Disability Rights Arkansas

United Methodist Children's Home Dacus / United Methodist Children's Home (Bono)

Location: Bono, Arkansas

Population Served: Children and adolescents in need of out of home psychiatric care in a residential setting

# of residents per unit: 25 Residents per room: 3-4 Capacity: 25

Contact with family (Calls and visit schedule): Clients have regularly scheduled phone call opportunities. The number of actual calls depends on the clients wish to utilize these opportunities. In person visitation (assuming no quarantine precautions) is available every weekend and can be scheduled at other times as needed by the family or guardian.

Restraint utilized? Yes Chemical Restraint utilized? Yes Seclusion utilized? Yes

Treatment Components:

Clinical Director - In process of hiring.

Therapists: 2 full-time therapists (1 LCSW, 1 LPC)

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

# of individual therapy sessions/week: Minimum 1 per week scheduled. May vary upon the treatment plan of the client.

# of group therapy sessions led by a licensed mental health professional/week: minimum of 1 with 2 preferred.

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Police Report

Battery, Battery Third Degree

Officer was informed that a juvenile hit a staff member in the face with a closed fist, and had done the same thing the day before to another staff member. Officer spoke with juvenile who stated he was angry and didn’t want to be there. Officer contacted juvenile probation, who instructed officers to let him stay at facility.

PRLU or OLTC

Notice of Incident, Self-Injury, Suicide Attempt, Visit Compliance Report

Client threw items at the tv, peers, and staff. Client broke the remote and a chair. Client attacked staff by punching staff with closed fist. Client was placed in a TCP from 6:14pm-6:15pm. Client continued to throw items at staff. Staff observed client through the window of the door for safety measures. Client took a hoodie and wrapped it around his neck. Client picked up a piece of broken plastic and scratched himself with it on his arm. Client had redden marks on anterior of neck and superficial scratches on right forearm. No active bleeding. Client denied pain. Client was placed on assault precautions, suicide precautions and 60k focus. The broken piece of plastic came from the remote when the resident broke the remote.

5/26/23- Licensing reviewed camera footage of the incident. Licensing Specialist: Chelsea Vardell.

PRLU or OLTC

Buildings and Grounds, Visit Compliance Report

Licensing Specialist completed building and grounds. Program Director escorted Licensing Specialist around the grounds of the facility. Licensing Specialist met two maintenance workers by the maintaince shed. The facility’s grounds were clean with no debris. Licensing Specialist observed basketballs around the fence in basketball court area. Licensing Specialist observed the dayroom where a family session was taking place. Ration 1:3, including the resident and his parents. The dining room area was clean.

Licensing Specialist observed the staff members’ lounge, combination locks are still being utilized for staff to lock up their belongings. Licenising Specialist observed the classrooms. Big Boys Classroom – ration 3:6. Two staff members and a teacher were observed. The residents were sitting at their desks facing the front of the class. Little Boys Classroom – ration 2:5. One teacher and on staff member were observed. Both classroom were neat and organized.

Licensing Specialist observed the emergency escape plan on different walls throught the facility. Fire extinguishers were observed in red metal cases. Licensing Specialist observed water fountains in the facility for residents to have drinking water.

PRLU or OLTC

Notice of Incident, Suicide Attempt

Client placed his hands around his neck and tried to choke himself. Client was placed on Suicide Precautions (SP) as well as Line of Sight (LOS) to be directly supervised by staff at all times. 2:5 at the time of the incident. 4/4/2023, Licensing Specialist received and reviewed documentation of order and nursing note. No licensing concerns noted.

Licensing Specialist informed that incident took place in the resident’s bedroom and bedroom hallway. There is no camera footage showing where resident placed his hands around his neck due to incident taking place inside of his bedroom.

PRLU or OLTC

Children's Records Review, Personnel Record Review, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Facility visited from 1pm – 2:30pm. Census: 13. Licensing reviewed 3 personnel files and 3 resident files. Citation was initially issued for R902.13 due to resident not having a copy of social security card; This was revised after staff provided documentation where resident’s social security card was requested by the caseworker.

PRLU or OLTC

Accidental Injury, Notice of Incident, Visit Compliance Report

Client was transitioning to the gym. Client did not use stair protocol and ran down the stairs. Client fell down the last three steps and landed on the right side of his face, causing [REDACTED]. Client was taken to the NEA Baptist ER. Client had [REDACTED]. The skin was glued. The x-ray revealed no fractures, no air-fluid levels, and the paranasal was clear. Client was prescribed for pain as needed. Client was reminded of the importance of following stair protocol and the dangers of not following stair protocol upon return to the facility. Licensing Specialist observed residents and staff members going down the stairs, ration 2:7. Staff members were positioned at the top and bottom of the stairs. Licensing Specialist observed the resident leaning on the rail on the wall leading down the stairs. Resident was observed sliding down the rail of the stairs and what appeared to have jumped on a stair.

Licensing Specialist: Kendra Rice.

