Millcreek Behavioral Health / Habilitation Center, Inc.

A complaint received reported that a staff member called a resident a derogatory name. The complaint also states that the staff member grabbed him by his hair and forced him down to the floor.

A complaint received reported that a resident has head sores due to lice not being treated, though she told the nurse 3 weeks prior. The complaint also states that staff failed to help the resident with hygiene.

A resident was transported for an x-ray after complaining of pain from punching a plexiglass window.

Officers responded to the facility after multiple 911 calls stating several physical altercations were taking place at the location.

An x-ray was ordered after a resident complained of finger pain from falling outside approximately a week earlier.

A resident reported that during a verbal altercation at the school, the principal tried to choke and bite him. The facility was cited as a result of this incident.

A resident was found attempting to tie a shirt around her neck.

A resident reported that a staff member allowed multiple patients to engage in a physical altercation against him. The facility was cited for missing restraint documentation and failure to protect a resident from verbal and physical abuse from peers and staff as a result of this incident. A staff member was terminated.

A resident was sent to the emergency room after complaining of shortness of breath and wheezing.

A resident reported that a staff member called him a “bitch” and his mother a “hoe”. The resident also reported that after the verbal confrontation, another staff member grabbed him by his shirt and swung him between two beds. The complaint was UNFOUNDED by Licensing.

A resident injured his finger while playing football.

A parent complained that her daughter was being taken to her home without her permission and requested to speak to someone about the complaint process.

A resident was sent for an x-ray after injuring her toe at the splash pad.

A resident was transported for evaluation after complaining of pain due to being “slammed” by a peer.

Complaint # AR00038949 and #AR00037200 were in compliance.

A resident was transported for an x-ray after hitting the wall while upset.

A resident was transported for treatment of a laceration after an altercation with a peer.

An x-ray was ordered after a resident complained of finger pain from recreational activities.

A resident was transported for evaluation after she reported knee pain from dancing.

A resident was transported for an x-ray after reporting ankle pain from landing wrong while coming down a waterslide.

Multiple deficiencies were noted during the Inspection of Care (IOC) conducted on 6/2/25.

A complaint received alleged concerns with the facility’s cleanliness, lack of supervision that leads to altercations between residents, and staffing ratio concerns. The complaint has been UNFOUNDED by Licensing.

A resident was transported for evaluation after she reported knee pain from falling.

A resident reported that she took an unknown medication provided to her by a peer.

A resident was transported for assessment and x-ray after complaining of left foot pain to the nursing staff.

A resident was transported for assessment after reporting a recreational injury to nursing staff.

A resident was sent for an x-ray after reporting finger pain from a recreational injury.

A complaint received states that staff will not let the resident go to the bathroom when she wants and makes her wait at least 2 hours between bathroom breaks. The report also alleges that staff does not believe the resident has panic attacks and did not believe she was injured when she fell off the monkey bars. The complaint was UNFOUNDED by Licensing.

A complaint received alleges that a resident has been overmedicated by the facility, causing adverse health side effects.

A guardian reported that a resident had been sexually assaulted by a peer while at the facility. The complaint was UNFOUNDED by Licensing.

A resident was transported to the hospital for a CT scan. The hospital recommended the resident be placed on seizure protocols.

A complaint received alleges that a resident has been overmedicated multiple times by the facility.

A resident tripped while sweeping, causing a laceration to the jaw. The resident was transported to the emergency room for treatment before being released back to the facility.

A resident reported pain after falling from the monkey bars. The resident was sent to the emergency room for an x-ray.

A resident was referred for an ultrasound of his scrotum due to right testicular pain.

A resident was transported for an x-ray after kicking an object. The x-ray showed no fracture.

A resident was transported to the Emergency Room for an x-ray after twisting her ankle when she tripped over her shoes.

A resident was transported to the Emergency Room after reporting that she swallowed ChapStick and an ink pen.

Licensing visited the facility to conduct a Buildings and Grounds inspection. The buildings were clean, safe, and in good repair, except for one pair of shorts with strings found in a resident’s bedroom. The grounds were clean and free of safety hazards. The facility was cited 911.15.f for the strings found in the bedroom.

A resident was transported to the Emergency Room after reporting that she brought illegal substances with her upon admission and inhaled them.

While working in the cafeteria, a resident was injured by spilling hot water on his right foot. The resident was transported to the Emergency Room for treatment before being released back to the facility.

A resident complained of pain in his right hand after playing football. An x-ray was ordered and showed no fractures.

A resident was sent for an x-ray after injuring his hand by punching a window.

A resident eloped from the facility and stole a truck from a nearby home, crashing the truck in a nearby town. The resident told officers he left the facility because he was being sexually abused by one staff member and physically abused by two other staff members. The facility was alerted to the resident’s absence by police officers approximately an hour after the resident eloped from the premises. The facility was cited 907.3 and 907.2 for supervision issues as a result of this incident.

A resident reported that a staff member shoved her face into the floor during a restraint and another staff member kicked her in the side. This complaint has been UNFOUNDED by Licensing.

A resident was injured after falling asleep and then falling out of her desk. The resident was transported to the emergency room for treatment before being released back to the facility.

