Disability Rights Arkansas

Centers for Youth and Families Little Rock

*Photos taken by DRA staff during onsite monitoring visits. Photos reflect the most recent conditions observed by DRA staff but may not reflect the current conditions at the facility. If you are associated with a facility and have updated information or photos you would like to share, please contact DRA at [email protected]

Location: Little Rock, AR

Population Served: Youth ages 5-18

# of residents per unit: Up to 8 Residents per room: 1-3 Capacity: 82 beds (PRTF and residential)

Contact with family (Calls and visit schedule): Facility declined to provide specifics regarding call frequency or schedule

Restraint utilized? Yes Chemical Restraint utilized? Yes Seclusion utilized? No

Treatment Components

Clinical Director - LCSW

Therapists: Facility declined to identify, report number employed, or share credential status of any therapists.

Treatment modalities offered: Facility declined to identify any specific modalities available.

# of individual therapy sessions/week: Facility declined to provide a number or range.

# of group therapy sessions led by a licensed mental health professional/week: Facility declined to provide a number or range.

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PRLU or OLTC

Accidental Injury, Notice of Incident

On 7/29/2023, client chipped her tooth while eating chicken strips. Although there was no swelling to her mouth, client reported she was in extreme pain. Centers’ medical personnel assessed client and made the decision to send her to Arkansas Children’s Hospital (ACH) for further evaluation. Once at ACH, medical personnel there examined client and determined she had sustained a broken tooth and would need to follow up with a dentist on Monday. After client’s evaluation, she was transported back to EMAC. Centers’ medical personnel continued to monitor until she was taken to a dentist (Leap kids) today, 7/31/2023. 8/2/2023, Licensing Specialist informed resident is scheduled for a root canal on 8/25/2023.

PRLU or OLTC

Notice of Incident, Self-Harm

On 7/28/2023, client intentionally punched the wall to harm her hand. Centers’ medical personnel assessed client’s hand and made the decision to send her to Ortho Arkansas for further evaluation. Once at Ortho Arkansas, medical personnel there examined and determined there were no fractures present. After client’s evaluation at Ortho Arkansas, she was transported back to EMAC.

PRLU or OLTC

Accidental Injury, Notice of Incident

On 7/27/2023, client tripped and hit her right hand/Wrist on the wall. Centers’ medical personnel assessed client and observed she had minimal bruising and swelling to the right wrist area. Client was treated with frequent ice packs to her right hand and given ibuprofen/Tylenol for any pain. Client’s guardian was notified about this incident. On 7/28/2023, continued to complain about the pain in her right wrist, so out of an abundance of caution, she was transported to Ortho Arkansas for further evaluation. Once at Ortho Arkansas, medical personnel there examined client and diagnosed her with contusions to the 3rd, 4th, and 5th metacarpals of the right hand. After client’s evaluation at Ortho Arkansas, she was transported back to EMAC by centers’ staff. Licensing narrative: Licensing Specialist was informed of provider reported incident. 8/1/2023, Licensing Specialist reviewed provider reported incident for licensing concerns. Licensing Specialist will inquire about what the resident tripped over. 8/2/2023, Licensing Specialist informed that resident tripped over her feet while trying to get away from an altercation.

Police Report

Battery

Officers made contact with staff member at facility. The staff member stated that while doing her regular counseling with juvenile, the juvenile got mad at her and proceeded to punch her in the stomach and slap her in the head. The staff member stated she had to get security to subdue the juvenile and put her in confinement. Officer advised the staff member to speak with the Juvenile Prosecuting Attorney’s Office.

PRLU or OLTC

Accidental Injury, Notice of Incident, Peer Altercation, Visit Compliance Report

On 7/27/2023, client became involved in a physical altercation with one of her peers. Staff immediately reacted to the incident and separated and her peer. During the altercation, client’s right foot was injured. Centers’ medical personnel assessed client’s right foot and noted the foot was swollen. Out of an abundance of caution, centers’ staff transported client to Ortho Arkansas for further evaluation. Once at Ortho Arkansas, medical personnel there conducted x-Rays of client’s right foot and determined there was a fracture. Client was directed to wear a walking boot on her right foot for three to four weeks. Client will have a follow-Up appointment at Ortho Arkansas in seven to ten days. After client’s evaluation at Ortho Arkansas, she was transported back to EMAC. Centers’ medical staff will continue to monitor condition. Client’s guardian was notified about this incident. Client and the peer involved in this incident will not be housed in the same dorm moving forward. Client reported that a staff member stepped on her foot during the altercation; however, after video review of the incident, it is unclear how client injured her foot (Did staff or client step on it or did she hit it on something). Licensing narrative: Licensing Specialist spoke with director of risk management regarding ELS case#[REDACTED]. Licensing Specialist reviewed camera footage of provider reported incident. Licensing Specialist observed residents and staff members in a classroom, ratio 2:6. Resident that injured her foot was observed walking around the classroom and walked toward the classroom doorway. Minutes later, Licensing Specialist observed resident get off the floor and walked toward where the staff and two (2) residents were sitting. Resident was observed walking behind a peer near staff and slapped her peer in the back of her head. Staff was observed getting up from their chairs and separated the two (2) residents. During the altercation, Licensing Specialist was unable to determined how resident injured her foot due to staff and peers surrounded around the residents. Resident was observed looking at her foot and limping around the classroom. Licensing Specialist observed resident limp toward the doorway of the classroom and kick the wall. Resident then limped to a desk where she sat down. Licensing Specialist observed the nurse enter the classroom and assess the resident’s foot. Licensing Specialist: Kendra Rice.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist conducted an annual review of policies and procedures for the centers. Ms. Abby Jenkins assisted Licensing Specialist with the review. Policies and procedures for the centers complied with minimum licensing standards.

