Disability Rights Arkansas

Little Creek Behavioral Health

*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 rstanford@disabilityrightsar.org

Location: Conway, AR                       Population Served: Non-Arkansas residents ages 6-21. Deaf and hard of hearing unit.

# of residents per unit: up to 8 Residents per room: 1-2 Capacity: 64

Contact with family (Calls and visit schedule): Weekly to Bi-weekly calls. Visits with families are scheduled (no additional details were provided).

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

Treatment Components:

Clinical Director: LPC-S                    Therapists:4 full-time therapists (2 LMSW, 1 LCSW, 1 LAC)

Treatment modalities offered: “Trauma-informed Care, Cognitive Behavior Therapy (CBT), Eye movement desensitization and reprocessing (EMDR) and Reality Therapy, Person-Centered and Deaf Mental Health.”*

# of individual therapy sessions/week: 1-2

# of group therapy sessions led by a licensed mental health professional/week: 2-3

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PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Client asked to contact the Child Abuse Hotline with neglect complaints. Client stated staff are breaking confidentiality, the nursing department sits on their phones and does not help residents when in need, and a therapist told one of the residents to “kill herself.” Child Abuse Hotline was called, not accepted.

Licensing Specialist: Clayton DeBoer.

Facility visited and multiple clients interviewed. Statements from clients:

– Client stated “all they do is smoke and get high”.

– Client stated she had been sick due to a new medicine, and nurses will not help her. She tried to refuse the new medication but was afraid it would make the nurses mad. Multiple clients complained about the nursing services.

– Client stated she had an accident one morning in which she urinated on herself, and a staff member started the nickname “Pissy [Client]”.

– Multiple clients stated a therapist told a client to kill herself. Four of the six clients interviewed referenced this therapist unfavorably.

– Client stated staff are disrespectful and a staff member called her a “retard” a few months prior. Client reported she did not remember staff’s name and had not seen this staff member in 2 weeks.

An in-service was scheduled for the therapist referenced in the complaint. No definitive evidence that staff member referenced is responsible for the deragatory nickname a client mentioned. As a precautionary measure, all staff will complete in-service training on 10/26/23 (“Do’s and Dont’s” section of BHA).

Licensing complaint unfounded.

Police Report

Sexual Assault

Investigator from Arkansas State Police advised officer of a report of sexual activity involving a staff member and resident at Little Creek. Report: Staff member stated to resident “why is your butt so big”, then proceeded to grab her butt when the resident walked by him. Officer provided incident report number to the investigator.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

While on unit, staff and client exchanged words (unclear from audio). Client kicked a table towards the staff member, who then removed the table from the unit. Client then stood out of his seat and aggressively walked toward staff, and staff failed to use a proper PRT single-man restraint to transition client to the floor. No injuries noted. Staff placed on administrative leave. The Child Abuse Hotline was called (screened out).

Licensing Specialist: Clayton DeBoer.

Facility visited and video reviewed. Video shows that staff did not use unnecessary force when taking client to the ground. However, although client approached staff rapidly, client was not causing injury to himself, peers, staff or property when this hold was initiated. Facility cited 905.10.

Facility advised that staff will not be returning to the facility and is no longer an employee.

PRLU or OLTC

Medical, Notice of Incident

Client complained of chest pain during recreation therapy. Nurse noted client had increased heart rate. Her heart rate was still tachy after several minutes, and client was sent to the hospital for further testing.

Follow up email from facility on 9/22/23: All tests were negative, and Naproxen was ordered for chest pain. She has had no further issues or problems. No follow up appointment needed.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Clayton DeBoer.

Building & Grounds conducted from 9am- 11am. Census: 61. Areas observed: Classrooms, gym, cafeteria, kitchen, art room, living area, bathrooms, and grounds. MARs checked for 5 residents. No licensing concerns noted during visit.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

Client reported that a staff member asked her an inappropriate question regarding her body and then proceeded to touch her on the butt when the resident returned from the bathroom. Staff has been placed on administrative leave and called into the Child Abuse Hotline (accepted).