A resident reported pain to his right hand after an altercation with a peer. An x-ray was ordered.

A resident reported that a staff member entered his bedroom and became physically aggressive, “slamming” him several times. This complaint has been UNFOUNDED by Licensing.

A resident was sent to the emergency room for an assessment after receiving a laceration injury when another resident threw a dustpan.

A resident reported that a staff member grabbed the hood of his hoodie while he was running, resulting in three petechiae marks on the front of his neck. The facility was cited 109.1.g for Unprofessional Conduct.

A resident received a laceration to his elbow after being pushed by a peer. The resident was transported to the Emergency Room for treatment and returned to the facility afterward with no restrictions.

A resident was sent for a CT scan. The resident returned to the facility afterward.

A resident was sent for an x-ray of his toe after he became angry and kicked a chair.

A resident forcefully kicked the living unit door open after becoming upset and remained outside until a physical restraint was implemented. Afterward, the resident was evaluated and referred for an x-ray. The Physical Escort Technique used was not an approved technique. The facility was cited 905.9 for the improper escort.

A resident complained of thumb pain after a fall. An x-ray was ordered. The x-ray showed no fracture or abnormality.

Complaint #AR00036068 was in compliance.

A staff member was seen on video pushing a resident twice. The resident was pushed to the ground. The facility was cited 109.1.g and 907.2 as a result of the incident. The staff member was terminated.

A resident was sent for an x-ray after complaining of pain due to punching a wall. The x-ray showed no fracture or abnormality.

A resident was sent to the Emergency Room due to a previous injury to his carotid artery, after staff found him barricaded in his room with a pair of pants tied around his neck. The resident was placed on suicide precautions and 1:1 monitoring.

A resident complained of knee pain after falling. He was sent for an x-ray. The x-ray showed no fracture or abnormalities.

A resident was sent for a follow up x-ray after her discharge from the hospital.

A resident was admitted to the hospital. The resident returned to the facility on 1/12/2025.

A complaint received states that a resident snorted medication she found in a staff member’s jacket. The resident reported that she provided pills to other residents on the unit. The facility was cited 907.5 for a staff member seen sleeping during a video review.

A resident was sent for a chest x-ray due to cough and congestion. The x-ray showed no negative findings.

An x-ray was ordered after a resident punched a wall while upset.

The facility medical director sent a resident for a different x-ray view due to the initial x-ray performed not being the correct view of the area in question.

A resident was sent to Dallas County Medical Center for an x-ray due to complaining of lower rib pain after an altercation with a peer.

A resident was sent to Dallas County Medical Center for assessment and x-ray after being pushed over a chair by a peer.

A resident eloped from the facility by taking a staff member’s keys, running away from staff as he was escorted to the nurse, and driving off in the staff member’s car. Police officers located the resident and transported him back to the facility. The facility was cited 907.2 as a result of this incident.

A resident was sent to Dallas County Medical Center for an x-ray of his right hand after he got mad and punched a wall.

A resident was sent to Dallas County Medical Center for an x-ray of his nose after an altercation with a peer.

Licensing visited the facility to interview residents.

A resident complained of arm pain after an altercation with a peer. The residents were separated, and an x-ray was ordered for the resident’s arm.

Licensing completed a Buildings and Grounds walkthrough for the Cafeteria, Gym, and facility grounds. No deficiencies cited.

A resident complaint of pain to the right hand after an altercation with a peer. The resident was sent to Dallas County Medical Center for an x-ray.

A resident was sent to Dallas County Emergency Room for a CT scan due to hitting her head when she fell over during what appeared to be a seizure.

An x-ray was ordered of a resident’s right foot due to complaints of pain. The injury occurred while the resident was playing football.

A resident got mad and punched a door after a peer ran up to him and hit him in the mouth. The resident was taken to Dallas County Medical Center for an x-ray of his hand.

A resident was sent to Dallas County Medical Center for an abdominal CT scan due to abdominal pain.

A Medicaid Inspection of Care review was triggered by a complaint against the facility.

A complaint received stated that a resident was receiving multiple medications that cause sedation and that one of the medications treats diagnoses that the resident does not have. The complaint has been UNFOUNDED by Licensing.

A resident was sent to Dallas County Medical Center for an x-ray of his right hand after he fell on his hand while outside.

A resident was sent to Dallas County Medical Center for a chest x-ray.

A resident was sent to Dallas County Medical Center for a chest x-ray.

A resident was sent to Dallas County Medical Center for an x-ray of his right hand. He complained of pain after getting angry and punching a wall.

A resident was sent to Dallas County Medical Center for an x-ray of his right hand due to complaints of pain after an altercation with a peer.

A resident was admitted to Dallas County Medical Center due to his condition declining despite a previous antibiotics change.

A resident was sent to Dallas County Medical Center for an x-ray due to a worsening cold despite being on antibiotics.

A resident was sent to Dallas County Medical Center for an abdomen and pelvic CT due to complaints of rectal bleeding.

A resident was sent for a scheduled scrotal ultrasound due to complaints of pain.