PRLU or OLTC

Notice of Incident, Visit Compliance Report

  • Suicide Attempt
    • After making threats to self-harm, client grabbed a cord from the power box to the chair lift and wrapped it around his neck. The cord was quickly removed by staff and no injuries were noted. Client was placed on suicide precautions and line of sight.
    • Licensing follow-up: Staff reported that client was being transported from the classroom to downstairs when the incident occurred. Licensing reviewed camera footage on 03/09/23. Staff reported that maintenance had bolted down the cord the day of the incident. No licensing concerns were noted.

PRLU or OLTC

Notice of Incident, Peer Altercation, Suicide Attempt

  • Peer Altercation, Suicide Attempt
    • While standing in the cafeteria line, a peer pushed and hit client with a closed fist. Client then punched peer with a closed hand several times until they were separated. After being redirected to the transitional hallway, client took off his shirt and wrapped it around his neck in an attempt to choke himself. Staff removed the shirt and no injuries were noted. Client was placed on suicide and assault precautions.
    • Licensing follow-up: Peer was placed on assault precautions as well. No licensing concerns noted.

PRLU or OLTC

Notice of Incident, Peer Altercation, Suicide Attempt

  • Licensing Specialist: Kendra Rice.
  • Facility visited from 11:15am – 12:15pm. Census: 13. Walkthrough conducted of the following areas: activity room, dining room, nurse station, big boy hall, little boy hall, library, seclusion room, staff breakroom, and classrooms. MARs reviewed for 5 residents. Licensing and staff discussed the repairs and replacement of the fence leading to and around the gym.

Police Report

Battery Third Degree

Officer interviewed staff member in reference to an incident that occurred. The staff member gave a statement, stating that he was only trying to gain control of the child and take away items that could be used to harm himself or others. On 3/8/23, Officer watched video of the incident and did not witness any criminal behavior on the part of the staff member.

Police Report

Runaway

Caller reported she had picked up her grandson today, and when she pulled into the parking lot, the juvenile took off walking and she lost sight of him. The juvenile was located by Jonesboro PD the same day and transported back to the facility.

Police Report

Battery Third Degree

Staff advised officer that a juvenile had punched her in the eye the day prior. Officer advised staff of the affidavit process.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

  • Maltreatment
    • After client took staff member’s walkie and would not give it back, staff member performed an improper restraint on client to retrieve the walkie. Shortly after, a peer gave client a piece of sharp plastic, and the staff member placed client in another improper restraint to retrieve the plastic. Client received a minor injury to his finger that required a bandage. The staff member was asked to leave the facility after camera review. Child Abuse Hotline was called. 
    • Licensing follow-up: Licensing was informed the hotline call was not accepted; After reviewing video, licensing made another hotline call that was accepted. Licensing spoke with staff who faxed in the report, and informed staff that more details needed to be provided. Staff stated that she had been informed by the CEO to keep things simple. Licensing requested nursing notes, ESI policy, and witness statements.
    • Facility cited for 109.1.g and 905.4.g (staff member engaged in behavior that could be viewed as physically harmful to the resident, staff displayed disciplinary action that could cause physical injury or threat of bodily harm to resident).
    • CACD case was unsubstantiated. Complaint was founded by Licensing.

PRLU or OLTC

Elopement, Notice of Incident

  • Elopement
    • Client broke through the gym door, then climbed over the fence with a peer and eloped from the property. Police were notified at 2:15 pm. Both residents were brought back to the facility by police at 9:30 pm. No injuries were sustained, and both were placed on elopement precautions.
    • Licensing follow-up: Licensing was informed there was no property damage.

Police Report

Runaway Juvenile

Two juveniles ran away from the facility. The facility could not give a direction of travel.

Police Report

Assault Third Degree

Staff advised officer that a juvenile got upset when he was not allowed to make a phone call and became aggressive with staff. Staff stated he attempted to approach the juvenile to cool the situation down, and the juvenile began swinging at him. Staff stated he grabbed the juvenile and took him to the floor, and the juvenile then bit him on the arm. The juvenile stated he bit staff because of the way staff grabbed him and pulled him to the floor.

Police Report

Battery Third Degree

Staff advised officer that juvenile punched him several times in the head as he attempted to keep juvenile from attacking a peer. The facility was advised to contact the juvenile’s caseworker, as the jail was currently full.

PRLU or OLTC

Children's Records Review, Personnel Record Review, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Facility visited from 11am – 2:15pm. Census: 14. Licensing reviewed 5 children’s records and 5 personnel files.
  • Regs out of compliance –
    • R904.1.k – educational reports were not in 4 children’s files.