Police Report

Runaway

Officers responded to this location for an assist medical call. Upon arrival, officers were informed that juvenile 1 was sent here to be housed. C1 advised juvenile 1 was taken from her home and placed into the custody of the state of Arkansas. Officers were advised on scene that as soon as MEMS stopped their ambulance, juvenile 1 opened the back doors and sprinted eastbound, on foot, toward University. A broadcast was issued and officers circulated the area with negative results. C1 advised juvenile 1 was originally from Little Rock and could be headed anywhere. C1 also advised that juvenile 1 has run away numerous times in the past. BWC in use.

Medicaid Inspection of Care

Corrective Action Plan, Inspection of Care Report

Deficiencies were noted during the Inpatient Psychiatric Inspection of Care (IOC) conducted on 07/18/23.

PRLU or OLTC

Medical, Notice of Incident

On 7/21/2023, client developed a rash on the left side of his chest area that spread to the right side. Centers medical personnel were unsure what caused the rash, so the decision was made to send to Arkansas Children’s Hospital (ACH) for further evaluation. Centers’ staff transported to ACH. Once at ACH, medical personnel there diagnosed client. Client was prescribed medicine to treat his rash. After client’s medical evaluation at ACH, he was transported back to EMCC.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

Client and peer engaged in a fight, during which the peer bit client on the wrist. Upon assessment, it was noted the bite penetrated the skin. Client also sustained a superficial scratch to the left side of her face. Client was sent to the hospital for evaluation, and was diagnosed with a human bite. Medication was prescribed as a preventative measure against infection. Client and peer were placed on assault precautions and placed in separate dorms.

Licensing Specialist (Kendra Rice) visited facility on 7/25 and viewed video of incident. Once the peer charged at client, staff intervened. Staff was observed attempting to separate the residents when the bite occurred, but client had the peer’s hair. Support staff was called to assist, and client was restrained after pushing a staff member. No licensing concerns noted regarding this incident.

PRLU or OLTC

Acute Placement, Notice of Incident

On 7/13/23, client became dysregulated and began making verbal statements about harming herself and others. Client also began to become more aggressive with her peers and staff. The centers’ medical team determined to keep client safe, she would need a higher level of care that an acute facility could provide. Acute placement was located for client at Conway behavioral health and mems ambulance service transported her to facility. Client’s guardian was notified about this incident. After treatment at Conway behavioral, client will return to EMAC. Licensing narrative: Licensing Specialist informed of incident 7/14/23. 7/17/23, Licensing Specialist reviewed provider reported incident of licensing concerns.

Police Report

Battery Third Degree

Officers responded to a battery at the listed address. Officers made contact with Katrena Finley. Ms. Finley advised juvenile had been assaulting her yesterday and today. Ms. Finley advised she could not give out the juvenile’s information and only wanted a paper trail. Ms. Finley advised juvenile would hit her and pull her hair whenever asked to do something she did not want to do. Ms. Finley advised she has no injuries. Officers provided an incident number. No further police actions taken

PRLU or OLTC

Visit Compliance Report

Licensing Specialists reviewed ten (10) personnel files: [REDACTED]. Licensing Specialist checked r103 general registry & criminal record checks and r105 staff qualifications & training. All personnel files reviewed complied with the minimum licensing standards.