A resident was taken to Dallas County Medical Center for an x-ray due to reported pain after injuring her finger while playing basketball.

A resident was sent to Dallas County Medical Center for an x-ray of his foot after a peer stepped on it.

A complaint received states that a staff member called a resident a “gay lil bitch boy,” grabbed him by the collar, and pushed him against the wall. The facility was cited 109.1.g and 110.9.c and the staff member was terminated as a result of this incident.

A resident was taken to Dallas County Medical Center for an x-ray after jamming his finger.

A resident was sent to Dallas County Medical Center for an x-ray of his left foot. The resident complained of swelling and bruising after kicking a soccer ball.

Complaint AR00035145 was in compliance. Complaint AR00035775 was in compliance.

A complaint received stated that the complainant was concerned a resident was being over-medicated. The resident was observed as groggy, incoherent, and drooling. The complaint was UNFOUNDED by Licensing.

A complaint was received that Millcreek clients are being overmedicated.

A resident eloped from the facility while outside playing football. The resident was returned to the facility approximately 3.5 hours later.

A resident reported that roaches were observed in the cafeteria of the facility, that staff yells and cusses at the residents, and that the units are “nasty”.

A resident reported that his roommate touched his private area and tried to pull his pants down.

At approximately 17:00, a unit supervisor received a call from Fordyce Police Department reporting that a patient had broken into a house and they needed to return him back to Millcreek. The facility was cited 907.2 and a staff member was terminated as a result of this incident.

A resident was sent to Dallas County Medical Center for an injury to his lip after being involved in an altercation with a peer.

Children’s Records reviewed for multiple residents. All required items present in hard copy file.

A resident was sent to Dallas County Medical Center for an x-ray of his right hand due to pain after punching a wall.

An x-ray was ordered after a resident complained of knee pain from falling prior to her arrival to the facility.

An x-ray was ordered after a resident injured her toe by kicking a door.

A resident was taken to Dallas County Medical Center for an x-ray after jamming his finger while playing basketball.

A CT scan was ordered for a resident.

A resident was sent to Dallas County Medical Center for an x-ray due to hand pain from punching a concrete wall.

A resident was transported to Dallas County Medical Center for evaluation after being involved in a physical altercation with several peers. The facility was cited 907.2 as a result of this incident.

A Medicaid Inspection of Care review was triggered by a complaint against the facility. Deficiencies were cited.

Multiple deficiencies were noted during the Inspection of Care (IOC) conducted on 9/16/24. A Corrective Action Plan (CAP) was submitted and approved.

A resident reported to her therapist that a staff member shut a door on her arm. This complaint was UNFOUNDED by Licensing.

A resident was sent for an x-ray due to complaining of hand pain from falling.

An officer was dispatched to the facility for a staff member wanting to report his stolen laptop.

Licensing received a complaint that Millcreek failed to provide appropriate medical care to resident. The complaint was UNFOUNDED by Licensing.

A resident reported that during a restraint, he bit a staff member, and the staff member hit him in the face. This complaint was UNFOUNDED by Licensing.

Building & Grounds conducted for Rock Hill and Magnolia Houses. The facility was cited 911.15.f for strings found in one bedroom.

A resident was sent to Dallas County Medical Center ER for treatment after injuring his foot during recreation time.

A resident was sent for an x-ray of his left hand after punching a wall while upset.

Three residents eloped from the facility while outside during activity time. The residents were located down the road and were returned to the facility.

A resident was sent to Dallas County Medical Center for a chest x-ray due to cough, congestion, and fever. Flamingo hall has been quarantined due to multiple respiratory illnesses.

A resident was sent to Dallas County Medical Center for a chest x-ray due to cough, congestion, and fever. Flamingo hall has been quarantined due to multiple residents with respiratory symptoms.

A resident was sent to Dallas County Medical Center for a chest x-ray due to cough, congestion, and fever. Flamingo hall has been quarantined due to multiple residents with respiratory symptoms.

A resident went to the Dallas County Medical Center Emergency Room due to high fever. Several residents in the same house are being x-rayed for respiratory illness. The House has been quarantined.

A resident was sent to Dallas County Medical Center for a chest x-ray. Flamingo Hall is quarantined due to multiple respiratory illnesses.

A resident was sent to the Dallas County Medical Center ER due to high fever, elevated pulse ox, and heart rate.

Officers were dispatched to assist with locating a missing juvenile. Officers deployed an arial drone and located the subject. The resident was taken into custody and returned to Millcreek with no injuries.

A resident was in school and ran out of the side doors. Supervisors followed the resident but lost sight of her after she turned at the stop sign and went in the woods. Police were contacted and came to assist with the search using a drone. The resident was located in woods and returned to unit. She has been placed on unit restriction.

A resident reported she brought a vape into the facility with her and a staff member found her vape charger. The resident stated the staff member told her to give them her vape and they would keep it for her so she wouldn’t get in trouble.

A resident was taken to Dallas County Medical Center for treatment after sustaining an injury during a physical altercation with several other residents.

During a behavior, a resident attempted to kick staff. The staff member grabbed the resident’s leg and pulled him out of the chair to the floor. The staff member walked out immediately following the incident and has been terminated. The facility was cited 110.9, 109.1.g, and 905.4.g.