Licensing Specialist: Clayton DeBoer.

Facility visited and video reviewed. Staff was observed walking to client’s room 4 times but did not enter, walked with client to the living area, then to the restroom area. Client was not on any increased precaution. Staff is not seen touching client inappropriately and no evidence from video observed shows something definitively was inappropriate. However, both client and staff observed movements were not indicative of normal interactions and/or behavior.

CACD and Licensing unfounded complaint. Staff was immediately suspended after incident and terminated on 11/20/23.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Chelsea Vardell.

Licensing visited facility to review incident report logs, hotline reporting log, fire drill, and severe weather log.

Licensing discussed standard 110.17 (what incidents are considered reportable to licensing) with facility staff. The facility explained the reports Licensing was reviewing were not part of the medical record and instead part of the internal document written directly by the staff involved. The the final report is then written and stored separately. Licensing requested copies of these reports. Due to facility concerns about what is considered a suicide attempt vs a suicide gesture, Licensing Specialist will seek guidance from upper management and the Child Welfare Agency Review Board regarding suicide attempts.

PRLU or OLTC

Maltreatment, Notice of Incident

A resident reported to staff that she was shown two videos of a staff member and his girlfriend having oral and sexual intercourse on his phone. The staff member admitted to showing the resident the videos. Little Creek has terminated the staff and turned him in to the Arkansas hotline.

Licensing Specialist: Clayton DeBoer.
Licensing visited facility on 8/22/23 and issued citation 109.1.g: Staff admitted to showing inappropriate material to a client on his phone. All staff will be retrained on appropriate boundaries with clients by 9/22/23 (Zero Tolerance). The training is scheduled for 8/24/23 and a sign in sheet will be provided to licensing.
Maltreatment report was founded by Crimes and Children Division (CACD) and Licensing.

Police Report

Elopement

Officer was dispatched for 3 runaway juveniles. Staff stated 3 juveniles took off running to the woods and changed clothes. Officers located the juveniles and returned them to the facility.

PRLU or OLTC

Elopement, Notice of Incident, Visit Compliance Report

Three residents eloped from Little Creek around 9:30am by snatching staff’s badge around her neck. The residents eloped from the side emergency exit. The supervisor contacted the Sheriff’s Department, and a BOLO was placed on each resident. The residents were returned around 11:00am by the Faulkner County Sheriff’s Department.

Licensing Specialist: Clayton DeBoer.
Facility visited 8/15/23 and video reviewed of incident which occurred in Minnows area. According to video reviewed, staff supervised clients continuously during this incident. Staff seemed to be having difficulty maintaining a boundary with client who took the badge (badges are on breakaway lanyards for safety). It appeared as though staff was attempting to maintain a physical boundary of greater distance than client who took badge would allow. At no time before client took staff’s badge, was client a physical threat to herself, peers or staff.

PRLU or OLTC

Visit Compliance Report

Buildings & grounds conducted from 11 m-12 pm. Brim and trout areas observed to be clean, safe and in good repair. Bathrooms clean and sanitary with functioning sinks, toilets, hot water in showers. Client rights and emergency evacuation diagrams posted. Brim staff/Client ratio 1:8. Trout staff/Client ratio 1:6. Brim area was short one staff today. MAR checked for: [REDACTED]. All initialed and up to date. Regulations out of compliance: 907.3 – brim area staff/Client ratio: 1:8 at 11:30 am. Licensing Specialist: Clayton DeBoer.

PRLU or OLTC

Visit Compliance Report

Building & grounds visit conducted in 6/6/23. Hallway observed with clients, staff/Client ratio: 9:12. Cafeteria and gym observed to be clean, safe and in good repair. Fire extinguisher located in the kitchen. Bass and snappers client areas observed to be clean, safe and in good repair except snapper’s room 1 had a pair of pajamas with roughly 3 ft. string in the waist. The string was immediately cut and removed. Unit wide administration correspondence sent during today’s visit for all areas to be inventoried for strings in clothing. Bathrooms observed to be clean and sanitary with functioning sinks and toilets. Client [REDACTED] had three am medications that had not been marked at 11:07 am. Nursing was consulted who stated that am meds are usually given between 7-8 am. Regulations out of compliance: 908.8 – client [REDACTED] am meds were not initialed for 6/6/23 at 11:07 am. 911.15.F – snappers room 1 had strings approx. 3 ft. in length in a pair of pajamas. Licensing Specialist: Clayton DeBoer.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