Police Report

Disturbance

Officers responded to the listed location in reference to a disturbance call. Upon arrival, offices made contact with Tamika Johnson (C1), who advised she wanted officers present to scare juveniles. Ms. Johnson advised she did not want a report made. Officers walked through the building and observed multiple disturbances between juveniles. Ms. Johnson advised multiple juveniles were in an altercation prior to officers’ arrival. Ms. Johnson advised she wanted officers present to scare the juveniles. Officers made contact with juvenile 1, who advised she and juvenile 2 were in an altercation. Juvenile 1 advised she was trying to watch tv, but the other girls were being too loud, and she told them to be quiet. Juvenile 1 advised juvenile 2 stated, “I’m going to beat our ass” and rushed at her. Juvenile 1 advised she defended herself by biting juvenile 2 on the foot. Officers made contact with juvenile 2, who advised that juvenile 1 bit her on the foot. Juvenile 2 was being irate. Officers assisted staff by escorting juvenile 2 to her room. Ms. Johnson advised no police action was needed. The juveniles live in separate living quarters.

PRLU or OLTC

Notice of Incident, Peer Altercation, Visit Compliance Report

On 07/08/2023, client engaged in a fight with two of her peers. Staff intervened in the fight and separated the clients from each other. Client was assessed by centers’ medical personnel, and she complained of pain in her right shoulder. The nurse noted that did not have any discoloration or swelling to the shoulder area. The doctor was contacted and advised to continue to monitor and notify her of worsening symptoms. On 7/09/2023, client continued to complain about pain in her right shoulder. Out of an abundance of caution, centers’ staff transported to Arkansas Children’s Hospital (ACH) for further evaluation. Once at ACH, medical personnel there conducted x-Rays of client’s right shoulder and determined there was no dislocation or fracture. After client’s medical evaluation at ACH, she was transported back to EMAC. Centers’ medical staff will continue to monitor. Client’s guardian was notified about this incident. Client is a private placement at the centers. Client and her two peers were placed on assaultive precautions because of this incident. Client will not be placed in a dorm with either of the two peers involved in this incident. Licensing narrative: Licensing Specialist reviewed camera footage for licensing concerns. Licensing Specialist observed three residents in a bedroom in dorm 2 of EMAC. Licensing Specialist observed resident jump off her bed and run toward her peer with another peer running toward the resident. The resident grabbed at her peer and the peer swung the resident to the floor. Both residents were tussling. The other peer was observed kicking the resident. Licensing Specialist observed staff coming into the room within 6 seconds and separated the residents. All three residents placed on assaultive precautions. Licensing Specialist: Kendra Rice.

Police Report

Battery Third Degree

Upon arrival on scene, Officer Estrada and I made contact with the caller. Caller stated she had been assaulted by juvenile while checking for contraband in her room. Caller said she was looking in juvenile’s cubby under her bed when juvenile began repeatedly punching her in the head. Caller also stated juvenile had also attacked her earlier and scratched her on her left arm. Caller had a small visible scratch on her left forearm. Caller was given the incident number and advised warrants.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

On 6/29/2023, client reported a staff member had pinched his arm. Centers’ medical personnel assessed and noted a bruise to his right upper arm. There was no skin broken and did not require any medical treatment because of this incident. Centers’ staff reported this incident to the child abuse hotline, and the alleged allegations were accepted (Referral #[REDACTED]) guardian was notified about this incident. [REDACTED] was suspended and will remain suspended until the completion of the investigation. Licensing narrative: 8/14/23, Licensing Specialist informed case found unsubstantiated. 8/14/2023, Licensing Specialist reached to investigator harp for an update. Investigator harp informed Licensing Specialist case was closed. Licensing Specialist inquired if staff member would be returning to work. Licensing Specialist reviewed camera footage for ELS case #[Redacted] at EMCC. Licensing Specialist observed ratio 2:1. Resident was observed throwing pillows at staff and walking around south dorm common area. Licensing Specialist observed staff members blocking pillows that the resident was throwing. The camera view was dark so Licensing Specialist could not review when and resident was in the corner on the furniture in the common area. Licensing Specialist observed staff walk away from the resident and him rubbing his arm. Resident was observed sitting in the common area of all the dorms, ratio 3:1. Licensing Specialist observed resident rubbing and picking at his arm. The nurse was observed taking pictures of the resident’s arm, ratio2:1. Licensing Specialist is not prepared to leave a finding at this time.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

CACD investigator visited facility to investigate an accepted hotline call involving a resident. The allegations involved supervision, treatment, and medical concerns regarding resident. Details of the complaint:

• A therapist at Centers LR doesn’t appear to have any set boundaries. The therapist wanted resident’s guardians to take her off birth control due to weight gain; The parents refused, as they believed the weight gain was from the various medications she was prescribed for sleep while at the facility. Complaint stated the facility had not documented any sleep issues the resident had, just prescribed and administered medication and didn’t document why she needed it.

• Several residents pierced their noses in May. When the guardian picked up the resident for an appointment, her nose was infected. When video was reviewed, the resident was observed going into the bathroom with a brush and came out hiding her nose; Staff allegedly figured out what they were doing but didn’t stop them. When the facility was contacted, no one had documented anything and did not contact the guardians. The complaint also stated that staff do not check residents for contraband after they return from outings.