A visit to the facility was conducted in order to review fire and severe weather drill logs. No severe weather log could be located. The facility was cited 914.9 for the missing log.

A Complaint Investigation survey was conducted on July 31, 2024. No deficiencies were cited during the survey. Complaint #AR00033837 was in compliance.

A resident was sent to Dallas County Medical Center for an x-ray after a physical altercation with a peer.

A recertification survey was conducted at this facility. This survey found the facility had deficiencies requiring correction/substantial correction.

The facility was in compliance with Title 42, Code of Federal Regulations 483.90 (a), life safety from fire.

After an intervention, a resident reported that he was pinched on his chest and scratched on his shoulder. The accused staff member chose to resign immediately after the report. The facility was cited 109.1.g and 905.4.g as a result of this incident.

Officers were dispatched to Millcreek regarding an assault of a resident by a staff member.

A resident was sent to Dallas County Medical Center’s ER for outpatient X-rays after reporting ongoing pain and swelling in her left ankle for about two weeks.

A resident was taken to Dallas County Medical Center for an x-ray of his knee after kicking a door.

A resident was sent to Dallas County Medical Center for an x-ray of his jaw after an altercation with a peer.

A resident was taken to Dallas County Medical Center for evaluation after hurting his knee playing on waterslides.

Buildings & Grounds conducted for Flamingo and Zebra Hall. The facility was cited 907.3 for being out of staffing ratio.

Buildings and Grounds were completed for Penguin Hall, Eagle Hall, and the outdoor area. No deficiencies cited.

A resident eloped while staff were dealing with another patient. The resident was located by staff about 1.5 hours later and returned to the facility.

Two residents eloped through a door during bedtime. One resident was found on campus and returned to the unit. The other resident was located hours later and transported back to the facility.

A resident was taken to Dallas County Medical Center for an x-ray after hurting his hand playing kickball.

A resident was transported to Dallas County Medical Center for an x-ray of the right hand after punching a wall several times.

A recertification survey was conducted at the facility. No deficiencies were cited.

A resident was taken to Dallas County Medical Center Emergency Department for an x-ray of his right knee after complaining of pain.

A resident was taken to Dallas County Medical Center for an x-ray of her left foot.

A resident was sent to Dallas County Medical Center for a scheduled CT of the head and thyroid.

A resident reported that a staff member stepped on her feet to keep her in place and pulled out 6 of her braids. The complaint was UNFOUNDED by Licensing.

Buildings and Grounds were completed for Kangaroo and Tiger Hall. No deficiencies cited.

A resident was sent to Dallas County Medical Center for an x-ray of the left ankle after falling while playing.

A resident was sent to Dallas County Medical Center for evaluation due to having an altered mental status after an altercation with a peer.

A resident was transported to Dallas County Medical Center after informing staff members that she took Ibuprofen out of a staff member’s bag and swallowed 3 handfuls. The facility was cited 910.1 for personal medication being left in an unlocked location.

A resident was transported to Dallas County Medical Center after not being able to remove a marker cap she put into her vagina.

A resident reported that she was in a physical altercation with a staff member. This complaint was UNFOUNDED by Licensing.

Licensing visited the facility to review personnel records. The facility was cited 103.3 for late child maltreatment registry checks.

A resident was taken to Dallas County Medical Center after complaining of rib pain following a physical altercation with two peers.

A resident was sent to Dallas County Medical Center after sustaining an injury while horseplaying with a peer.

Personnel Records Review. Technical Assistance provided for 105.15h for missing references.

A resident was sent to Dallas County Medical Center for evaluation due to being lethargic and complaining of shortness of breath.

A resident was sent for a follow up CT scan for continued hip and leg pain.

A resident was injured while horseplaying with a staff member. The resident was sent to Dallas County ER for evaluation. The facility was cited 109.1.g and 907.2 as a result of this incident. Three staff members were terminated.

A resident was sent to Dallas County Medical Center for an ultrasound of her gallbladder.

A resident was transported to Dallas County Medical Center for x-rays after complaining of right hip and leg pain.

Buildings & Grounds conducted for Deerfield and School buildings. No deficiencies cited.

A resident was taken to Dallas County Medical Center for a tetanus shot after stepping on a nail while outside playing football.

Officer River Byrne was dispatched to Millcreek in reference to a parent filing a complaint against a staff member.

A resident reported to his mother that a staff member called him inappropriate names and threw him around. This complaint has been UNFOUNDED by Licensing.

A resident was sent to Dallas County Medical Center ER for assessment of possible allergic reaction.

A resident was transported to Dallas County Medical Center after injuring her ankle while playing basketball.

A resident was sent to Dallas County Medical Center after injuring her toe by kicking a wall.

A resident was transported to Dallas County Medical Center after injuring his toe while playing basketball.

Licensing conducted an after-hours visit. No deficiencies cited.

Licensing visited the facility in follow up to the attempted elopement of a resident in January 2024. No deficiencies cited.

