Disability Rights Arkansas

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

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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

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.

Police Report

Battery Third Degree

Officer responded to facility for an assault on an employee. Upon arrival, officer noted employee had a busted lip and stated he was punched 2 times in the head by juvenile. Juvenile involved stated they [staff] were trying to give him a shot in his bottom; Juvenile was not showing signs of aggression to officer and did not admit to anything. Staff stated juvenile hit a peer earlier and destroyed property. Juvenile was transported to JDC.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

  • Maltreatment
    • Client tried to kick the door that a staff member was in front of, and the staff member pushed the client away from the door and moved his leg to block the client from kicking the door. The client then punched the staff member in the stomach, and staff then shoved the client back and into the cafeteria. Staff told the client “please come at me”, and client tried to hit staff several times, and staff then kicked the client in the legs. The staff member was told to leave the room, and client stated “you picked the wrong kid to fuck with” to which staff responded “I will stab you” while he was walking out. The staff member was removed from the facility and suspended until further notice.
    • Licensing follow-up: On 12/05/22, Licensing contacted the investigator and reviewed video footage. The video footage showed the staff member shoving the client and arguing with the client as 2 other staff stood by watching. After the staff member kicked the client, the staff member was asked to leave by the other staff. The facility reported that the staff members that stood by will be retrained on how to interact with residents and appropriate de-escalation techniques by 12/09/22 and will not work with residents until retrained. Licensing Complaint founded; The facility will be cited for 109.1.g and 905.4.g. On 01/27/23, Licensing was informed by the CACD investigator that the case was found unsubstantiated.

PRLU or OLTC

Licensing Follow Up, Notice of Incident, Peer Altercation

Licensing (Peer Altercation)

  • Client was punched in the face with a closed fist by his peer. The client then proceeded to return the punches, and they fell to the ground fighting. Staff separated the residents, and client was taken to the hospital due to laceration on his lip. Client’s laceration was closed with absorbable sutures at the hospital. Residents were placed on a 10-foot peer restriction and will be supervised by staff at all times.

  • Licensing follow-up: Specialist was informed of safety precautions. No licensing concerns noted.

Medicaid Inspection of Care

Inspection of Care Report

  • Included: IOC, CAP
  • Multiple deficiencies noted. CAP must be completed within 30 calendar days (CAP submitted and approved).

PRLU or OLTC

Buildings and Grounds, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Buildings & Grounds conducted from 10:30am – 11:25am. Census: 15. The dayroom, dining room, transitional hallway, upstairs hallway, and classrooms were observed. MARs checked for 5 residents. No licensing concerns noted.

PRLU or OLTC

Self Report Visit, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Facility visited from 10:30am – 1:30pm in response to a complaint that a resident had taken medication not prescribed to him. Licensing reviewed camera footage and observed residents pushing staff from the entrance of the BI office, and once they gained entrance began searching the office. A resident was observed swallowing a substance. The resident reported to Licensing that he swallowed both pills and coffee condiments. Licensing was informed the staff member was retrained on monitoring/supervision and an email was sent to all staff stating no residents are allowed in the BI office for any reason. Locks have been purchased for all lockers in the BI office as a safety precaution.
  • Regs out of compliance –
    • 9.907.2 – Staff member failed to provide level of supervision to ensure the safety and well-being of the residents at the facility.

PRLU or OLTC

Complaint, Licensing Follow Up, Notice of Incident

  • Dual (Complaint)
    • Client stated that an unknown staff member got in his face, stuck her fist in his face, and told him that if he didn’t listen to her, she would hit him. Client reported the staff member bent his fingers back, causing pain, put him in a dark room, and closed the door as a form of punishment. It was reported that client obtained 10 Tylenol pills and had to be taken to the ER. Caller stated that some other residents broke into the medicine box. Caller also reported an infestation of roaches and mice at the facility. Client stated he was told that if he reported anything, he would be in trouble when he returned to the facility.
    • Licensing follow-up: The timeframe of the incidents is unknown to Licensing. Camera footage was not reviewed. Specialist spoke with the resident on 9/19/22 and completed a walkthrough of the big boy’s hall, dayroom, dining room, and the focus room. No evidence of bug infestation was noted. Specialist was informed that the exterminator was at the facility on 9/19/22 and comes out monthly. CACD investigation was unsubstantiated.

PRLU or OLTC

Licensing Follow Up, Notice of Incident, Overdose

  • Licensing (Overdose)
    • Client and peers pushed their way into staff’s office. A peer took medicine (acetaminophen) out of locker while client distracted staff by stealing coffee condiments. Peer hid pill bottle under desk, and while staff was distracted with another client, peer poured pills in client’s hand and client swallowed them. Client was taken to the ER, and after acetaminophen levels were decreased, client was discharged with recommendations to follow up with PCP.
    • Licensing follow-up: Specialist viewed camera footage of incident and observed residents and staff in classroom (ratio 3:1). Residents pushed past staff into the BI office and began going through things. Staff attempted to get residents out of the office with many distractions. Specialist observed client opening something and swallowing but was unable to identify if they were pills or coffee condiments. Outcome: Founded.

