Disability Rights Arkansas

Timber Ridge / Neurorestorative Timber Ridge

Location: Benton, AR

Population Served: Youth 4-12 years old

# of residents per unit: 15 Residents per room: 1-2 Capacity: 15

Contact with family (Calls and visit schedule): Families can call daily. Clients can call as long as they have been safe towards themselves and others

Restraint utilized? Yes Chemical Restraint utilized? Yes Seclusion utilized? No

Treatment Modalities:

Clinical Director – MSE, CCC-SLP

Therapists: 3 full-time therapists (1 LPE-I, 1 LAC, 1 PhD Neuropsychologist)

Treatment modalities offered: Play therapy, sand tray therapy, polyvagal, CBT, solution focused, reality therapy

# of individual therapy sessions/week: 1-2/week

# of group therapy sessions led by a licensed mental health professional/week: 1

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PRLU or OLTC

Maltreatment, Notice of Incident

Client was not following instructions and became physically aggressive towards self and staff. Staff used non-approved hold method. Staff was suspended from shift. Her agency manager was notified. Guardian-DHS Case Worker notified. Child liscensing agent notified. Witness statement describes staff put clients right arm behind his back extended up with his hand between his shoulder blades. Staff pushed his head to the floor and said “call me a bitch again”. Staff was immediately suspeneded after incident and will no longer be scheduled to work for Timber Ridge. Licesning Specialist: Clayton DeBoer. Regulations out of Compliance: 109.1.g – Engaging in behavior that could be viewed as sexual, dangerous, exploitative, or physically harmful to children. 905.4.c – The following actions shall not be used, including as discipline: Lewd or obscene language.

PRLU or OLTC

Technical Assistance, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Review of the agency’s current mandated reporter policy determined it does not comply with A.C.A. 12-18-402 nor the Minimum Licensing Standards. Please ensure facility policy is updated to reflect the need of all staff to report directly to the child abuse hotline without delay. The updated policy shall be submitted to the Licensing Unit by 04/13/23 and all applicable staff shall be retrained on the updated policy within 2 weeks of the enactment of the updated policy.
  • TA –
    • 110.9 – Any owner/operator, employee, foster parent, or volunteer in a child welfare agency shall immediately notify the Child Abuse Hotline if he or she has reasonable cause to suspect that a child has been subjected to child maltreatment, died as a result of child maltreatment or if they observe a child being subjected to conditions or circumstances that would reasonably result in child maltreatment.
    • 102.3.h -Child Maltreatment/Mandated Reporter policy; according to Arkansas law, including, procedures to ensure that alleged, suspected, or witnessed incidents of maltreatment are reported to the Child Maltreatment Hotline, and documented as required by these or other applicable rule or laws.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Buildings & Grounds conducted for PRTF building from 11am – 12pm. Census: 12. Sleeping areas, bathrooms, living area, kitchen, and dining areas observed. MARs checked for 5 clients.
  • Regs out of compliance –
    • 911.15.f – Room 7 had 3 garments with tie-strings in them. The garments were immediately removed, and staff will inventory all clothing for strings.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Buildings & Grounds conducted for Americana House. Census: 3. Sleeping areas, living area, dining room, kitchen, bathrooms, and classrooms observed (clients in school). MARs checked for 3 clients. No licensing concerns noted.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Buildings & Grounds conducted from 9am – 10am. Census: 13. All sleeping areas, bathrooms, kitchen, dining area, and school observed. A bathroom was awaiting part for new shower control; 5 showers functioning. MARs checked for multiple residents.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Buildings & Grounds conducted from 10:30am – 11:30am. Census: 13. All areas inspected were clean, safe and in good repair except room #3 has a hole in the wall where the plaster has been broken off from a previously patched hole. MARs checked for 5 residents.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Dual (Accidental Injury)
    • On 10/02/22, client stated he “came off the slide wrong” on the playground and bent his pinky finger back. Client reported no pain at the time and no injuries were noted. On 10/03/22, client was sent for an x-ray after telling the nurse he thought his finger was broken, as the area was bruised. X-ray results: Fracture to finger. Client has an appointment with ortho for continued treatment. No follow-up details.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Buildings & Grounds conducted from 5:30pm – 6:30pm. All bedrooms, kitchen, dining area and dayroom observed. One bathroom observed (showers in use during visit). MARs checked for 5 residents.
  • TA –
    • 9.911.6 – Bedroom 7 has a hole behind the door in the wall flush with the door handle.

PRLU or OLTC

Buildings and Grounds, Visit Compliance Report

  • Licensing Specialist: Not listed.
  • Facility visited from 12:30pm – 1:30pm for PRTF building. Census: 11. MARs checked for multiple residents with no licensing concerns noted. When asked to show a posted list of client rights, the facility could not provide at this time. The Program Director stated she would post a copy of client rights at conclusion of licensing visit.
  • TA –
    • 9.901.3 – The agency shall establish and post a written list of children’s rights.

Medicaid Inspection of Care

Inspection of Care Report

  • Included: IOC Report
  • No deficiencies noted.

PRLU or OLTC

Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Facility visited from 1:00pm – 2:00pm for PRTF building. Census: 11. MARs checked for 5 residents. No licensing concerns noted during visit.