A resident reported that a staff member hit him in the mouth and nose during an attempted elopement and physical restraint. This complaint was UNFOUNDED by Licensing.

A resident was sent for an x-ray after complaining of pain from a fall that occurred during a basketball game.

A resident reported that a staff member choked him during a physical restraint. This complaint has been UNFOUNDED by Licensing.

Personnel Records Review conducted for staff. All items accounted for. Background check file reviews also conducted for 33 additional staff.

A resident was sent to Dallas County Medical Center for an outpatient x-ray after complaints of thumb pain from catching himself after losing his balance.

A resident eloped from the property and was found within 200 yards of the facility.

A Buildings and Grounds walkthrough was conducted. The facility was cited 911.6 for issues identified in the visit.

A resident complained of ankle pain after playing kickball. An x-ray was ordered.

A resident reported that a peer had coerced the resident into engaging in non-consensual sexual contact. This complaint was UNFOUNDED by Licensing.

A resident was slapped twice in the back of the head by a staff member and had her legs yanked out from under her, causing her to fall to the floor. The staff member was terminated immediately. The facility was cited 905.4.g and 109.1.g as a result of the incident.

A resident reported to his therapist that he was forced to inappropriately touch a peer’s penis. The complaint has been UNFOUNDED by Licensing.

A resident was sent to Dallas County Medical Center for an outpatient x-ray after reporting hand pain from punching a wall.

Licensing visited the facility to review staff background checks. No licensing concerns noted.

A resident was transported to Dallas County Medical Center after swallowing all the Ibuprofen inside a bottle she took from the Activity Director’s desk drawer. The facility was cited 908.4 for the ibuprofen left in an unlocked drawer.

A resident was referred to Dallas County Medical Center for an outpatient x-ray after accidentally closing a door on her hand earlier in the week.

Annual Review/Policies PRTF completed. All items on checklist accounted for.

An officer was dispatched to the facility for a runaway child report.

A resident was referred to Dallas County Medical Center for outpatient x-rays after reporting pain to her PCP during a wellness checkup.

A resident reported he was punched by a staff member after an altercation between two of his peers. A second resident reported that he confronted the staff member and was also punched in the face. A second staff member witnessed the incident and corroborated the resident’s report. The accused staff member was terminated. The facility was cited 109.1.g and 905.4.g as a result of this incident.

A resident eloped while staff members intervened in a physical altercation between two other residents.

An officer was dispatched to the facility in response to a runaway patient.

Licensing conducted a visit to confirm an applicant was not employed by the facility.

A resident eloped from the facility by exiting a rear door and jumping a fence. The Fordyce Police Department was notified. The resident was located on facility grounds.

Officers were dispatched to the facility in response to a runaway juvenile.

A resident was sent to Dallas County Medical Center for an x-ray after reporting foot pain from an injury sustained while playing volleyball.

A resident was sent to Dallas County Medical Center for an x-ray after reporting pain in her thumb following an incident where staff had to remove rocks from her hands during a de-escalation process.

A resident was sent to Dallas County Medical Center for an x-ray after complaints of back pain related to an injury sustained before admission to the facility.

Licensing visited the facility to conduct a Buildings and Grounds walkthrough. The facility was cited 908.8 for issues identified during the review.

Annual Reviews/Policies PRTF completed. All items on checklist accounted for.

A resident reported that a staff member hit her in the head with a closed fist multiple times. The complaint was UNFOUNDED by Licensing.

Licensing visited the facility to review personnel records. No deficiencies cited.

A resident was sent to Dallas County Medical Center for an x-ray after punching a wall.

A resident was sent to Dallas County Medical Center for an x-ray after kicking a door.

A resident was sent to Dallas County Medical Center for treatment of a laceration she received from a fence gate.

Licensing visited the facility to review video of the late night/early morning hours of 10/25/23, 10/27/23, and 10/29/23. No deficiencies cited.

Licensing visited the facility to conduct a Buildings and Grounds walkthrough. No deficiencies cited.

A resident was sent to Dallas County Medical Center for an x-ray after punching a wall.

A resident reported that a peer forced him to perform a sexual act in exchange for clothes. The complaint was UNFOUNDED by Licensing.

Licensing visited the facility to conduct a Buildings and Grounds Walkthrough. No deficiencies cited.

A resident was sent to Dallas County Medical Center for assessment after a physical altercation with another resident. The facility was cited 907.2 and 907.3 for issues identified during a review of the incident.

A resident was sent to Dallas County Medical Center for an x-ray of an injury received when he became upset and punched a wall.

A resident was sent for an emergency dental appointment after one tooth was knocked out and a second tooth was damaged during a physical altercation with a peer.

A resident was sent for an x-ray after complaining of pain from punching on a punching bag during recreation time.

Licensing visited the facility to review random video of cottages during evening hours. No deficiencies cited.

A resident was sent to Dallas County Medical Center for assessment of a leg laceration after slipping on the bleachers.

A resident was sent to Dallas County Medical Center for treatment after injuring his ankle by falling while playing basketball.

Licensing visited the facility to review personnel records. No deficiencies cited.

A resident was sent to Dallas County Medical Center for an outpatient gallbladder ultrasound.

