIE Dispatched By: Fire Type:
Completed By: ReOpened By: ReOpened Reason:
Site Dangers: NO K9 Used: NO Bill For Call: NO
Business Check: NO Toneout: 08/29/2024 14:00 Permit #:
Business:

AA: GYM FRONT DOOR PULL STATION

KH: MATT WILKSHIRE 501-249-7731

CONTACT WILL BE ATTEMPTED AFTER WE ARE NOTIFIED
Incident Information
Common Name: Zone:
Address: 161 SKUNK HOLLOW RD SubDivision:
CSZ: CONWAY, AR 72032 Intersection:
ESN: 316 Lat/Lon: 35.0682371,
Caller Information
Name: , SUMMIT Address:
Phone #: (800) 687-0668 CSZ:
Notes
Entry Date Entry By Note Type Notes
08/29/2024 14:00:38 BRABHAM, DIXIE 286E toned out.
08/29/2024 14:01:16 BRABHAM, DIXIE 286E acknowledged toneout.
08/29/2024 14:02:35 BRABHAM, DIXIE Complete all units.
08/29/2024 14:02:35 BRABHAM, DIXIE Call cancelled.

Total Notes: 4

Units
Unit Number _ Unit Name Department Mileage Start_ Mileage End _ Primary Unit
286E1 286 E 1 286E 0 0 NO
Dispatched Date: 08/29/2024 14:00 EnRoute Date: 08/29/2024 14:00 Arrived Date:
Transport Start: Transport End: Completed Date:

Disposition Date:

Print Date: Sep 19 2024 - 12:37:37
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Call Canceled: 08/29/2024 14:02 Back At Station:

Total Units: 1

FAULKNER COUNTY SHERIFFS OFFICE, 24083646

CAD_ Details

KASMUCK

phheheoy, FAULKNER COUNTY SHERIFFS OFFICE

Call for Service Card
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Radio Traffic

Traffic Date Unit # Unit Name Traffic

08/29/2024 14:00 286E1 286 E 1 UNIT DISPATCHED
@20240829T14:01:16

08/29/2024 14:00 286E1 286 E 1 UNIT ENROUTE

@20240829T14:01:16
Total Radio Traffic: 2

Toneouts
Dispatched Date Unit # Unit Name Department
286E
Toneout 1: 08/29/2024 14:00 Toneout 2: 08/29/2024 14:00 Toneout 3:
Ack. Date: 08/29/2024 14:00 Cancel Date: Toneout 1 By: BRABHAM, DIXIE
Total Toneouts: 1
Case Numbers
Entry Date Case Number Department
08/29/2024 14:01:16 286 EAST FIRE DEPARTMENT
Print Date: Sep 19 2024 - 12:37:37 FAULKNER COUNTY SHERIFFS OFFICE, 24083646

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summary: A staff member reported that they overheard a unit conversation regarding a sexual assault that took place around a month ago between residents.

raw_content:
Licensing Narrative: Facility contacted Program Coordinator via telephone. Licensing
reviewed complaint for licensing concerns. Program Coordinator will inquire about
assigned investigator. 8/20/2024, Program Coordinator requested permission to contact the
facility from Investigator Powell. Program Coordinator inquired about safety plan and if
residents were separated. Received permission to contact the facility. Facility reported
residents are on separate units for safety. 9/26/2024, per CHRIS still pending. 10/7/2024,
per CHRIS unsubstantiated. Case completed.


summary: A complaint submitted to Licensing stated that the complainant received two separate emails containing personal information about another child at the Little Creek facility. The facility was cited 108.1.a as a result of this complaint.

raw_content:
be cited for 108.1.a due to the nurse emailing resident information to the wrong guardian.
Case complete.

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: Little Creek Behavioral Health
Facility Number: 255
Licensee Address: 161 SKUNK HOLLOW
CONWAY AR 72032
Licensing Specialist: Kendra Slade
Person In Charge: Jlynn Price
Record Visit Date: 9/3/2024
Home Visit Date: 9/3/2024
Purpose of Visit: Complaint Visit
Regulations Out of Compliance:
Regulations Needing Technical Assistance:
Regulation Not Applicable:
Regulations Not Correctable:
Narrative:
Time of visit: 1:30 pm to 3:30 pm
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 1 of 2

Census: 64
Licensing received a complaint on 8/29/2024 for ELS Case #023610.
Program Coordinator spoke with Director of Risk Management and Director of Nursing regarding this
complaint. The facility was aware of the concern due to the guardian stating she was going to contact the
Lieutenant Governor.
The Director of Nursing informed Program Coordinator that the nurse will receive an in-service regarding
sending emails.
Per Director of Nursing, guardian was informed of the appointment with the doctor on Wednesday, 8/28/2024
by the case manager via text. When the Director of Nursing and other staff called the guardian for the
appointment, she was irate. Guardian informed the staff that she was unable to meet due to the time zone
difference. Appointment has been rescheduled for guardian to meet with the doctor on 9/11/2024 per Director
of Nursing
Facility provided a copy of the resident’s MAR. The medication that guardian reported the resident was
receiving without her consent was listed on the MAR; however, the resident did not receive the medication.
Program Coordinator requested documentation (witness statements, text messages, narrative from
conversations).
Licensing is not prepared to leave a finding at this time.
Provider Comments:
CCL Staff Signature : Date: 9/3/2024
Provider Signature : Date: 9/3/2024
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 2 of 2


summary: The facility was informed of an outside complaint regarding a resident. The complaint stated that the resident was overly medicated, lying in her own vomit and unresponsive, and received no help from nursing or other staff members at Little Creek.

raw_content:
situation. Everyone in charge is choosing to do this. There is concern for health as
she has been unresponsive on at least one occasion.
Licensing Narrative: Program Coordinator received an email from investigator regarding
maltreatment and accompanying her on the interview. Program Coordinator received
documentation from the facility. Risk Management and the DON discussed the resident's
behavior and the possibility of who made the hotline call. 8/9/2024, Program Coordinator
will request the nursing notes for 8/1/2024 to 8/7/2024. Facility provided a copy of an
assessment dated 8/2/2024. 9/6/2024, checked CHRIS case is still pending. 9/17/2024, per
CHRIS case is still pending. 9/26/2024, per CHRIS case found unsubstantiated. Case
complete.


summary: A resident was transported to the local Emergency Department due to a possible broken ankle. The resident received the injury while running in a circle around a table, being chased by two of his peers.