[REDACTED] reported to the nursing department that one staff member [REDACTED] physically pushed her against the wall and pulled her hair. Another [REDACTED] chocked her while attempting to take a spray bottle away from her. A camera review was conducted for the incident; [REDACTED] was not a witness on the camera choking the resident at all. However, the administration could see the push from staff [REDACTED]. Client did not have any bruises or injuries. Both staff will be retrained in handle with care techniques and verbal de-escalations on 6/1/23. The incident was called into the child abuse hotline for Arkansas and submitted online to the state of [REDACTED]. Regulations our of compliance: 109.1.G – staff [REDACTED] is seen shoving client [REDACTED]. 907.2 – staff [REDACTED] did not initially intervene when client [REDACTED] got the cleaning product. Licensing Specialist: Clayton DeBoer.

Police Report

Sex Crime Under 18

On Wednesday May 24, 2023 at approximately 9:20 am, I was dispatched to a call for service in reference to a juvenile case. I made contact with complainant Arkansas State Police investigator [REDACTED] via telephone. [REDACTED] stated that she got a report of staff members from Little Creek Behavioral showing inappropriate photos to juveniles. [REDACTED] stated that (Offender 1) showed juvenile 1 (Victim 1) a picture of a unknown staff member’s private parts. [REDACTED] also stated that (Offender 2) and (Offender 3) showed juvenile 2 (Victim 2) the same picture of the unknown staff member. [REDACTED] stated that she did not have any other information about the incident. I then requested an incident report number from dispatch and provided a copy to [REDACTED].

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

On 05.04.23, [REDACTED] reported to behavioral health associate that she saw a penis picture that belong to REDACTED from REDACTED. [REDACTED] stated she saw the penis picture (Above mention staff) from REDACTED and also staff REDACTED showed her a picture of a vagina on her cellular device. [REDACTED] and [REDACTED] have all been called into the [REDACTED], and accepted: referral [REDACTED]. Licensing conducted visit on 5/9/23 in response to complaint that Little Creek staff had shown pornographic material to multiple clients from staff’s phone. Licensing interviewed both clients. One client stated that staff [REDACTED] initiated conversation with her stating: “I want to show you something” regarding male genitalia then proceeded to show her a picture of a man’s penis on her phone. Client stated this occurred in the laundry room of her living area. Other client was interviewed and stated that staff [REDACTED] showed her a picture of a penis on his cellphone. Client then stated that [REDACTED] made a sexual comment to her regarding the picture. Client indicated that the same staff later showed her the same picture a second time later. Client indicated that both incidents occurred at “The table”. Client stated that staff [REDACTED] showed her a picture of a vagina on her cellphone. Client stated that she believed staff was trying to show her a picture of a “Prom dress” but accidently showed her a picture of a vagina first, adding that she remembered that staff indicated she did not mean to show her the nude picture. Regulations out of compliance: 110.9 – client notified little creek staff of incident on 5/4/23. Little creek staff called the child abuse hotline on 5/8/23. 109.1.G – little creek staff showed and/Or allowed pornographic picture(S) to be viewed by clients on their (Staff’s) cellphone. Licensing Specialists: Clayton DeBoer and Chelsea Vardell.

Police Report

Welfare Check

Caller hasn’t heard from her daughter in over a week and isn’t able to get anyone at the facility to answer her calls. Dispatcher called Little Creek and was given several different reasons why they could not contact her. Caller requested an officer respond to facility for welfare check; Contact was made with nurse at facility who will reach out to caller.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Buildings & Grounds conducted from 10:30am – 12:30pm. Census: 60. Classrooms (4), gym, Angelfish, Starfish, Minnows, and Guppies areas observed. MARs checked for 5 residents.
  • Regs out of compliance –
    • 911.15.f – Drawstrings found in clients clothing in 3 rooms. Drawstrings were immediately removed, and staff were advised to conduct inventory on client clothing.