A resident was sent to Dallas County Medical Center for assessment of a leg wound received before admission to the facility.

No deficiencies were noted during the Inpatient Psychiatric Inspection of Care (IOC) conducted on 09/05/23.

Officers were dispatched to the facility in response to three runaway juveniles. The juveniles were caught by staff and officers and were transported back to the facility.

Three residents eloped from the facility. The residents were located by Fordyce Police Department and escorted back to the facility.

Licensing visited the facility to conduct a Buildings and Grounds walkthrough. The facility was cited 911.15 for issues identified during the review.

A resident reported that a staff member forcefully pushed him into a chair after the resident attempted to continue a fight with a peer. The complaint was FOUNDED by Licensing. The facility was cited 905.4.g and 109.1.g for the staff member’s actions.

A resident reported that a peer entered his room and began touching him inappropriately.

Licensing conducted a monitoring visit at the facility. No deficiencies cited.

A resident was sent to Dallas County Medical Center for an x-ray after complaining of back pain to her PCP.

A resident was sent to Dallas County Medical Center for an ultrasound of his gallbladder after reporting digestive tract concerns to nursing.

A resident was sent to Dallas County Medical Center for an x-ray after being struck in the hand by a ball during recreation time.

A resident was sent to Dallas County Medical Center for an x-ray after injuring her hand by punching a metal door.

A resident was sent to Dallas County Medical Center for an x-ray after reporting continued pain in his jaw from accidently striking his jaw on a peer’s head while sliding down a water slide.

A resident was sent to Dallas County Medical Center for an x-ray after reporting pain and swelling to his hand from punching a metal pole.

A resident was sent to Dallas County Medical Center for treatment of a head laceration after he was pushed out of a chair by a peer.

A resident was sent to Dallas County Medical Center for an x-ray due to complaint of pain after punching a peer in the face.

A resident was sent to Dallas County Medical Center for assessment after a physical altercation with a peer.

A resident was sent to Dallas County Medical Center for treatment of a head laceration after colliding with a peer while on a water slide.

A resident reported he sustained a bruise when a staff member grabbed his arm while trying to separate him and a peer who were engaged in a physical altercation. The facility received technical assistance for 905.9 and 110.10 as a result of the incident.

Resident became non-compliant when prompted to get out of bed and later reported on a phone call to her parents that she was dragged out of her bed and beaten up by staff member. Resident reported she was dragged by her wrists and ankles, and her hair pulled to the point that strands broke off. A pin-point red area was noted to resident’s inner ankle and her knee. This complaint was UNFOUNDED by Licensing

A resident was sent to Dallas County Medical Center for assessment of a laceration following a physical altercation with a peer.

A resident was sent to Dallas County Medical Center for x-rays after reporting hand pain from a physical confrontation with a peer.

Licensing visited the facility to conduct an afterhours buildings and grounds walkthrough. The facility received technical assistance for 911.6 for a hole found in the laminate tile flooring.

A resident was sent to Dallas County Medical Center for an x-ray after reporting hand pain following a game of basketball.

A resident was sent to Dallas County Medical Center for an x-ray after punching a wall.

A resident was sent to Dallas County Medical Center for an x-ray of his hand after punching a wall.

A resident was sent to Dallas County Medical Center for an x-ray of her foot after playing kickball.

A resident was sent to Dallas County Medical Center for an x-ray of her wrist after slipping and trying to catch herself while falling.

Licensing visited the facility to conduct a buildings and grounds walkthrough. Technical assistance for 911.6 was provided for two showers not functioning in Zebra Hall.

A resident was sent to Dallas County Medical Center for an x-ray of his hand after he punched a wall.

A former resident reported that while he was at Millcreek in 2022, his roommate raped him. The alleged victim stated that he told his therapist at Millcreek, but she did nothing about it and “blamed him”.

A resident was sent to Dallas County Medical Center for assessment of a laceration to the nose after a physical altercation with a peer.

Licensing visited the facility to review personnel files. No deficiencies cited.

A resident was sent to Dallas County Medical Center for x-rays after hitting his thumb against the wall while horseplaying.

A complaint received states: Resident has been at Millcreek since 2019 for mental health. Since December 2022 until now, there have been 6 or more phone calls from staff stating the resident has been injured due to an altercation. This past weekend, (6/10-6/11), a nurse reported the resident tried to run away, and a staff member tried stopping him. The staff member “accidentally” kneed the resident in the mouth. The caller believes that something more may be going on at the facility and doesn’t understand how a staff person’s knee could accidentally make its way to the child’s mouth. It is believed that the resident does have injuries, but the exact level of injury is unknown.

A resident was sent to Dallas County Medical Center for a CT scan due to having blood-tinged sputum/stool.

A resident was sent to Dallas County Medical Center for an x-ray after injuring his right foot by tripping over something days before.

A resident was sent to Dallas County Medical Center for assessment following a physical altercation with a peer.

A resident was sent to Dallas County Medical Center for assessment of his eye following a physical altercation with a peer.