PRLU or OLTC

Notice of Incident

  • Elopement
    • Client eloped from facility and a search was immediately started and authorities notified. Once located, EMS came to facility and determined client did not need to go to ER. Per licensing email to facility on 6/2/22, client remains at facility and is doing fine.

PRLU or OLTC

Notice of Incident

  • Maltreatment
    • Client stated while at facility between 2018-2019, staff members would take him and other residents and pull their arms behind their backs, lift them off the ground, and hold them while they screamed in pain. He stated staff members would grab him by the neck and push his head forward and down to his crotch until he was grasping for air. He mentioned having to shower with the curtains open and staff members making fun of his and others private parts. Client stated a staff member had broken his fingers, bending them backwards until they snapped. He stated his fingers were purple for weeks and he received no medical treatment. Client disclosed that he was placed in a corner, his hair was grabbed, and his head yanked around.
    • Child Abuse Hotline was called and accepted. Licensing call with CACD supervisor on 6/7/22: Supervisor stated no additional information was available as it pertains to licensing. Staff in report unknown. Report dates back 3-4 years.

PRLU or OLTC

Validation Survey

During the Validation Survey conducted from 5/9/22 – 5/16/22, the facility was found to be in compliance with program requirements.

PRLU or OLTC

Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Census: 12. Buildings and grounds conducted from 1:30pm – 3:00pm and MARs checked for 5 clients; No concerns noted.

PRLU or OLTC

Notice of Incident

  • Maltreatment
    • Client was being provided safety escort due to being physically aggressive towards peers outside when he spit in staff member’s face. Staff member then hit client with an open hand in his face. Staff member was terminated immediately, and client remains at facility.
    • Child Abuse Hotline was called and accepted. Specialist visited facility on 3/7/22 to address incident. No video footage was available (facility does not have cameras). Facility staff provided termination papers on staff member, and signed sheets of recent retraining (“Self-Regulation”) that she had facilitated for most of staff, still lacking some night shift. Client was assessed by nurse with no issues and met with the neuropsychologist who noted client to be okay. Facility cited for 905.4g and 907.2.

PRLU or OLTC

Visit Compliance Report

Facility visited and records reviewed for 10 clients and 10 personnel.

PRLU or OLTC

Visit Compliance Report

Walkthrough conducted of Americana and Cabin 6 (visit cut short due to immediate notification of quarantine); MARs checked for 5 residents. No concerns noted.

PRLU or OLTC

Visit Compliance Report

  • Census 13; Reviewed 7 medication logs. Most children were at school during the visit.
  • Regs out of compliance –
    • R908.8 – All evening dosages were pre-signed on the medication log. Ensure medication is only logged as dispensed and training is provided to nurses.
    • R406.3 – Nurse came back to sign a noon and PRN dose while reviewing logs; Ensure medications are only logged as dispensed and training is provided to nurses.
    • R406.5 – Prescription cream was left in child’s room. Corrected 11/10/21.
  • TA –
    • R911.6 – Hole in wall appeared to be in process of being repaired in room 9.

Medicaid Inspection of Care

On-Site Inspection

  • Included: IOC (revised), CAP
  • Multiple deficiencies noted. Plan of Correction required to be completed within 30 days.

Police Report

Information, Sex Crime

Detective received referral from Child Abuse Hotline on 8/13/21. Sent in by fax to hotline: Juvenile 1 is 10 yo and Juvenile 2 is 11 yo. J1 reported that J2 asked him to suck his penis in exchange for toys. J1 told him no and J2 continued to bribe him with toys and to “just let him do it.” J1 reported he did suck J2s penis 2 times and J2 sucked J1s penis 5-6 times. J2 said if J1 ever told anyone that he would punch him in the face. J1 reports another time where J2 asked J1 to pull his pants down; J1 told him no and J2 pushed him against the wall and tried to stick “it” in his butt. J2 denied any penetration or contact.

PRLU or OLTC

Visit Compliance Report

  • Specialist conducted building and grounds inspection; Reviewed medication logs for 8 residents. Initials were missing from the logs on the date of 8/10/21 for all 3 residents. Found multiple items of clothing during walkthrough that contained drawstrings.
  • Regs out of compliance –
    • R911.15.f – Ensure all shoelaces, drawstrings, and cords are removed from belongings and are not accessible to residents. This was corrected on site at the time of visit.
    • R406.4.d – Ensure initials of the person giving meds are on the med log. The nurse that was on duty advised that she normally fills these out at the end of the shift. Nurse agreed to fill them out when the meds are given. The Compliance Officer advised the Nurse Manager would re-train all staff on this procedure.

PRLU or OLTC

Visit Compliance Report

  • Reviewed 10 personnel records. No regs noted out of compliance.

PRLU or OLTC

Visit Compliance Report

  • Specialist viewed new building that will be in use in next couple of weeks, Extension of cabin 6. Also viewed cabin 6 and Americana.
  • Regs out of compliance:
    • R911.15.f – One clothing item found in room with drawstring. Correction date 12/7/20.
  • Regs not correctable:
    • R908.8 – Meds not logged for Sunday, 12/6/20 for 2 children at 5:30am.

PRLU or OLTC

Background Check Review, Visit Compliance Report

No regs out of compliance.