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: 022995
Date of Incident: 8/3/2024
Date Received: 8/5/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Licensing
Report Description: On 08.03.24, Risk was notified by the DON that
was being transported
to the local ED due to a possible broken ankle. received the due to running
in a circle around a table while being chased by two of his peers. shoe slipped off
his foot, and he fell. was transported to the local ED by Little Creek. was at
Baptist Health in Conway Ar for a few hours and then transported to Children's Hospital in
Little Rock, AR, . was diagnosed
around 0820 on Sunday, 08.04.24. had
physical therapy this morning and arrived back to Little Creek this afternoon 2:00pm.
Interim Action Narrative: Resident was assessed by the nurse and transported to the ER
then ACH.
Maltreatment Narrative:
Licensing Narrative: Program Coordinator received a phone call regarding this provider
reported incident, reviewed this incident for licensing concerns, and request documentation
(nursing note and discharge summaries). 8/6/2024, facility provided documentation from
Baptist Health, ACH, and nurse's note. Program Coordinator reviewed camera footage for
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

the provider reported incident. 9/3/2024, facility reported that resident is scheduled for a
follow up appointment on 9/4/2024.


summary: A resident wrapped a TV cord around his neck and began chewing on the portion that went into the wall. The resident stated he no longer wanted to be at Little Creek or be around his peers. The facility was cited 110.17 as a result of this incident.

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: 022748
Date of Incident: 7/21/2024
Date Received: 7/23/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Licensing
Report Description:
was sitting by the wall under a T.V. on the unit. He could get the cord from the T.V. and
have it wrapped around his neck, and began chewing on the portion that went into the wall.
stated he no longer wanted to be at Little Creek or be around his peers.
Interim Action Narrative: A screening was completed on resident.
Maltreatment Narrative:
Licensing Narrative: Program Coordinator received a phone call regarding incident.
7/23/2024, Program Coordinator reviewed provider reported incident for licensing
concerns. Facility reported a Columbia Suicide Screening was completed on the resident
and resident is currently on close observation. 7/29/2024, Program Coordinator inquired if
resident was assess by the nurse and requested the nursing note. Facility reported the
Columbia screening was completed by the therapist and the resident was assessed by the
nurse. 8/2/2024, Program Coordinator inquired about the facility's policy regarding placing
a resident in acute care. 8/6/2024, Program Coordinator confirmed with facility that
resident's behavior was considered a suicide attempt. Facility reported that a resident is sent
to acute care per doctor's order. Facility will be cited for 110.17.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A complaint of physical abuse was received by the facility. A resident reported that she was injured during a restraint, receiving bruises to her inner arm. The restraint packet completed after the restraint does not note any bruises or redness, however, the resident showed her peers and the floor supervisor a bruise. The complaint was UNFOUNDED by Licensing.

raw_content:
Placement and Residential Licensing Unit
P.O. Box 1437, Slot S140, Little Rock, AR 72203‐1437
P: 501.682.8590 F: 501.683.6060 TDD: 501.682.1550
Notice of Serious Incident
Case Number: 022913
Date of Incident: 7/20/2024
Date Received: 7/31/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Dual
Report Description: On 07.30.24, I, Risk Manager, was notified of physical
abuse to a resident that she allegedly received during a restraint on 07.20.24.
on 07.30.24. The resident went to a
restraint due to her becoming physically aggressive with the staff during an escort, which
was from her refusal to return to the unit. After the restraint on 07.20.24, the resident had no
pain or bruises/redness on her. The restraint packet also does not note any bruises or
redness. However, she showed her peers and the floor supervisor a bruise. Time and date
unknown. Three noted to see the bruise located in the resident's inner arm. Camera footage
was reviewed by the RM and DON on 07.22.24 for the restraint, and the patient did not
show any signs of pain or distress during the restraint. Risk attempted to have the patient
assessed on 07.31.24 for a follow-up by nursing, and the patient refused the treatment.
The
staff in question will be placed on administrative leave pending the outcome
Interim Action Narrative:
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

Licensing Narrative: Facility called Program Coordinator regarding complaint. 7/31/2024,
Program Coordinator reviewed complaint for licensing concerns and request permission
from to contact the facility. Program Coordinator requested date of birth of
resident and guardianship. 8/1/2024, permission granted to contact facility. Program
Coordinator will meet on 8/2/2024 at the facility. Facility reported there
are no nursing notes. The nurses were not made aware of the bruise. When the DON
attempted to assess the resident on 07.31.24 the resident refused to be seen. 8/2/2024,
Program Coordinator met at the facility and attempted to interview the
resident. The resident refused to speak and would not get out of bed. 8/6/2024, Program
Coordinator sat in on the interview with investigators. Resident answered all questions and
was cooperative. 8/9/2024, notified Licensing via email that case would
be closed as unbstantiated. 8/21/2024, checked case found unsubstantiated.


summary: A resident reported that she received a bruise while horseplaying with a staff member. The resident stated she punched the staff member in the arm, and he punched her back. The facility was cited 109.1.g and 907.3 as a result of this incident.

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: 022512
Date of Incident: 7/9/2024
Date Received: 7/10/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Dual
Report Description: On 07.09.24,
stated
staff plays with them (horseplaying). One person hit the staff and then the staff return the
hit. punched in the arm and he punched her back, which left a bruise on
her arm. stated she poked and he poked her back, which left a bruise on her
arm as well. Both resident stated there is no ill intention only playful.
Interim Action Narrative: Staff member was suspended pending outcome of the
investigation.
Maltreatment Narrative: AVs are and
AO is Little Creek Behavioral staff person
stated that (a worker at Little Creek) punched her in the arm.
However, it was not intentional they were just playing around. She stated, ?I hit him, and he
hit me." She showed her arm and there was a bruise on her arm where he had hit her. She
states that it did hurt and that she didn't know if he knew that he had hit her that hard. She
stated that this incident happened last week sometime, but she could not remember the
date. She also stated that he hit another child here, , and that she also had a
bruise on her arm. stated that, she and were playing a game in which
they were poking each other on the arm. She stated that he poked her on her arm, and it did
leave a bruise. When asked when this incident occur, she stated that it happened Sunday
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

July 7, around 6 or 7 o'clock pm. Pictures were taking of the bruises and action is being
taken.
Licensing Narrative: Program Coordinator was informed of the incident via telephone call
from Ms. Perkins and reported that staff member involved was suspended. 7/10/2024,
Program Coordinator reviewed camera footage and sat in on the interviews with Ms
Perkins. 7/11/2024, Program Coordinator contacted investigator and requested permission
to contact the facility. Permission granted by investigator and Program Coordinator will
meet investigator at the facility. Facility reported an ICA will be submitted for the staff
member and would be retrained on boundaries. 7/12/2024, Program Coordinator requested
witness statements. 7/15/2024, Program Coordinator emailed facility ICA approved and
requested training documentation once completed. 7/17/2024, facility reported ICA was no
longer needed. Staff member will remain suspended/administrative leave pending the
outcome of the investigation. 8/16/2024, Program Coordinator checked CHRIS and case is
still pending. 8/22/2024, case is still pending according to CHRIS. 8/23/2024, facility
reported that staff member had been cleared. Program Coordinator checked CHRIS, case
found unsubstantiated and inquired if staff member had received any training. 8/27/2024,
facility provdied training documentation.