During a camera review of a physical restraint of a patient, it was determined that two staff members did not perform the restraint in compliance of facility expectations. Staff hit the resident in the face as a response to being bitten on the arm. The other staff member can be seen pulling the resident’s shirt over their face.

The facility was cited 109.1.g and 905.4.g as a result of this incident. The staff members were terminated.

A resident was sent to Dallas County Medical Center for assessment after hitting his head while playing ball.

A resident reported that a peer was in his room being sexually inappropriate. In a family session with his therapist, the resident reported that he was raped by a peer. The facility was cited 110.9 for late reporting.

A resident was sent to Dallas County Medical Center for assessment after a physical altercation with peers. After assessment at DCMC, he was referred to Arkansas Children’s Hospital.

A resident was slapped on the left cheek by a staff member as he was picking up candy that had fallen to the floor. The staff member was terminated. The facility was cited 905.4.g and 109.1.g as a result of this incident.

The following non-compliance areas have been cited during the past 3 months:

109.1.g (Unprofessional Conduct) – Facility received a citation on 03/03/23 regarding the inappropriate discipline given to a resident based on their age, development, and history.
905.3 (Behavior Management) – Facility received a citation on 03/13/23 regarding the inappropriate discipline given to a resident based on their age, development, and history.
905.4.f (Behavior Management) – Facility received a citation on 03/13/23 regarding inappropriate behavior management.
905.4.g (Behavior Management) – Facility received a citation on 03/17/23 regarding inappropriate behavior management.
907.2 (Ratio & Supervision) – Facility received citations on 01/03/23, 01/17/23, 03/03/23, and 03/13/23 regarding the failure of staff to provide adequate supervision to residents.
The facility is required to complete the following:

Present an intent training for all facility staff regarding the Minimum Licensing Standards sections 109, 110, and all of 900.
Conduct a minimum of once per week camera reviews of 3 separate locations in facility to ensure staff are appropriately supervising residents.
If a discovery is made of staff failing to supervise or participating in inappropriate behavior management, the facility will report it to the Licensing Unit by the next business day.
Retrain all child caring staff on behavior management policy.
Continue daily leadership rounding program to ensure all doors required to be locked are secured, looking for safety concerns, and any environment of care issues.
Proceed with training all direct care staff on the topics of Nurtured Heart Approach, Improving the Milieu, De-escalation with Highly Aggressive Patients, and Processing with our Clients.

Licensing met with facility leadership to discuss the Corrective Action Agreement put in place between Millcreek and the Placement and Residential Licensing Unit.

A resident was sent to Dallas County Medical Center for x-rays after reporting ankle pain from a recreational injury.

A resident was sent to Dallas County Medical Center for x-rays after punching a wall.

Licensing visited the facility to conduct a buildings and grounds walkthrough. The facility was cited 908.8 and received technical assistance for 911.6 for issues identified during the review.

A resident was sent to Dallas County Medical Center for assessment following a physical confrontation with a peer.

A resident was sent to Dallas County Medical Center for x-rays of his arm after falling during a recreational game.

A resident was sent to Dallas County Medical Center for assessment of a head injury after striking the back of his head on the floor when he was dropped by a peer.

A resident was sent to Dallas County Medical Center for x-rays following a physical altercation with a peer.

A resident reported that Millcreek staff members performed a personal body search on her while they were looking for contraband. During the search, an unnamed staff member rubbed her hand against the resident’s breast. Four staff were present during the search, and all staff present were interviewed. All staff corroborate the same story. The resident was asked to remove some clothes for the search, but staff never asked the resident to remove their undergarments.

A resident was sent to Dallas County Medical Center for assessment of injuries following a physical altercation with a peer.

A resident was sent to Dallas County Medical Center for an x-ray after punching a wall.

Received complaint 4/13/23 as follows: Resident’s guardian said she’s dissatisfied with Millcreek of Arkansas’ services. Guardian reported that he has had on campus visits with the resident and each time she has witnessed poor hygiene: dirty clothes, dirty fingernails, toenails, and bruises. The guardian also reported the resident always says he’s hungry during phone calls and appears to be starving whenever she sees him. Guardian also mentioned that when she calls the facility, she hardly ever gets someone to answer the phone and that they have only been giving the resident antibiotics and medication to help with bowel movements. Guardian said she spoke with the CEO once, and he was nice, but did mention that they normally don’t take in individuals that wear pull ups, who aren’t potty trained, and the resident is old enough to go to the restroom on his own. Guardian said the CEO was really nice aside from that statement. Guardian said there are no changes in the resident’s medications and that she was under the impression that Millcreek would be helping the resident, but instead his behaviors have worsened.

Licensing Specialist: Clayton DeBoer.

Regulations out of compliance: 908.8 – 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.

A resident was sent to Dallas County Medical Center for an x-ray after falling while playing kickball.

A resident was sent to Dallas County Medical Center for assessment following a physical altercation. The facility was cited:

907.2. Staff responsible for supervising residents involved made minimal effort to mitigate the situation.
109.1.g. Staff bear hugs resident causing him to fall to the floor.

A resident was sent to Dallas County Medical Center for assessment following a physical altercation with a peer. The facility was cited 907.2. Staff did nothing to intervene nor assist resident in this incident.