PRLU or OLTC

Accidental Injury, Elopement, Notice of Incident, Visit Compliance Report

  • Elopements, Accidental Injury
    • Four residents kicked the dayroom door open and eloped from the facility at 2:50 pm. Police were notified. Client 1 was located by police at 3:38pm; He returned with scratches from falling on rocks (no pain noted) and placed on 24/7 supervision. Client 2 returned on his own at 4:24 pm with no injuries noted, placed on 24/7 supervision. Client 3 was located by police at 7:54 pm and returned to his guardian’s care. Client 4 was located by police at 9 pm; He returned to the facility with no injuries noted and placed on 24/7 supervision and assault precautions.
    • Licensing follow-up: Facility visited on 12/27/22 and camera footage reviewed; Staff ratio 2:4, then 1:4. No damage was reported to the door from being kicked open.

Police Report

Missing Person

Staff advised officer that 4 juveniles kicked open a door and left the facility. J3 and J4 later returned to the facility. J2 was located at a family member’s house in Jonesboro (J2 was discharged from facility) at approximately 7:30pm. J1 was found shortly after and returned to the facility.

PRLU or OLTC

Elopement, Notice of Incident, Visit Compliance Report

  • Elopements
    • Three residents cornered and assaulted staff, knocking staff to the ground. The residents took the staff’s keys and eloped from the facility. All 3 residents were located by police and returned to the facility at 12:37 am. While waiting on the nurse to return to conduct a body search, the residents eloped from the facility again at 2:54 am. All 3 residents returned to the facility on their own at 5:08 am. Residents were placed on 24/7 supervision.
    • Licensing follow-up: Facility visited on 12/27/22 and camera footage reviewed. Staff ratio 1:3 during first elopement. No staff mentioned during review of second elopement; Licensing observed residents walking around in the dayroom when they kicked the door open. Staff reported residents were placed on 24/7 supervision, elopement precautions, and assault precautions.

PRLU or OLTC

Notice of Incident, Peer Altercation, Suicide Attempt, Visit Compliance Report

  • Peer Altercation, Suicide Attempt
    • Client was slamming doors, making racial slurs, and attempting to hit staff. After proceeding to his bedroom, a peer ran into client’s room and attacked him, punching client until staff were able to separate them. Client was directed back to his room while staff were trying to calm peer down, and another peer ran into client’s room and began kicking and punching client. Staff separated them and took client to the nurse’s station; Edematous, redness, and slight bruising present to client’s nasal bridge. An x-ray determined no fractures were present.
    • Licensing follow-up: Facility visited on 12/21/22 and camera footage reviewed. No licensing concerns were noted. On 01/11/23, Licensing received additional footage of the incident that was not presented on 12/21/22, in which client was attacked by peers while in the hallway after the first 2 altercations (staff reported she was unaware of the second half of the incident due to it occurring several minutes after the first one and was only provided with the first timeframe). Licensing interviewed staff and residents on 01/12/23; Staff reported the client was pulled out of his bedroom due to self-harm behaviors (client tied sweater around his neck). Licensing discussed with staff how other residents could have been removed off the hallway once the client was placed on the floor. Staff reported they are not allowed to move a resident off the floor when a resident refuses to comply with directions unless the resident is causing harm to self or others.
    • Facility cited on 01/25/23 for 907.2: Childcare staff shall be responsible for providing the level of supervision, care, and treatment necessary to ensure the safety and well-being of each child at the facility (encourage staff to remove other residents from escalated incidents for safety).

Police Report

Assault Second Degree

Officer responded to facility for an assault on 2 employees. Staff reported 3 juveniles had assaulted 2 employees, then took facility keys from one of the staff members and left the facility on foot. The facility informed officer that they could provide a physical description of the juveniles the next day.

PRLU or OLTC

  • Licensing Specialist: Kendra Rice.
  • Buildings & Grounds conducted from 10:45am – 12:30pm. Census: 15. The dining room, classrooms, gym, bathrooms, laundry rooms, big and little boy’s halls were observed. MARs reviewed for 5 residents. No licensing concerns noted.

PRLU or OLTC

Arrest, Notice of Incident, Visit Compliance Report

  • Arrest
    • Client got out of bed and attempted to get in a peer’s room. After staff prevented client from leaving his room, client began throwing and destroying items. Client then threw shoes at staff and attempted to hit staff, and client was placed in a CCP by staff until calm. Once released, client attempted to get to his peers and was placed in a TCP by staff until calm. Once released, client hit staff in the face, resulting in a laceration to staff’s lip. Client was placed in another CCP and escorted to the cafeteria. The police were called, and client was arrested.
    • Licensing follow-up: Licensing visited facility on 12/14/22 to discuss with staff and view camera footage and records. Licensing discussed concerns with staff related to staff not taking residents off the unit during the incident, nursing not staying to observe the restraint or assist, and no other staff being available to respond. Staff received re-training on not entering an escalated resident’s room, the nurse will be re-trained on how to properly respond to a restraint hold, and staff will receive re-education on removing residents out of the area during an ongoing incident. Licensing received training documentation on 02/06/23. Licensing also discussed a note in the police report, stating “the juvenile told me that they was trying to give him a shot in his bottom and was not showing any signs of aggression in my presence”; It was determined no chemical restraint was requested or ordered by the doctor and the resident did not receive a chemical restraint.