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: Little Creek Behavioral Health
Facility Number: 255
Licensee Address: 161 SKUNK HOLLOW
CONWAY AR 72032
Licensing Specialist: Kendra Slade
Person In Charge: Jlynn Price
Record Visit Date: 9/3/2024
Home Visit Date: 9/3/2024
Purpose of Visit: Revisit Complaint
Regulations Out of Compliance:
Regulations Needing Technical Assistance:
Regulation Not Applicable:
Regulations Not Correctable:
Narrative:
No in-person licensing visit was completed on 9/3/2024.
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 1 of 2

Licensing received a complaint on 7/10/2024 for ELS Case #022512.
This complaint has beenFOUNDEDby Licensing. Facility was cited on 7/10/2024 for standards 109.1.g and
907.3.
Provider Comments:
CCL Staff Signature : Date: 9/3/2024
Provider Signature : Date: 9/3/2024
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 2 of 2


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

raw_content:
521 Visit Compliance Report

Licensee: Little Creek Behavioral Health

Facility Number: 255

Licensee Address: 161 SKUNK HOLLOW
CONWAY AR 72032

Licensing Specialist: Kendra Rice
Person In Charge: Jlynn Price
Record Visit Date: 7/3/2024
Home Visit Date: 7/3/2024

Purpose of Visit: Child Record Review Visit

Regulations Out of Compliance:

Regulations Needing Technical Assistance:

Regulation Not Applicable:

Regulations Not Correctable:

Narrative:

Time of Visit: 11:15 am to 1:15 pm

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

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

Page 1 of 2

Census: 63

Licensing Specialist reviewed twelve (12) children files:

\S)
le)
wo

Admission Date

All children’s files reviewed complied with the minimum licensing standards.

Provider Comments:

CCL Staff Signature : Date: 7/3/2024
} i he
Provider Signature : Date: 7/3/2024

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

doc_type: Compliance Report


summary: Officers were dispatched regarding a suspicious person at the facility. The male, who is with the Department of Child and Family Services (DCFS), was at the facility to visit a resident. False or unfounded call.

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Faulkner County Sheriffs Office

Call for Service Card
Page 1 of 2

Call Information

Received Date: 06/30/2024 16:41 Dispatch Date: 06/30/2024 16:48 EnRotue Date: 06/30/2024 16:48

Arrived Date: 06/30/2024 16:54 Completed Date: 06/30/2024 17:41 Call Canceled:
Disposition: HANDLED BY OFFICER-NO REPORT

CFS #: 24063671 Case #: Priority:

Nature: SUSPICIOUS PERSON How Received:

Initial Nature: Alarm:

Call Taken By: GILLIAM, KELLI Dispatched By: WIMBERLY, OLIVIA Fire Type:

Completed By: WIMBERLY, OLIVIA ReOpened By: ReOpened Reason:

Site Dangers: NO K9 Used: NO Bill For Call: NO
Business Check: NO Toneout: Permit #:

Business:

male claiming to be a pt guardian and wanting to see a child / the childs caseworker is adv caller to not allow him to see the child / male is
refusing to leave / staff believes it is the patients "pimp" / he is the lobby acting flustered

marquez byers from illinois / 6'1" b/m black polo grey pants and black sandals / something in his right front pocket but cant tell what it is

Incident Information
Common Name: LITTLE CREEK BEHAVIORAL Zone:

Address: 161 SKUNK HOLLOW RD SubDivision:
CSZ: CONWAY, AR 72032 Intersection:
ESN: 316 Lat/Lon: 35.0682371,

Caller Information
Name: SCEIFRES, KAYLA Address:

Phone #: (479) 692-1680 CSZ:
Notes
Entry Date Entry By Note Type Notes

06/30/2024 16:54:00 WIMBERLY, OLIVIA
06/30/2024 16:54:29 WIMBERLY, OLIVIA

06/30/2024 17:18:56 GILLIAM, KELLI MR BYERS IS ACTUALLY WITH DCFS / SHOWED EMAILS TO
F14 TO PROVE SO

06/30/2024 17:40:53. WIMBERLY, OLIVIA

06/30/2024 17:41:16 WIMBERLY, OLIVIA Complete all units.
Total Notes: 5

Units
Unit Number Unit Name Department Mileage Start Mileage End Primary Unit
F14 MORGAN, CODY FCSO 0 0 YES
Dispatched Date: 06/30/2024 16:48 EnRoute Date: 06/30/2024 16:48 Arrived Date: 06/30/2024 16:54
Transport Start: Transport End: Completed Date: 06/30/2024 17:40
Disposition Date: Call Canceled: Back At Station:

Print Date: Jul 17 2024 - 13:05:07 Faulkner County Sheriffs Office, 24063671

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Faulkner County Sheriffs Office

Call for Service Card
Page 2 of 2

Units
Unit Number Unit Name Department Mileage Start_ Mileage End Primary Unit
F32 THOMAS, AUSTIN FCSO 0 0 NO
Dispatched Date: 06/30/2024 16:48 EnRoute Date: 06/30/2024 16:48 Arrived Date: 06/30/2024 16:54
Transport Start: Transport End: Completed Date: 06/30/2024 17:41
Disposition Date: Call Canceled: Back At Station:
Total Units: 2

Radio Traffic
Traffic Date Unit # Unit Name Traffic
06/30/2024 17:03 F14 MORGAN, CODY SUSPICIOUS PERSON

Name: BYERS, MARQUISE D

Race: BLACK OR AFRICAN AMERICAN / Sex: MALE / DOB: 11/02/1975 00:00:00

Hair Color: BLACK / Eye Color: BROWN

DL State: ILLINOIS / DL Number: B62054475312 / DL Expires: 11/02/2023
06/30/2024 16:48 F32 THOMAS, AUSTIN UNIT ENROUTE
06/30/2024 16:48 F32 THOMAS, AUSTIN UNIT DISPATCHED
06/30/2024 16:48 F14 MORGAN, CODY UNIT ENROUTE
06/30/2024 16:48 F14 MORGAN, CODY UNIT DISPATCHED

Total Radio Traffic: 5

People Involved

Name: BYERS, MARQUISE D DOB: 11/02/1975 SSN:
Race: BLACKOR~ Sex: MALE Cell Phone: Work Phone:
AFRICAN
AMERICAN
Address: Apartment: Home Phone:
CSZz: Email:
How Involved: Relationship:
DL Number: IL/B62054475312 Class: Expires On: 11/02/2023 Status:

Total People: 1

Case Numbers

Entry Date Case Number Department
06/30/2024 16:48:39 FAULKNER COUNTY SO
Print Date: Jul 17 2024 - 13:05:07 Faulkner County Sheriffs Office, 24063671

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summary: Licensing completed an after visit of the facility. No deficiencies cited.

raw_content:
ARRAN SE AS
DEPARTMENT OF

~a\ SERVICES
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot $140, Little Rock, AR 72203-1437
P: 501.508.8910 F: 501.683.6060 TDD: 501.682.1550

521 Visit Compliance Report

Licensee: Little Creek Behavioral Health

Facility Number: 255

Licensee Address: 161 SKUNK HOLLOW
CONWAY AR 72032

Licensing Specialist: Kendra Rice
Person In Charge: Jlynn Price
Record Visit Date: 6/25/2024
Home Visit Date: 6/25/2024

Purpose of Visit: Special Visit

Regulations Out of Compliance:

Regulations Needing Technica! Assistance:

Regulation Not Applicable:

Regulations Not Correctable:

Narrative:

Time of Visit: 4:30 pm to 5:00 pm

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

Census: 63

Program Coordinator completed an after visit at Little Creck Behavioral Health. Jlynn Perkins, Compliant
Officer, appeared to be Icaving for the day but was able to assist. Ms. Perkins escorted Program throughout
the building.

Ms. Perkins informed Program Coordinator that residents were on their dorms preparing for dinner of doing
activities.

Trout Dorm — Ratio 2:8, residents were observed signing with staff and/or peers. Other residents were sitting
in chairs facing the television.

Brim Dorm — Ration 2:7, residents were observed watching television and talking with staff.
Bass Dorm — Ration 2:8, residents were standing around the common area getting ready for dinner.

Snapper Dorm — Ratio 2:8, residents and staff were standing around the television. Program Coordinator
observed cones in front of the television in different locations. Per staff, they were playing a game.

Program Coordinator observed other staff members and residents transitioning in the hall to different areas.

Provider Comments:

CCL Staff Signature : Date: 6/26/2024

4h

v
Provider Signature : “pt “He q KL Date: 6/26/2024

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


summary: Two residents eloped from the facility after one resident stole a staff member’s car keys and her peer snatched a staff member’s badge off her shirt. The residents were located by the Sheriff and returned to the facility.

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: 021546
Date of Incident: 5/26/2024
Date Received: 5/28/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Licensing
Report Description: On 05.26.24, ) stole the
staff car keys and hid them in her jacket pocket, and
) snatched a staff badge off her shirt. and proceeded
towards the laundry area and ran eloped from the facility. Sheriff Cox located the girls two
blocks over, called Little Creek and they were brought back to the facility by Little Creek
staff.
Interim Action Narrative: The police were called. Residents were placed on elopement
precautions and clinical restrictions.
Maltreatment Narrative:
Licensing Narrative: Facility informed Program Coordinator of incident via text message.
5/29/2024, Program Coordinator reviewed provider reported incident for licensing
concerns. Program Coordinator and Licensing Specialist Norton reviewed camera footage.
Facility reported the Faulkner Co Sherriff Deparment were called but no report number was
provided. Staff member involved will received additional training. 6/3/2024, Program
Coordinator will follow up with facility for documentation of staff member completing
training. 6/6/2024, Program Coordinator followed up with facility regarding documentation
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

of training for staff member present during this incident. 6/10/2024, training documentation
provided.


summary: A resident was found unresponsive on the floor of the bathroom with cuts to both thighs.

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: 021545
Date of Incident: 5/26/2024
Date Received: 5/28/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Licensing
Report Description: On 05.26.24, at 1850, Resident
asked to take a shower right before med pass time. While, in the shower,
responded to all calls from the staff who were checking in on the resident. During
med pass on a separate unit, a code was called. The staff called for again, and she
answered the staff. After, the third call to get the resident out of the shower, did
not answer. was found unresponsive on the floor upon staff entering the
bathroom. had a sliver small blade and lying beside her with cuts to her left and
right thigh. The nursing staff entered the unit when the code blue was called grabbed vitals,
and called for the EMT and Director of Nursing. The Director of Nursing arrived at the unit
and did a sternum rub, and she popped up. She was transported to the Emergency
Department with superficial cuts to rule out anything further. She returned to Little Creek at
2118.
Interim Action Narrative: Resident was assessed by the nurse and sent to the ER for further
evaluation. Resident placed on close observation and clinical restrictions.
Maltreatment Narrative:
Licensing Narrative: Program Coordinator reviewed provider reported incident for
licensing concerns. Program Coordinator inquired about incident and requested
We Care. We Act. We Change Lives.
humanservices.arkansas.gov

documentation. Resident was placed on close observation and clinical restrictions. While on
another visit, Program Coordinator requested nursing notes. Facility reported that resident
got the small blade from a pencil sharpner out of a classroom. Per facility, hand held pencil
sharpners have been confiscated and will no longer be utilized in the classrooms.


summary: Caller requested EMS assistance for an unresponsive juvenile.

raw_content:
Faulkner County Sheriffs Office

Call for Service Card
Page 1 of 3

Call Information

Received Date: 05/26/2024 19:14 Dispatch Date: 05/26/2024 19:17 EnRotue Date: 05/26/2024 19:17
Arrived Date: 05/26/2024 19:22 Completed Date: 05/26/2024 19:41 Call Canceled:
Disposition: PATIENT TRANSPORTED-MED CALL ONLY

CFS #: 24053262 Case #: Priority:

Nature: SUICIDE-ATTEMPT How Received: 911
Initial Nature: Alarm:

Call Taken By: HALL, KEALI Dispatched By: ALARCON, PEARLY Fire Type:

Completed By: HALL, KEALI ReOpened By: ReOpened Reason:

Site Dangers: NO K9 Used: NO Bill For Call: NO
Business Check: NO Toneout: 05/26/2024 19:17 Permit #:

Business:

14 yof harming herself cutting her thighs unresponsive but she does have a pulse

Incident Information

Common Name: LITTLE CREEK BEHAVIORAL Zone:

Address: 161 SKUNK HOLLOW RD SubDivision:

CSZ: CONWAY, AR 72032 Intersection:

ESN: 316 Lat/Lon: 35.0682371,

Caller Information

Name: » ANGELA Address:
Phone #: (501) 514-8235 CSZ:
Notes

Entry Date Entry By Note Type Notes

05/26/2024 19:17:01

05/26/2024 19:17:24
05/26/2024 19:17:44
05/26/2024 19:19:08
05/26/2024 19:20:58
05/26/2024 19:22:40
05/26/2024 19:23:15
05/26/2024 19:25:27

05/26/2024 19:25:45
05/26/2024 19:30:39
05/26/2024 19:33:03
05/26/2024 19:35:16
05/26/2024 19:37:09
05/26/2024 19:40:15

HALL, KEALI

WIMBERLY, OLIVIA
ALARCON, PEARLY
ALARCON, PEARLY
WIMBERLY, OLIVIA
WIMBERLY, OLIVIA
WIMBERLY, OLIVIA
WIMBERLY, OLIVIA

WIMBERLY, OLIVIA
WIMBERLY, OLIVIA
WIMBERLY, OLIVIA
ALARCON, PEARLY
ALARCON, PEARLY
HALL, KEALI

in the bathroom in the back of the unit
caller adv to come to the side of the building

PAFFORD NOTIFIED

286E toned out.