After review of the facility’s mandated reporter policy, Licensing determined that it does not comply with A.C.A 12-18-402 nor the Minimum Licensing Standards. Technical assistance was provided regarding A.C.A 12-18-402, R102.3.h and R110.9.

Licensing documented employment status of persons not eligible to be employed by a child welfare facility. Offer was rescinded for 3 individuals, 3 individuals were never hired, 1 individual was terminated on 01/23/23, and 1 individual who was on leave since 03/23/23 is scheduled to be terminated on 03/28/23.

A resident was sent to Dallas County Medical Center for x-rays after punching a closed door multiple times.

Officer was dispatched for a runaway juvenile from the facility. The officer located and returned the juvenile to the facility.

Licensing visited the facility to conduct a buildings and grounds walkthrough. The facility was cited 901.3 and 911.6 for issues identified during the review.

Maltreatment
During a therapy session, client reported that a staff member had threatened to “cut his vocal cords” because he wouldn’t stop humming, made him get under a table and pushed a chair against him, made him “stand up in a corner when it was time to go to bed”, and “poked him with a pen” behind his ear and the side of his head. Nurse noted a healed abrasion with scab behind ear. Child Abuse Hotline was called and accepted. Staff member was placed on administrative leave pending the investigation.
Licensing follow-up: Video reviewed on 03/13/23 showed client being directed to stand in the corner from 7:15pm until 9:40pm with brief breaks (on 03/09/23). The office door was open during the entire time reviewed, and a staff member was on her cellphone during most of the video. During further review, a staff member was seen bumping client with her stomach area to direct client back to the corner (Child Abuse Hotline was called separately for this incident) and a client is seen transporting a cleaning agent unsupervised (later determined to be soap).
Unfounded: At no time is alleged staff member seen pushing a chair against client or poking him with a pen.
Founded: Client was observed being directed by 2 staff members to stay in corner area until 9:40pm. On 03/17/23, facility indicated staff 1 remains on administrative leave pending certain termination and staff 2 will be retrained on TCI which encompasses appropriate staff/client interaction.
CACD investigation was unsubstantiated as of 05/03/23. Staff 1 was terminated on 03/23/23. Staff 2 was retrained and has since been terminated as of 05/22/23.
Regs out of compliance –
905.3 – Child stood in the corner from 7:15pm – 9:40pm.
905.4.f – Child stood in the corner from 7:15pm – 9:40pm.
907.2 – Door to the office in video reviewed was open with no staff inside the office for duration of the video. A client is seen transporting what appears to be a cleaning agent unsupervised.
905.4.g – Staff member bumped client with her stomach to direct him back to a corner he had been standing in for an extended period of time.

A resident was sent to Dallas County Medical Center for an x-ray after he was punched in the nose by a peer.

A resident was sent to Dallas County Medical Center for x-rays after reporting pain and bruising to his hand from punching a peer.

Officers were dispatched to the facility for a report of an escapee. A staff member advised that a resident ran away through the woods towards Johnson’s Furniture. The resident was later located by Millcreek staff.

A resident was sent to Dallas County Medical Center for an x-ray of his hand after punching a cinderblock wall.

A resident was sent to Dallas County Medical Center for an x-ray after he slipped in the mud and then complained of right shoulder pain.

A resident was sent to Dallas County Medical Center for an x-ray after he was punched in the nose by a peer.

A resident was sent to Dallas County Medical Center for an x-ray after falling and hurting his right forearm and wrist while playing basketball.

A resident was sent to Dallas County Medical Center for an x-ray after he was punched in the face by a peer.

A resident was sent to Dallas County Medical Center for an x-ray after injuring his hand by punching a tree.

A complaint received states: My daughter was at Millcreek for treatment for 6 weeks. She was treated poorly by staff. They would yell at her. They were constantly yelling and cussing at the other children there. She wasn’t being given her medication properly.

The facility was cited 908.8 and 905.4.c as a result of this complaint.

A resident was sent to Dallas County Medical Center for an x-ray after slipping and falling.

A resident was sent to Dallas County Medical Center for an x-ray of her ankle after tripping and falling.

A resident was sent to Dallas County Medical Center for an x-ray of his knee after slipping while playing basketball.

A resident was sent to Dallas County Medical Center for x-rays after he was punched in the face by a peer.

Licensing visited the facility to review children’s records. No deficiencies cited.

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

A resident was sent to Dallas County Medical Center for an x-ray of his arm after slipping while getting out of the shower.

A resident was sent to Dallas County Medical Center for an x-ray after punching a door with his fist while upset that a peer had punched him in the back.

Licensing visited the facility to review children’s records. The facility was cited 902.3 for missing records.

A resident was sent to Dallas County Medical Center after swallowing Pine Sol cleaner. The facility was cited 910.1 and 907.2 for issues identified in this incident.

A resident was sent to Dallas County Medical Center for an x-ray following a physical altercation with a peer.

A resident was sent to Dallas County Medical Center for an x-ray of his right hand after a physical altercation with a peer.

A resident was sent to the emergency room after swallowing batteries from a television remote.