- Injury (Accidental)
- Resident complained of pain to right ankle on 12/3/21 and reported he twisted it while playing outside on 12/2/21. Resident’s ankle was x-rayed. No follow-up details.
PRLU or OLTC
Notice of Incident
PRLU or OLTC
Notice of Incident
- Elopement
- Resident eloped from the facility by scaling a fence at the property. Police department was called.
PRLU or OLTC
Notice of Incident
- Elopement
- Resident scaled the fence while outside playing, then scaled a second fence by the apartment complex nearby and left facility grounds. The police department was called, and staff attempted to follow the resident on foot, but lost sight of the resident. No follow-up details.
Police Report
Missing Person
Caller reported Juvenile jumped the fence. Juvenile was located and returned to the facility without incident. Initial head count had 2 more missing kids; Head nurse did her own role call and there were no more missing.
PRLU or OLTC
Notice of Incident
- Injury (Unknown)
- Resident complained of right wrist pain with no known cause. X-ray was ordered for resident. No follow-up details.
PRLU or OLTC
Notice of Incident
- ER Visit (Accidental Injury)
- Resident was taken for x-ray after reporting pain in her ankle from another resident stepping on it.
- Specialist emailed a 521 to the agency due to the late reporting on this incident (reported 11/23/21).
PRLU or OLTC
Notice of Incident
- Accidental Injury
- Resident injured his ankle while playing basketball. Physician ordered x-ray.
- Specialist emailed a 521 to the agency due to the late reporting on this incident (reported 11/23/21).
PRLU or OLTC
Notice of Incident
- ER Visit (Self-Harm)
- Resident was transported to ER after complaining of pain in her arm. The resident stated she put pieces of her comb into an open wound on her arm and they became stuck. No follow-up details.
PRLU or OLTC
Notice of Incident
- Elopement
- Two residents eloped from the facility after forcing their way through the cafeteria door and then through a gate that went outside the facility. The police department was notified.
- Specialist followed up with facility via email to request further info; Staff reported the residents bent a handle and forced their way through the cafeteria door. Facility reported they have cut off the handle now and they reinforced the fence that the residents eloped through.
Police Report
Missing Person
Caller reported 2 runaway juveniles at 1830 hours. Upon police arrival, Juvenile 1 was recovered. After conducting search, police were informed Juvenile 2 was returned to facility at 2114 hours.
PRLU or OLTC
Notice of Incident
- Injury (Peer Altercation 1)
- Resident was taken for x-ray on 11/12/21 after complaining of pain in his face from an altercation that took place on 11/11/21. No follow-up details.
PRLU or OLTC
Notice of Incident
- Injury (Peer Altercation 3)
- Resident was hit in the face by a peer on 11/11/21. Resident taken for x-ray of his nose. No follow-up details.
PRLU or OLTC
Notice of Incident
- Injury (Peer Altercation 2)
- Resident was taken for an x-ray on 11/12/21 after complaining of shoulder pain from an altercation that took place on 11/11/21. No follow-up details.
PRLU or OLTC
Notice of Incident
- Elopement
- Resident became upset while outside, climbed a fence, and eloped from facility grounds. Staff followed resident to maintain visual and police department was called. No follow-up details.
Police Report
Missing Person
Caller reported one of the kids got over the fence. Caller stated juvenile often climbs on their awning but today made it over the fence. Caller advised staff located Juvenile and are on their way back to facility.
PRLU or OLTC
Notice of Incident
- ER Visit (Self-Harm)
- Resident became upset with peer and punched a wall. Resident was taken to ER on 11/7/21 for further evaluation. No follow-up details.
PRLU or OLTC
Notice of Incident
- Elopement
- Two residents eloped from the facility after running from staff and climbing a facility fence. Police Department was notified. No follow-up details.
PRLU or OLTC
Notice of Incident
- ER Visit (Peer Altercation)
- Resident was in altercation with peer when he was hit in the head/ear. Resident was taken to ER. No follow-up details.
PRLU or OLTC
Notice of Incident
- ER Visit (Self-Harm)
- Resident was taken to ER after he stated he had placed teeth from his comb into an open wound on his forearm. No follow-up details.
PRLU or OLTC
Visit Compliance Report
- Completed walkthrough and reviewed 4 MARs.
- Specialist discussed complaint alleging staff were not in ratio on 10/16/21. Staff provided a list of staff who worked that night. A staff member was late to work causing the ratio to be 31/3 for approximately 30 minutes. The CEO stated they had 2 extra direct care staff in the building, but that they would make sure extra staff are always assigned to prevent shortages.
- Regs not correctable –
- R1007.4 – Licensing determined complaint to be founded; The North Unit was out of ratio with the residents 31/3 for approximately 30 minutes.
- R1008.4.d – Medications were not documented as given to 3 residents.
- Regs out of compliance –
- R1013.8 – Several bedsheets had stains or debris on them (The CEO stated bedsheets are changed weekly and residents can change their sheets as needed. A training will be conducted to ensure everyone is aware they can have clean linens as needed).
PRLU or OLTC
Notice of Incident
- ER Visit (Overdose)
- Peers reported to staff that resident had taken an unknown amount or type of medications that she had been “cheeking” during medication administration by staff. Resident taken to ER; No follow-up details.
PRLU or OLTC
Notice of Incident
- ER Visit (Self-Harm)
- Resident was self-harming by biting the inside of her lip so she could “see the blood”. The biting left several deep cuts to the interior portion of her bottom lip that continued to bleed. Resident was taken to ER. No follow-up details.
PRLU or OLTC
Notice of Incident
- ER Visit (Foot Pain)
- Resident reported pain/swelling to his right foot. Resident was sent for X-ray at ER. No follow-up details.
PRLU or OLTC
Notice of Incident
- Complaint
- Complaint received that staff were out of ratio with the residents on the North unit this past Saturday (10/16/21).
- Specialist visited the facility and staff provided a print out of staff who were working on 10/16/21. The report shows there were 4 staff with 31 residents, and then 1 staff clocked out at 22:00 leaving 3 staff to 31 residents. The relief worker was late to work and did not clock in until 22:30 which brought the ratio back up to 31 residents to 4 staff.
PRLU or OLTC
Notice of Incident
- Sexual Abuse
- A former resident reported sexual abuse by an unknown peer between 2018 and 2019 while at the facility. No further information can be provided.
- Child Abuse Hotline was called and accepted, unsubstantiated. The resident is no longer in the care of the facility so the Specialist cannot interview him. The A/O is an unknown peer and the time frame of the alleged abuse is sometime in 2018 or 2019 making video review impossible.