286E acknowledged toneout.
DISPATCH COMMAND NOTIFIED

F13 ADV TO SEND PAFFORD IN
PAFF NOTIFIED TO GO IN

JUV IS AWAKE AND CONSCIOUSNESS AND IS SITTING UP
PAFF 97

F11 ADV F13 TO ASK STAFF TO DO A HEAD COUNT

F13 ADV THAT THE STAFF IS AWARE OF THE ISSUE

juveniles that had left call card / 24053264

05/26/2024 19:40:21
05/26/2024 19:40:52

05/26/2024 19:41:38

HALL, KEALI
HALL, KEALI

HALL, KEALI

Print Date: Jun 17 2024 - 10:14:48

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on scene time for 286 was roughly 8 mins after they were paged
out

Complete all units.

Faulkner County Sheriffs Office, CFS: 24053262 10-74A
CAD_ Details KASMUCK

Faulkner County Sheriffs Office

Call for Service Card

Notes
Entry Date Entry By Note Type Notes

05/26/2024 19:41:38 HALL, KEALI
05/26/2024 19:51:20 WIMBERLY, OLIVIA

Complete all units.

F13 ADV BEHAVIORAL STAFF AT THIS LOCATION DECLINED A

Page 2 of

REPORT
Total Notes: 19
Units
Unit Number Unit Name Department Mileage Start_ Mileage End Primary Unit
F13 COX, SKYLAR FCSO 0 0 YES
Dispatched Date: 05/26/2024 19:17 EnRoute Date: 05/26/2024 19:17 Arrived Date: 05/26/2024 19:22
Transport Start: Transport End: Completed Date: 05/26/2024 19:41
Disposition Date: Call Canceled: Back At Station:
286E1 286 E 1 286E 0 0 NO
Dispatched Date: 05/26/2024 19:19 EnRoute Date: 05/26/2024 19:19 Arrived Date: 05/26/2024 19:40
Transport Start: Transport End: Completed Date: 05/26/2024 19:40
Disposition Date: Call Canceled: Back At Station:
F411 EVERETT, TY FCSO 0 0 NO
Dispatched Date: 05/26/2024 19:35 EnRoute Date: 05/26/2024 19:35 Arrived Date: 05/26/2024 19:35
Transport Start: Transport End: Completed Date: 05/26/2024 19:41
Disposition Date: Call Canceled: Back At Station:
Total Units: 3
Radio Traffic
Traffic Date Unit # Unit Name Traffic
05/26/2024 19:17 F13 COX, SKYLAR UNIT ENROUTE
05/26/2024 19:17 F13 COX, SKYLAR UNIT DISPATCHED
05/26/2024 19:19 286E1 286 E 1 UNIT DISPATCHED
05/26/2024 19:35 F11 EVERETT, TY UNIT DISPATCHED
05/26/2024 19:35 F114 EVERETT, TY UNIT ENROUTE
05/26/2024 19:19 286E1 286 E 1 UNIT ENROUTE
05/26/2024 19:17 F13 COX, SKYLAR UNIT ENROUTE
Total Radio Traffic: 7
Toneouts
Dispatched Date Unit # Unit Name Department
286E
Toneout 1: 05/26/2024 19:17 Toneout 2: 05/26/2024 19:17 Toneout 3:
Ack. Date: 05/26/2024 19:19 Cancel Date: Toneout 1 By: ALARCON, PEARLY

Total Toneouts: 1

Print Date: Jun 17 2024 - 10:14:48
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Faulkner County Sheriffs Office, CFS: 24053262 10-74A
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Faulkner County Sheriffs Office

Call for Service Card
Page 3 of 3

Case Numbers

Entry Date Case Number Department
05/26/2024 19:17:15 FAULKNER COUNTY SO
05/26/2024 19:19:08 286 EAST FIRE DEPARTMENT
Print Date: Jun 17 2024 - 10:14:48 Faulkner County Sheriffs Office, CFS: 24053262 10-74A

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summary: Caller reported that two young ladies came to his door asking for a ride. Caller believes they came from Little Creek Behavioral.

raw_content:
Faulkner County Sheriffs Office

Call for Service Card
Page 1 of 2

Call Information

Received Date: 05/26/2024 19:23 Dispatch Date: 05/26/2024 19:32 EnRotue Date: 05/26/2024 19:34
Arrived Date: 05/26/2024 19:34 Completed Date: 05/26/2024 19:35 Call Canceled:
Disposition: HANDLED BY OFFICER-NO REPORT

CFS #: 24053264 Case #: Priority:

Nature: SUSPICIOUS ACTIVITY How Received: 911
Initial Nature: Alarm:

Call Taken By: WIMBERLY, OLIVIA Dispatched By: ALARCON, PEARLY Fire Type:

Completed By: ALARCON, PEARLY ReOpened By: ReOpened Reason:

Site Dangers: NO K9 Used: NO Bill For Call: NO
Business Check: NO Toneout: Permit #:

Business:

FEW MINUTES AGO 2 YOUNG LADIES CAME TO THE DOOR THINK THEY ARE FROM THE BEHAVIORAL PLACE THEY ASKED FOR A RIDE
FROM THE CALLER AND HE STATED HE TOLD THEM NO AND THEN THEY HAVE LEFT/ THEY WALKED BACK DOWN TOWARDS SKUNK
HOLLOW

BLACK ANKLE BRACELT ON RIGHT LEG
WHITE FEMALE / 5'2 / SHORT BLACK CURLY HAIR

OTHER FEMALE WAS IN DARK CLOTHING/PANTS LONGER HAIR/

Incident Information

Common Name: Zone:

Address: 3100 SOUTHERN OAKS RD SubDivision:

CSZ: CONWAY, AR 72032 Intersection: 161 SKUNK HOLLOW RD
ESN: 316 Lat/Lon: 35.0710327,

Caller Information

Name: Address:

Phone #: (479) 857-0912 CSZ:

Notes

Entry Date Entry By Note Type Notes

05/26/2024 19:32:21 ALARCON, PEARLY f13 advised of this / gen info / while on scene at cfs:24053262,

adv that pafford is aware of this situation and have people out
looking for them at 1930

05/26/2024 19:34:18 ALARCON, PEARLY the two females have been found and brought back to the facility
05/26/2024 19:34:29 ALARCON, PEARLY
05/26/2024 19:34:49 ALARCON, PEARLY per f13, f11 adv, as he was in the area of southern oaks atl
05/26/2024 19:35:05 ALARCON, PEARLY Complete all units.
05/26/2024 19:35:05 ALARCON, PEARLY Complete all units.
05/26/2024 19:35:06 WIMBERLY, OLIVIA DISPATCH COMMAND NOTIFIED
Total Notes: 7
Print Date: Jun 21 2024 - 16:23:27 Faulkner County Sheriffs Office, 24053264

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Faulkner County Sheriffs Office

Call for Service Card
Page 2 of 2

Units
Unit Number Unit Name Department Mileage Start_ Mileage End Primary Unit
F13 COX, SKYLAR FCSO 0 0 NO
Dispatched Date: 05/26/2024 19:32 EnRoute Date: Arrived Date:
Transport Start: Transport End: Completed Date:
Disposition Date: Call Canceled: 05/26/2024 19:35 Back At Station:
F411 EVERETT, TY FCSO 0 0 YES
Dispatched Date: 05/26/2024 19:34 EnRoute Date: 05/26/2024 19:34 Arrived Date: 05/26/2024 19:34
Transport Start: Transport End: Completed Date: 05/26/2024 19:35
Disposition Date: Call Canceled: Back At Station:
Total Units: 2

Radio Traffic
Traffic Date Unit # Unit Name Traffic
05/26/2024 19:34 F11 EVERETT, TY BACKUP-TO-PRIMARY-TEN-CODE

F11 made primary.
05/26/2024 19:34 F11 EVERETT, TY UNIT ENROUTE
05/26/2024 19:34 F11 EVERETT, TY UNIT DISPATCHED
05/26/2024 19:32 F13 COX, SKYLAR UNIT DISPATCHED

Total Radio Traffic: 4

Case Numbers

Entry Date Case Number Department
05/26/2024 19:34:29 FAULKNER COUNTY SO
Print Date: Jun 21 2024 - 16:23:27 Faulkner County Sheriffs Office, 24053264

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summary: A resident was sent to the emergency room after swallowing two batteries.

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: 021388
Date of Incident: 5/19/2024
Date Received: 5/20/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Licensing
Report Description: came to the
staff admitting, she had self-harm by swallowing 2-67-sized batteries (blue) while in the
bathroom. was sent to the emergency department on 05.19.24 at 1340 and returned at
1646 on 05.19.24.
Interim Action Narrative: Resident was taken to the emergency room. Resident is on close
observation and clinical restriction.
Maltreatment Narrative:
Licensing Narrative: Program Coordinator reviewed providere reported incident for
licensing concerns.Facility reported the batteries came from the resident's hearing aids.
Program Coordinator will inquire about precautions, nursing note, and discharge summary
from the emergency room. Documentation received and uploaded.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: Licensing completed a buildings and grounds walkthrough. No deficiencies cited.

raw_content:
521 Visit Compliance Report

Licensee: Little Creek Behavioral Health

Facility Number: 255

Licensee Address: 161 SKUNK HOLLOW
CONWAY AR 72032

Licensing Specialist: Kendra Rice
Person In Charge: Jlynn Price
Record Visit Date: 5/8/2024
Home Visit Date: 5/8/2024

Purpose of Visit: Subsequent Building and Grounds

Regulations Out of Compliance:

Regulations Needing Technical Assistance:

Regulation Not Applicable:

Regulations Not Correctable:

Narrative:

Time of visit: 10:15 am to 11:00 am

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

ARMXAN BEA S
DEPARTMENT CF

‘ 4 HUMAN
wat SERVICES
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot $140, Little Rock, AR 72203-1437
P: 501.508.8910 F: 501.683.6060 TDD: 501.682.1550

Page 1 of 3

Census: 62

Program Coordinator Rice completed buildings and grounds. Program Coordinator observed three (3)
buildings being built on the grounds. The parking lot and grassy area of the grounds were maintained. No
debris was observed.

The following areas were observed: lobby area, classrooms, residential dorms, dining room, gym, coffee shop,
and nurse’s station.

There is a total of five (5) classrooms. Residents were observed interacting in the classrooms, talking with
staff in the classrooms or on the classroom hall. Ratios are as follow: Room 116, 6:11. Room 117, 3:15. Room
118, 3:9. Room 119, 2:11. Room 118B, 4:14.

Water fountains are located on each dorm for drinking water. Smoke detectors are in the day areas and each
bedroom. Program Coordinator observed the emergency escape plan and schedules for therapy, groups, and
activities posted on the walls. Bedrooms were maintained with the exception some residents are more
organized than others.

Spoke with maintenance while observing the dorms. Maintenance informed Program Coordinator that all
dorms are scheduled to be painted so that the dorms would have the same color scheme.

Program Coordinator reviewed the MAR’s on the residents listed below:

All initialed and up to date.

Provider Comments:

CCL Staff Signature : Date: 5/9/2024

| !

Vp las
ALLAN 4

i | ‘ft

Date: 5/9/2024

Page 2 of 3


summary: A resident reported injuring his wrist while horseplaying with a peer. The facility was cited 907.2 for allowing horseplay.

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: 020628
Date of Incident: 4/12/2024
Date Received: 4/16/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Licensing
Report Description: On 04.12.24 staff reported while playing on the playground resident
and a peer were horse-
playing and fell on his side and hurting his wrist/arm.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 4/17/24-Email sent to inquire if client was x-rayed and why
facility did not report this incident the next business day. Jlynn Perkins of Little Creek
indicated that the client was x-rayed and this was reported late because she was off Monday,
4/15/24. Visit scheduled for 4/18/24. 4/18/24, Facility visited and cited 907.2 for staff
allowing horseplay that resulted in resident injury.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: A complaint received by Licensing stated that the facility was allowing a supervisor to work with two felonies. The staff member was terminated on 4/2/2024.