Licensing follow-up: An ICA for the involved therapist was placed on hold after further information was received. Nursing notes were received regarding the nose piercings, and Licensing visited facility on 6/30/23. Staff informed Licensing that it was reported the residents were using teeth from their combs to pierce their noses, and 3-4 residents were involved. All residents were assessed; No infection was reported, and they were prescribed triple antibiotic ointment. The case was unsubstantiated by CACD and Licensing.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist observed the following areas in EMAC: therapy hallway, exercise room, classrooms, dining area, rage room, cozy room, hygiene closet, exercise room, and all dorms (One (1), two (2), three (3)And four (4). The grounds leading into the building were clean and free of debris. The parking lot was full of parked cars. There was an ACH dental trailer on the grounds that provided dental hygiene to the residents. Licensing Specialist was escorted by Ms. Jade, program manager. Walking down the therapy hallway, Licensing Specialist observed closed and opened doors with staff sitting in their offices. In Ms. Gretchen’s classroom, speech therapy was taking place. Ms. Karin’s classroom was empty. Ms. Jade informed Licensing Specialist that residents are participating in the following activities during this summer: real teen talk, arts and crafts, and yoga. If the residents do not have any precautions on Wednesday, they are able to volunteer at the zoo. In the dorms, Licensing Specialist observed the clients’ rights on the walls, the evacuation plan, and the menu (breakfast, lunch, and dinner) on the walls. The rage room ratio, 1:1. Exercise room ratio, 1:1.Dorm 1, ratio 2:8. Licensing Specialist observed residents laying down in their bedrooms, watching television, or playing a game with staff observing. Dorm 2, ratio 2:8. Residents were sitting in the day area with staff. Dorm 3, ratio 1:3. Residents were playing tricks with uno cards. Dorm 4. Ratio 2:7. Residents were resting in their bedrooms or watching television with staff. All bathrooms were cleaned and sanitary. Licensing Specialist: Kendra Rice.

PRLU or OLTC

Acute Placement, Notice of Incident

On 6/26/2023, client became dysregulated and started making verbal statements about harming herself. Client also began to become aggressive with her peers and staff. The centers’ medical team determined, to keep client safe, she would need a higher level of care that an acute facility could provide. Acute placement was located for client at Perimeter Healthcare (West Memphis) and mems ambulance service transported her to the facility. After her treatment at perimeter, client will return to EMAC. Licensing narrative: Licensing Specialist informed of incident. 6/28/2023, Licensing Specialist reviewed provider reported incident for licensing concerns.

PRLU or OLTC

Medical, Notice of Incident

On 6/25/2023, client complained to centers’ medical personnel that her stomach was hurting. It should be noted that on 6/22/2023, client was transported to Arkansas Children’s Hospital (ACH) where she was diagnosed with a cyst of the right ovary. Out of an abundance of caution, centers’ staff transported to ACH. Once at ACH, medical personnel there conducted several tests. The attending provider noted was bleeding from her uterus and increased the dosage of medication she was prescribed on 6/22/2023. The cause of the bleeding was from the cyst on the right ovary. After client’s medical evaluation, she was transported back to EMAC. Licensing narrative: Licensing Specialist received incident via email. 6/17/2023, Licensing Specialist reviewed provider reported incident for licensing concerns.

PRLU or OLTC

Notice of Incident, Self-Harm

On 6/24/2023, client became dysregulated and hit the plexiglass window in her dorm with her right hand. Centers’ medical staff assessed client’s right hand and noted some swelling in the right little finger and right ring finger. Client reported she was unable to make a fist. Out of an abundance of caution, centers’ staff transported to Arkansas Children’s Hospital (ACH). Once at ACH, medical personnel there conducted x-Rays of clients right hand and determined there were no fractures present. After client’s medical evaluation, she was transported back to EMAC. Licensing narrative: Licensing Specialist received incident via email. 6/27/2023, Licensing Specialist reviewed provider reported incident for licensing concerns.

PRLU or OLTC

Accidental Injury, Notice of Incident

On 6/24/2023, client reported she closed the bathroom door on her left hand. Centers’ medical staff assessed client’s left hand and noted the area was red and the hand was slightly swollen. Client’s left hand was treated with an ice pack, and client was given ibuprofen. Client continued to complain about pain in her left hand so out of an abundance of caution, centers’ staff transported her to Arkansas Children’s Hospital (ACH). Once at ACH, medical personnel there conducted x-Rays of left hand and determined there were no fractures present. After client’s medical evaluation, she was transported back to EMAC. Licensing narrative: Licensing Specialist was informed of this incident via email. 6/27/2023, Licensing Specialist reviewed provider reported incident for licensing concerns.