Police Report

Elopement, Missing Juvenile

Officers responded to facility for a suspicious person inside a vehicle on the property. Upon arrival, the individual stated she was a night shift supervisor and that 2 juveniles ran away and they were trying to locate them. The juveniles had been missing for approx 30 minutes. They were in the gym area and found an open gate in the yard to leave the facility. On 04/04/23, the juveniles returned to the facility with a purse they took from somewhere.

PRLU or OLTC

Elopement, Notice of Incident, Visit Compliance Report

On 04.03.23, client eloped from the facility at 2030. The residents were leaving free time at the gym, and and a peer struck out, running behind the gym and running through the gate. Faulkner County Sheriff’s Department was called, and there was a BOLO placed on the resident and the peer. The residents were returned to the facility by the staff on 04.04.23 at 09:43 am. Email received 4/5/23 that camera system tower was struck by lightning and that facility has no access to camera footage until it is repaired. 4/5/2023- Program Coordinator requested the police report and 911 call from the Conway police report and received them on 4/6/2023 for review with the specialist. Facility visited 4/10/23. Area observed where clients eloped from. The fence is currently down due to construction. There was no fence erect at the time of the elopement. Clients did not elope through a gate, but through an open area directly outside of the gym door. [REDACTED] and [REDACTED] explained that while construction is underway in this area, the fence will be down. There has since been a wooden barrier built in the area with no fence. Clients and have been placed on elopement precautions. Licensing Specialist: Clayton DeBoer.

PRLU or OLTC

Technical Assistance, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Review of the agency’s current mandated reporter policy determined it does not comply with A.C.A. 12-18-402 nor the Minimum Licensing Standards. Please ensure facility policy is updated to reflect the need of all staff to report directly to the child abuse hotline without delay. The updated policy shall be submitted to the Licensing Unit by 04/14/23 and all applicable staff shall be retrained on the updated policy within 2 weeks of enactment of the policy.
  • TA –
    • 110.9 – Any owner/operator, employee, foster parent, or volunteer in a child welfare agency shall immediately notify the Child Abuse Hotline if he or she has reasonable cause to suspect that a child has been subjected to child maltreatment, died as a result of child maltreatment or if they observe a child being subjected to conditions or circumstances that would reasonably result in child maltreatment.
    • 102.3.h -Child Maltreatment/Mandated Reporter policy; according to Arkansas law, including, procedures to ensure that alleged, suspected, or witnessed incidents of maltreatment are reported to the Child Maltreatment Hotline, and documented as required by these or other applicable rule or laws.

PRLU or OLTC

Medical, Notice of Incident

At 1330, client tested positive for oxygen level at 92%. The resident was sent out to the ER for further evaluation due to her asthma and history of covid pneumonia. Pt returned to Little Creek at 1845. Pt sent to Baptist Health Hospital of Conway. Client was returned to Little Creek the same day she was sent to the hospital. continues to be monitored by nursing and is reportedly doing well. Per email from Little Creek 3/17/23, is now 4 clients/1 staff. Facility is on quarantine until Wednesday, 3/22/23. Phone call made to Jlynn Perkins 3/21/23 for an update. No answer. Continue to monitor. Received phone call from [REDACTED] 3/22/23 at 6:30PM that Little Creek is no longer under quarantine.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • Client became upset and punched the molding on the corner of the wall. After assessment, and x-ray was ordered and ice was applied to the injured area. X-ray results: Fracture of the fifth metacarpal.
    • Licensing follow-up: Client remains at facility. Will continue to monitor.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Buildings & Grounds conducted from 5:30pm – 6:30pm. Census: 60. Cafeteria, Starfish, and Angelfish areas observed. MARs checked for 5 residents. No licensing concerns noted.

PRLU or OLTC

Children's Records Review, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Children’s record review completed for 10 residents. No licensing concerns noted.