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: 020465
Date of Incident: 4/10/2024
Date Received: 4/10/2024
Facility Name: Little Creek Behavioral Health
Facility Number: 255
Incident Type: Licensing
Report Description: Little creek is allowing a supervisor work with two
felony?s a battery an a DWI. I do not fell comfortable with him working at little creek with
those types of charges being that we work with children that have behavioral/mental issues.
He?s also court ordered to go to jail on the weekends. A lot of the kids from our facility are
aware of this and think it is ?cool?. He is not a good example for these children and most of
the time we are their last resort.
Interim Action Narrative:
Maltreatment Narrative:
Licensing Narrative: 4/10/2024- Program Manager spoke to the background check unit
and discovered that this staff was approved in 11/2022. The facility was contacted to request
that the background checks be re-ran. However, the facility reports that they are aware that
the staff is now ineligible per the minimum licensing standards, so they moved forward to
terminate the staff on 4/2/2024. 4/11/2024- Licensing requested information on how and
when the facility was alerted to the staff's ineligibility. The facility reports that they received
a complaint on 4/2/2024 and proceeded to terminate the staff on 4/2/2024. Complaint is
unfounded.
We Care. We Act. We Change Lives.
humanservices.arkansas.gov


summary: An officer was dispatched to the facility in response to a report of a harrassing voicemail.

raw_content:
Faulkner County Sheriffs Office
Incident Report Report Status: FILED IN RECORDS
Case Number: 24000790 Case Status: ADMINISTRATIVELY
CLOSED
Page 1 of 2
Case#: 24000790 Report Date: 03/29/2024 09:42
Report By: Deputy. Brandon Jones - (F12) Arrival Time:
Case Type: HARRASSMENT Reporting Zone: D
Business: Occurred From: 03/28/2024 17:00
Address: 161 SKUNK HOLLOW RD Occurred Through: 03/29/2024 08:00
Intersection: Reportable IBRS: No
City/State/Zip: CONWAY, AR 72032 School:
Lat/Long: Lat: 35.0682283 / Long: -92.3841968 Case Status: ADMINISTRATIVELY
CLOSED
Case Type: HARRASSMENT File / Cad ID:
Assigned To: Assigned Date:
Cleared By: Sergeant. Chad Pruett - (Cd2) Cleared Date: 04/05/2024
How Cleared: MISDEMEANOR
IBR Clear Code: Clery Related: NO
UCR / Offenses
UCR: All Other Offenses - [90Z] Status:Completed
Charge: GENERAL INFORMATION REPORTS
Statute: Charge Code:GEN INFO
Business Involved
Business Type: Business
Business Name: LITTLE CREEK BEHAVIORAL HEALTH
Address: 161 SKUNK HOLLOW
City/State/Zip: CONWAY, AR 72032
Phone: (501) 358-7484 Email:
Offender / Suspect
Name UNKNOWN, UNKNOWN DOB: Race/Sex: U/U
Address: Current Age: Height:
City/State: Age:0 Weight:
Resident: UNKNOWN Hair Color: Eyes:
Complainant
Name: SHIVERS, ALLYSON RENEE DOB: 05/06/1979 Race/Sex: W/F
Address: Current Age: 44 Height: 5 Ft. 07 In.
City/State: Age: 44 Weight: 135
Email: Hair Color: BLN Eyes: BRO
Home: Cell Phone: DL#:
Occupation: Work Phone:
Print Date: Apr 18 2024 - 08:58:55 Faulkner County Sheriffs Office
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Faulkner County Sheriffs Office
Incident Report Report Status: FILED IN RECORDS
Case Number: 24000790 Case Status: ADMINISTRATIVELY
CLOSED
Page 2 of 2
Complainant
Employer:
Narrative
On March 29, 2024, at approximately 0928 hours, I was dispatched to make a call for service in reference to a
terroristic threat.
I spoke with Allyson Shivers (complainant) by cell phone. Ms. Shivers is the director of admissions for Little Creek
Behavioral Health (victim business). Ms. Shivers stated an unknown male (offender) left a bizarre voicemail on their
office phone. Ms. Shivers stated the voicemail was left sometime after business hours and she had a recording of it. I
listened to the recording of the voicemail and could hear a male subject state "One day there is going to be a suicide
or murder because you fucks can't answer the goddamn phone". Ms. Shivers stated she was unaware of who the
male was but the number he called from was .
Ms. Shivers provided me with the voicemail recording to be uploaded to the "patrol pics" folder. I advised Ms.
Shivers I would be doing a report to document the incident. Ms. Shivers was given this report number and advised
how to obtain a copy.
JONES, BRANDON 3/29/2024, 4:47:55 PM
Reporting Officer Approved By Officer
Deputy. Brandon Jones - (F12) Sergeant. Zachary Cooley - (F6)
Reported On: 03/29/2024 09:42 Approved On: 03/30/2024 16:29
FILED IN RECORDS
Case Status: ADMINISTRATIVELY
Administrative Use Only - IBRS Date
CLOSED
141056
Print Date: Apr 18 2024 - 08:58:55 Faulkner County Sheriffs Office
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Faulkner County Sheriffs Office
Call for Service Card
Page 1 of 2
Call Information
Received Date: 03/29/2024 09:24 Dispatch Date: 03/29/2024 09:28 EnRotue Date: 03/29/2024 09:44
Arrived Date: 03/29/2024 09:44 Completed Date: 03/29/2024 09:44 Call Canceled:
Disposition: INC REPORT TAKEN
CFS #: 24033461 Case #: Priority:
Nature: TERRORISTIC THREAT How Received: ADMIN LINE
Initial Nature: Alarm:
Call Taken By: NORRIS, EMILY Dispatched By: NORRIS, EMILY Fire Type:
Completed By: HALL, KEALI ReOpened By: ReOpened Reason:
Site Dangers: NO K9 Used: NO Bill For Call: NO
Business Check: NO Toneout: Permit #:
Business:
ph number
this number called little creek behavioral last night and left a voicemail saying that if they didnt answer the phone there was going to be a murder.
director of admissions allison shivers is calling to report it, she adv she has a copy of the recording but there is no identifying information other
than it is definitely an adult.
Incident Information
Common Name: Zone:
Address: 161 SKUNK HOLLOW RD SubDivision:
CSZ: CONWAY, AR 72032 Intersection: SHIVERS
ESN: 316 Lat/Lon: 35.0682283,
Caller Information
Name: SHIVERS, ALLISON Address:
Phone #: CSZ:
Notes
Entry Date Entry By Note Type Notes
03/29/2024 09:27:32 NORRIS, EMILY she wants to make a report just in case
03/29/2024 09:44:51 HALL, KEALI
03/29/2024 09:44:57 HALL, KEALI Complete all units.
Total Notes: 3
Units
Unit Number Unit Name Department Mileage Start Mileage End Primary Unit
F12 JONES, BRANDON FCSO 0 0 YES
Dispatched Date: 03/29/2024 09:28 EnRoute Date: 03/29/2024 09:44 Arrived Date: 03/29/2024 09:44
Transport Start: Transport End: Completed Date: 03/29/2024 09:44
Disposition Date: Call Canceled: Back At Station:
Total Units:1
Print Date: Apr 18 2024 - 08:54:29 Faulkner County Sheriffs Office, 24033461
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Faulkner County Sheriffs Office
Call for Service Card
Page 2 of 2
Radio Traffic
Traffic Date Unit # Unit Name Traffic
03/29/2024 09:44 F12 JONES, BRANDON UNIT ENROUTE
03/29/2024 09:28 F12 JONES, BRANDON UNIT DISPATCHED
Total Radio Traffic:2
Case Numbers
Entry Date Case Number Department Unit Narcan Used
03/29/2024 09:41:46 24000790 FAULKNER COUNTY SO F12 No
Print Date: Apr 18 2024 - 08:54:29 Faulkner County Sheriffs Office, 24033461
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summary: An officer took a report from the Arkansas State Police Crimes Against Children of an allegation that a juvenile was choked by a staff member at the facility.

