Caller who brought juvenile to facility stated juvenile was refusing to get out of the vehicle. Juvenile threatened to kill siblings with a knife earlier in the day in Fort Smith. Juvenile was detained and transported to children’s hospital via CEMS.
Caller (resident at apartment complex nearby) stated loud music was coming from facility area and was playing “all day yesterday and started up again at noon”. Officers responded, and no excessive noise heard in area. Officer advised caller to call back if noise continues.
- Complaint #AR00028818 was substantiated, all or in part, with deficiencies cited.
- Regs out of compliance –
- N 128 – Failed to ensure a physical restraint did not result in injury for 1 client who received a head injury during a physical restraint.
- N 142 – Failed to ensure an order for a physical and chemical restraint was not received at the same time and failed to ensure a physical restraint was utilized long enough to determine its effectiveness before the administration of a chemical restraint for 1 client.
- N 147 – Failed to ensure the documented times on the Physician’s Order and the time on the ESI Report were the same for 1 client who was placed in a physical restraint.
- N 188 – Failed to ensure all staff involved in an ESI were present at the client debriefing for 1 client.
- N 189 – Failed to ensure all staff involved in an ESI were present at the staff debriefing for 1 client.
- N 207 – Failed to report a serious occurrence to the appropriate agencies for 1 client who received a head injury during a physical restraint.
Officers responded for a missing person complaint at approx 2:30pm. Upon arrival, staff stated juvenile jumped over the fence in the playground area and ran down the fence line towards the wooded area. Juvenile was recovered by Johnson PD at approx 7pm, and was taken back to the facility. Fayetteville PD confirmed the juvenile was back at facility.
Dispatch received 911 hang up. Upon call back, caller stated they were attempting to contact CEMS. No emergency at this time.
- Client refused to go back inside after the unit was outside and climbed onto an awning on the sidewalk between buildings. Client then jumped on the other side of the fence and off the property. Staff followed client and the police were called. Client was returned to the facility and evaluated; No injuries reported. Client was placed on restriction and re-evaluated in hours, placed on elopement precaution, and followed up with primary therapist. No follow-up details.
Juvenile left facility with staff following. Juvenile does have wounds on arm from self-harm. An hour later, caller advised juvenile was walked back to facility by staff and had scrapes but was fine and currently talking with the therapist.
- X-ray (Hand Pain)
- Client was evaluated by the APRN after complaining of right-hand pain. X-ray ordered: No fracture or foreign body noted. No follow-up details.
- X-ray (Peer Altercation)
- Client was hit in the face by a peer; Client’s nose was swollen and bruised upon assessment. APRN was notified and an x-ray was ordered. Diagnosis: Displaced fracture of nasal bone. Client will follow-up with APRN on 8/8/22 for the next step of treatment. Peer was placed on precautions. No follow-up details.
- Licensing Specialist: Kendra Rice.
- Licensing reviewed resident’s chart and nursing notes. Licensing is not prepared to leave a finding at this time.
- While outside processing with their therapist, client ran and jumped over the fence. Staff followed client, and client returned by jumping back over the fence. Client was assessed by nursing staff, and minor scrapes to legs were cleaned. Client was placed on RTU and seen by their therapist.
- Licensing follow-up on 8/1/22: RTU – Restricted on the Unit.
Juvenile left facility and said they were going home (Colorado). Juvenile was located on road by facility and was walked back by staff. Juvenile does self-harm and did cut their arm today.
- Client made a claim that staff cut client’s wrist and was on precautions. DON assessed client and checked client’s skin, noting a scratch on upper arm.
- Child Abuse Hotline was called and accepted. Licensing follow-up on 8/1/22: Informed by RA that information would be provided on 8/2/22.
Staff advised front door was found shattered; It’s unknown if someone tried to break in or not. A rock was found in a lobby chair, no staff reported anything overnight. There is possible security footage.
- Licensing Specialist: Kendra Rice.
- Visit conducted from 14:15 – 15:40 with Program Coordinator Chelsea Vardell. Census: 92. Partial walkthrough was conducted due to an increase in Covid-19 cases. Construction on the Annex building is still underway and expected to be completed in mid-August. No licensing concerns noted.
- X-ray (Peer Altercation)
- Client was hit in the face with a closed fist and kicked in the nose by a peer. Client complained of nose pain; X-ray was ordered. No fractures were seen.
- Licensing follow-up on 7/22/22: Incident report received. Staff did attempt to intervene.
- X-ray (Peer Altercation, Self-inflicted Injury)
- Client had an altercation with a peer on 6/20/22 where client punched a wall and did not report pain until 7/18/22. X-ray was completed on 7/19/22: Fracture to right 5th finger. A cast was applied on 7/19/22, and follow-up appointment scheduled on 8/1/22. Client placed on no sports.
- Licensing follow-up on 7/22/22: Inquired about nurse’s note from 6/20/22 and incident report. Copy of incident report and nurse’s note received.
Silent open line; On call back, line was picked up and immediately disconnected. Officer made contact with staff, and it was determined a student was messing with the phone.
- Licensing Specialist: Not listed.
- No site visit conducted. Licensing received notification that client and 3 other peers were taken to the nurse’s station by staff to separate them from a disturbance on the East Unit. The client refused to leave the station and was left unattended by staff for “approximately one minute”. The client was able to obtain Benadryl that was left on a cabinet and took an unknown amount (peer reported this to staff). The nurse assessed the client and called poison control. Client was then taken to the ER and administered activated charcoal, clonidine, and IV fluids for dehydration. The facility reports they have changed the locks on the nurse’s doors to ensure that only nurses can access the stations. The staff will not be able to enter a nurse’s station without a nurse present.
- ER Visit (Peer Altercation)
- Residents were playing basketball when client stole the ball from a peer. Peer hit client quickly one time in the face. Client fell to the ground and would not respond to staff for a few minutes. The client was taken to the ER.
- Licensing follow-up: Facility reports that the peer was moved to another unit and placed on assault precautions.
Staff at Vantage Point advised officers that a juvenile from Piney Ridge was on the roof. Officers made contact with Piney Ridge staff, who stated the juvenile was back in the building.
- Multiple residents were taken into the nurse’s station by staff to separate them from a conflict on the east unit. Client refused to leave the station, so staff left the client unattended for approx. 1 minute. During that time, the client’s peer reported they saw client grab Benadryl and take an unknown amount. The nurse assessed the client and contacted poison control.
- Licensing follow-up on 7/11/22: The facility reports they have changed the locks on all nurse station doors so that only nurses can have access to the stations. This was done to prevent any future occurrences of staff using the nurses station as a place to separate residents.
- X-ray (Accidental Injury)
- Client was outside playing on a water slide when the client slid shoulder first into a padded pool. Client complained of shoulder and rib pain. The physician ordered an x-ray to be completed. No follow-up details.
- Acute Care
- Client attempted to tie a pillowcase around their neck and refused to give it to the nurse. The pillowcase was removed, and staff were able to maintain the client’s airway the entire time. No follow-up details.
- ER Visit (Abscess & Fever)
- Client was on antibiotics for a possible abscess and fever of 102.7. The mass began to swell slightly larger, and client complained of increased pain. Client taken to the ER.
- Licensing follow-up: Resident will be discharging so all follow up will be communicated to client’s guardian.