PRLU or OLTC

Licensing Follow Up, Maltreatment, Notice of Incident

Dual (Maltreatment)

  • Client told therapist that on 08/26/22, he was making noise and a staff member was being rude with him. Client threw socks at the staff member, who then ran into the client’s room and kicked client in the back and started hitting him. Client stated the staff member put client in a hold, grabbing him by the neck and leaving scratches. The staff member involved has been placed on suspension during the investigation.
  • Licensing follow-up: Specialist viewed camera footage and observed staff member kick her leg towards a resident at 7:26pm. At 8:14pm, client threw socks and other items at staff, and staff threw socks back in their room. At 8:15pm, client threw shoes at staff, who then threw the shoes down the hallway. At 8:17pm, staff was observed entering client’s bedroom. It was reported that client previously threatened to get staff fired. Specialist observed another staff intervening as confrontation went back and forth. Staff was observed going in and out of client’s room. Other residents were observed watching and/or instigating the situation. Specialist was unable to observe what took place in the bedroom, however observed tension between staff and client. Outcome: Unfounded.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Licensing reviewed camera footage from 8/27/22 and observed resident being aggressive, hitting and punching staff, and attempting to get outside of the dayroom. Staff was observed blocking the hits and talking to the resident. Police then entered and after speaking with the resident and staff, the resident was arrested. No licensing concerns noted.

Police Report

Criminal Mischief First Degree

Officer was dispatched for a large fight between staff and clients. Upon arrival, staff advised that 2 juveniles had been destroying property and fighting staff. Juveniles were semi combative upon officers arrival. Juveniles were arrested and transported to JDC.

PRLU or OLTC

Notice of Incident

  • Licensing (JDC) 1
    • Client and peer caused property destruction and threatened staff. Client charged at staff, punching them multiple times in the head and other body sections. While a peer was in a restraint, client grabbed a staff member, causing peer to escape restraint. Due to the escalation of aggression, Bono PD was called to the facility. Officers escorted client and peer from facility. On 8/29/22, client returned from Craighead County JDC.
    • Licensing follow-up: Specialist viewed camera footage of the incident and observed client’s aggressive behavior.

PRLU or OLTC

Notice of Incident

  • Licensing (JDC) 2
    • Client and peer caused property destruction and threatened staff. While client was in a restraint, peer grabbed a staff member, causing client to escape restraint. Due to the escalation of aggression, Bono PD was called to the facility. Officers escorted client and peer from facility. On 8/29/22, client returned from Craighead County JDC.
    • Licensing follow-up: Specialist viewed camera footage of the incident and observed client’s aggressive behavior.

Police Report

Disorderly Conduct

Officer was dispatched for a juvenile trying to fight employees. Upon arrival, staff stated her boss advised her not to call the police, but she had already done so. Staff stated the juvenile did not hit or strike anyone, he was just running up and down the hall.

Police Report

Runaway Juvenile

Officer was dispatched for 2 runaway juveniles at approx. 11:24pm. Staff stated the juveniles had gotten the keys from another worker and left the facility. On 8/27 at approx. 6:15pm, both juveniles had been located and were being taken back to the facility.

PRLU or OLTC

Elopement, Licensing Follow Up, Notice of Incident

  • Licensing (Elopement) 1
    • Client and peer eloped from the facility after peer picked up keys that fell out of a staff member’s jacket. Police were called. Both clients were brought back to the facility on 8/27/22 by Baxter County Police. Client placed on elopement precautions.
    • Licensing follow-up: Specialist viewed camera footage of the incident and observed residents running through the front door with a key fob. It is unknown what staff member the key fob came from due to the dishonesty of the residents.

PRLU or OLTC

Elopement, Licensing Follow Up, Notice of Incident

  • Licensing (Elopement) 2
    • Client and peer eloped from the facility after peer picked up keys that fell out of a staff member’s jacket. Police were called. Both clients were brought back to the facility on 8/27/22 by Baxter County Police. Client placed on elopement precautions.
    • Licensing follow-up: Specialist viewed camera footage of the incident and observed residents running through the front door with a key fob. It is unknown what staff member the key fob came from due to the dishonesty of the residents.

Police Report

Disorderly Conduct

Officer was dispatched for an assault; Upon arrival, staff stated juvenile was pushing him around trying to get his keys and radio, and juvenile did not actually assault him. Officer spoke with juvenile, who stated he didn’t care and the officer could take him to juvenile detention because his friends are there. No further action taken.

PRLU or OLTC

Licensing Follow Up, Maltreatment, Notice of Incident

  • Licensing (Maltreatment)
    • During routine camera review, the facility discovered a staff member did not execute a proper CPI technique as trained. Client was attempting to get staff keys and kick windows, and staff member grabbed client by the leg causing client to fall. The staff member was terminated.
    • Child Abuse Hotline was called, not accepted. Licensing follow-up: Specialist viewed camera footage of incident, and observed staff grab client’s leg with client hitting the floor. The other staff member present appeared to try and assist client from falling but was unsuccessful. Facility cited (R109.1.g: Staff observed causing physical harm to resident).