raw_content:
Faulkner County Sheriffs Office
Call for Service Card
Page 1 of 2
Call Information
Received Date: 03/19/2024 14:04 Dispatch Date: 03/19/2024 15:08 EnRotue Date: 03/19/2024 16:00
Arrived Date: 03/19/2024 16:04 Completed Date: 03/19/2024 16:04 Call Canceled:
Disposition: INC REPORT TAKEN
CFS #: 24032340 Case #: Priority: CALL FOR SERVICE
Nature: ASSAULT How Received: ADMIN LINE
Initial Nature: Alarm:
Call Taken By: WIMBERLY, OLIVIA Dispatched By: ALARCON, PEARLY Fire Type:
Completed By: STARK, CARRIE ReOpened By: ReOpened Reason:
Site Dangers: NO K9 Used: NO Bill For Call: NO
Business Check: NO Toneout: Permit #:
Business:
NEEDS TO MAKE A REPORT
SOMEONE ON STAFF CHOKED A PATIENT
THIS OCCURRED WEEK OF THE 4TH OF MARCH
STAFFF MEMBERS NAME IS
Incident Information
Common Name: Zone: SOUTH
Address: 161 SKUNK HOLLOW RD SubDivision:
CSZ: CONWAY, AR 72032 Intersection: POWELL
ESN: 316 Lat/Lon: 35.0682283,
Caller Information
Name: POWELL, LINDA Address:
Phone #: CSZ:
Notes
Entry Date Entry By Note Type Notes
03/19/2024 14:53:23 ALARCON, PEARLY code 0
03/19/2024 16:02:51 ALARCON, PEARLY Name:
Race: BLACK OR AFRICAN AMERICAN / Sex: MALE / DOB:
00:00:00
DL State: ARKANSAS / DL Number:
03/19/2024 16:03:21 ALARCON, PEARLY Name:
Race: WHITE / Sex: FEMALE / DOB: 00:00:00
DL State: TEXAS
03/19/2024 16:04:24 STARK, CARRIE
03/19/2024 16:04:36 STARK, CARRIE Complete all units.
Total Notes: 5
Print Date: Apr 18 2024 - 08:56:39 Faulkner County Sheriffs Office, 24032340
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Faulkner County Sheriffs Office
Call for Service Card
Page 2 of 2
Units
Unit Number Unit Name Department Mileage Start Mileage End Primary Unit
F36 WILCHMAN, JEFFREY FCSO 0 0 YES
Dispatched Date: 03/19/2024 15:08 EnRoute Date: 03/19/2024 16:00 Arrived Date: 03/19/2024 16:04
Transport Start: Transport End: Completed Date: 03/19/2024 16:04
Disposition Date: Call Canceled: Back At Station:
Total Units:1
Radio Traffic
Traffic Date Unit # Unit Name Traffic
03/19/2024 16:00 F36 WILCHMAN, JEFFREY UNIT ENROUTE
03/19/2024 15:38 F36 WILCHMAN, JEFFREY BUSY
Setting unit F36 location to FUEL @ 8 MILE / STILL ON CFS for .
03/19/2024 15:38 F36 WILCHMAN, JEFFREY UNIT DISPATCHED
re-dispatched to oldest call.
03/19/2024 15:38 F36 WILCHMAN, JEFFREY UNIT DISPATCHED
re-dispatched to oldest call.
03/19/2024 15:08 F36 WILCHMAN, JEFFREY UNIT DISPATCHED
Total Radio Traffic:5
People Involved
Name: DOB: SSN:
Race: WHITE Sex: FEMALE Cell Phone: Work Phone:
Address: Apartment: Home Phone:
CSZ: Email:
How Involved: Relationship:
DL Number: TX/ Class: Expires On: Status:
Name: DOB: SSN:
Race: BLACK OR Sex: MALE Cell Phone: Work Phone:
AFRICAN
AMERICAN
Address: Apartment: Home Phone:
CSZ: Email:
How Involved: Relationship:
DL Number: Class: Expires On: Status:
Total People: 2
Case Numbers
Entry Date Case Number Department
03/19/2024 16:00:39 FAULKNER COUNTY SO
03/19/2024 16:02:17 24000705 FAULKNER COUNTY SO
Print Date: Apr 18 2024 - 08:56:39 Faulkner County Sheriffs Office, 24032340
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summary: Licensing visited the facility to conduct a staff record review. All files reviewed complied with the minimum licensing standards.

raw_content:
Division of Child Care & Early Childhood Education
P.O. Box 1437, Slot S140, Little Rock, AR 72203-1437
P: 501.508.8910 F: 501.683.6060 TDD: 501.682.1550
521 Visit Compliance Report
Licensee: Little Creek Behavioral Health
Facility Number: 255
Licensee Address: 161 SKUNK HOLLOW
CONWAY AR 72032
Licensing Specialist: Kendra Rice
Person In Charge: Jlynn Price
Record Visit Date: 3/12/2024
Home Visit Date: 3/12/2024
Purpose of Visit: Staff Record Review Visit
Regulations Out of Compliance:
Regulations Needing Technical Assistance:
Regulation Not Applicable:
Regulations Not Correctable:
Narrative:
Time of Visit: 12:45 pm to 1:15 pm
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 1 of 2

Census: 62
Program Coordinator Kendra Rice reviewed five (5) personnel files. Training files were not reviewed during
this visit.
Q. Miller (1/30/2023) Behavioral Health Associate
D. Ellis (2/8/2021) Behavioral Health Associate
J. Woods (12/5/2022) Behavioral Health Associate
M. Hervey (8/2/2021) Behavioral Health Associate
D. Daniels (2/28/2022) Behavioral Health Associate
All files reviewed complied with the minimum licensing standards.
Provider Comments:
CCL Staff Signature : Date: 3/12/2024
Provider Signature : Date: 3/12/2024
www.arkansas.gov/dhs
Serving more than one million Arkansans each year Page 2 of 2