Timber Ridge / Neurorestorative Timber Ridge

Client made an allegation against a staff member on 9/6/24 stating that she slapped him. Staffing documentation states that the client slapped staff but that staff continued in the intervention. Another staff was monitoring the intervention in case staff needed to switch out and she stated that she never saw the staff member slap the client. Nursing notes state no injuries were reported. Staff member on administrative leave. A report was made to the AR Child Abuse Hotline and accepted.

Licensing Specialist: Clayton DeBoer

No visit scheduled at this time. Witness statements and nursing notes provided to licensing and reviewed. 9/9/24-Received email from facility as follows: “When [redacted] came to investigate this morning and spoke with the client involved, he (A/V) named [redacted] as the alleged offered who was terminated in August from our facility. We will be calling and updating the [redacted].” 9/28/24-Received completed training sign-in for [redacted].

10/21/24-CACD case unfounded. Licensing issued a “521 Visit Compliance Report” on 10/21/24 stating the following: “This is to document that Case #023791 has been investigated and determined to be unfounded. A/O no longer works at facility.”

Resident was dysregulated and became aggressive toward property and others. The case manager entered the room to help with de-escalation, and the resident reported to the case manager that a staff member pushed him against the wall, put her arm on his neck, and abused him. The staff member was suspended pending the investigation outcome. Staff to client ratio was 5:10.

Licensing Specialist: Clayton DeBoer

The facility was visited by Licensing in response to the complaint. When interviewed, the resident stated that he didn’t remember why he was mad and he didn’t remember what staff did in response. No visual marks or bruising were noted. Nursing note was reviewed and no injury, redness, or bruising was noted there. Witness statements reviewed do not indicate physical abuse or harm. As a precautionary measure, the staff member will be retrained on hands-on and verbal de-escalation.

This complaint has been determined Unfounded by Licensing. Proof of retraining will be immediately provided to Licensing upon completion.

Resident was engaged in a behavioral outburst, during which scratches appeared on his face. Documentation reads that staff were trying to assist him with staying safe and in the midst of it his face was scratched by staff. When he was pulled for therapy he said the staff did it “on purpose”. A report was made to the Child Abuse Hotline and accepted for investigation.

Licensing Specialist: Clayton DeBoer

Program Coordinator inquired about documentation (nursing note, witness statements, and other staff involved). Facility provided documentation. Program Manager requested documentation from facility showing both staff involved in this incident had been trained in de-escalation and restraints. The facility provided CPI training certificates for both staff. The facility stated that the staff did not put the resident in a restraint, but instead used an L2 seated.

Witness Statements from accused staff and witness reviewed. Statements do not indicate that either staff scratched resident during incident. Both witness statements indicate that the resident banged his head against a chair. Resident was interviewed. No observable scratch today. When asked if he could tell what happened when he got his faced scratched he said, “I don’t know”. Resident stated facility staff were nice. When he was given the opportunity again to speak about the incident, he declined. Staff placed on administrative leave pending investigation.

CACD investigation and licensing complaint determined to be unfounded.

As the therapist was processing the journals with the client in session 2/28/24, she came across an entry that stated that staff “let me hit her THC pen and I am high as f, she’s in there laughing her ass off.” The therapist asked the client about this after they read it and the client confirmed that the staff “let me hit her weed pen.” Client stated this happened on 12/14/23 and stated it happened again in January 2024 but did not have a specific date. The client also reported that this staff bought her a nicotine vape, but that she does not have the vape anymore. The staff did complete room sweeps on 2/27/24 to ensure there was no nicotine in the room and nothing was found. To ensure safety of this client, she was placed on safety and intensive supervision. Staff has been suspended and we called this into the child maltreatment hotline.

Licensing Specialist: Clayton DeBoer.

Staff informed Licensing Specialist that the hotline call was not accepted for investigation, and that staff will be terminated subsequent current suspension. Facility visited 2/29/24. Journal entry reviewed. It is the opinion of facility and licensing that this incident did occur.

• Facility cited 109.1.g: Staff gave 17 y/o client vape pen access which may have contained marijuana and/or nicotine.

This complaint has been founded by Licensing.

Client was sent for an x-ray today due to reported thumb pain. X-ray showed irregularity with possibility of small avulsion fracture. On 11/24/23, client began attacking staff by punching and hitting them. Staff used their body as a barrier and blocked to maintain safety. When trying to intervene and help client calm, he lost his balance and caught himself with his hand on the ground and continued to attempt to attack staff. Staff worked with him to try to calm, but he continued to be aggressive towards staff and then was placed in an NCI approved therapeutic hold to maintain safety of himself and others. Client was assessed by nursing and was treated and monitored accordingly. On 11/27/23, nursing assessed and informed the medical director of symptoms, and the medical director ordered the x-ray. Client accused staff of bending his thumb during the incident and this was called into the Child Abuse Hotline on 11/25/23 (not accepted, documented only). There is no camera footage of this incident.

Licensing Specialist: Clayton DeBoer

Licensing reviewed nursing notes and 6 witness statements. No documentation reviewed mention staff bending client’s thumb or indicate any inappropriate hold. Client was interviewed, who stated that staff member “bent my thumb and finger back on purpose”. When asked how he knew staff did this on purpose, client stated “because I punched her in the face”. Client indicated that this happened during the hold on the ground with staff . Staff Tylyn was interviewed who was involved in the ground supine hold and stated they did not observe the accused staff who had ahold of the other arm. Staff Anna interviewed and stated she was present for the entirety of the ground supine hold. Staff Anna stated that she observed staff holding client ‘s wrist during hold, and at no time did she witness staff grab or grab near client’s hand. Staff Anna stated that after the incident, she was present for and aided in deescalating when client disclosed that staff bent his thumb. Staff Anna stated that she did not report this to the hotline because she did not have reasonable cause to suspect that maltreatment occurred. Upon receiving this report the next morning, Timber Ridge PRTF Director Kenleigh Bennett advised staff Anna to call the Child Abuse Hotline.

T/A given for 110.9.a: Any owner, operator, employee, foster parent, or volunteer in a child welfare agency shall immediately notify the Child Abuse Hotline if they have reasonable cause to suspect that a child has been subjected to child maltreatment. All staff will be retrained on mandated reporter policy and sense of urgency for making reports. Staff sign in sheet will be provided to licensing by 12/28.23

Licensing unfounded complaint.