Disability Rights Arkansas

Timber Ridge / Neurorestorative Timber Ridge

*Photos taken by DRA staff during onsite monitoring visits. Photos reflect the most recent conditions observed by DRA staff but may not reflect the current conditions at the facility. If you are associated with a facility and have updated information or photos you would like to share, please contact DRA at [email protected]

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

Visit Compliance Report

Licensing Specialist: Clayton DeBoer

Buildings & Grounds conducted for PRTF building and Americana House. PRTF Census: 13, Americana Census: 4.

PRTF Building clients in line for school. Staff/client ratio: 6:12. One client was disrupting and in room 1 with 1 staff present. Grounds, bedrooms, and bathroom areas viewed. Kenleigh Bennett of Timber Ridge explained that single room walls are having puncture resistant white lining installed. One single room observed to have this today.

T/A given for 911.6: Room 3 had torn baseboard and room 5 had baseboards completely missing. Maintenance confirmed these issues are currently being addressed.

MAR checked. All initialed and up to date.

Americana House observed to be clean, safe, and in good repair. Bathrooms clean and sanitary with functioning sinks, showers, and toilets. Grounds clean and free of hazards.

Annual Review/Policies PRTF review conducted. All items on checklist observed during today’s visit.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Clayton DeBoer.

Personnel Record Review conducted for 6 staff members. All items missing from review on 8/31/23 have been sent via email or viewed during today’s visit.

PRLU or OLTC

Notice of Incident, Peer Sexual Contact

Two clients were horse playing together and were cued multiple times to stop. Client then came running out of his room and told the staff that the peer touched his butt. The peer confirmed that he did briefly touch his butt over the clothes. CACD was called and initially accepted, but screened out.

Safety plan and incident information: At the time of the incident the ratio was 6 staff to 14 kids. Client was immediately removed, placed on intensive supervision, and he is sleeping in the common area now. He is also on safety and has been moved rooms away from peer.

No licensing findings as this was not a licensing complaint investigation.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Clayton DeBoer.

Buildings & Grounds conducted from 8:30am – 9:30am. Census: 14. Areas viewed: Living areas, dayroom, kitchen, sleeping areas, bathrooms, and grounds. MARs checked for 5 residents. No licensing concerns noted.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Clayton DeBoer.
Personnel records review conducted for 4 staff members. Several missing items noted in today’s visit. Personnel files will be audited by facility for items listed in the checklist for minimum licensing standards and progress will be reviewed by 9/30/23.

Regulations out of compliance:

  • 103.1: No FBI check in files for 2 staff members.
  • 105.4.d: No suicide awareness and protocol training for 1 staff member.
  • 105.8: No proof of 30+ hours of training or documentation of annual training for 3 staff members.
  • 105.13: No proof of 30+ hours of training or documentation of annual training for 3 staff members.
  • 105.15.d: No proof of 30+ hours of training or documentation of annual training for 3 staff members.
  • 105.15.a: No resume or application for any of the files checked today.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Clayton DeBoer.
Building and Grounds conducted for Americana House. Census: 4. Grounds, sleeping areas, bathrooms, fire extinguisher, and emergency evacuation plan observed. MARs checked for 4 residents. No licensing concerns noted during visit.8.282

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Clayton DeBoer.
Children’s Records Review conducted for 10 clients.
Facility cited 902.3: Three clients did not have proof of immunizations in their files. Proof of immunizations are required for clients by 9/11/23.

PRLU or OLTC

Visit Compliance Report

Buildings & grounds conducted from 11 AM – 12 PM. Staff/Client ratio 6:12. Living areas and kitchenette clean, safe and in good repair. Sleeping areas furnished, clean and in good repair. All bathrooms clean and sanitary with functioning sinks and toilets. Grounds clean and free of safety hazards. Emergency evacuation diagrams and client rights posted. Fire extinguisher observed. MAR checked for: [REDACTED]. All initialed and up to date. Licensing Specialist: Clayton DeBoer.

PRLU or OLTC

Visit Compliance Report

Buildings & grounds conducted for Neurorestorative Timber Ridge PRTF building from 5:30 PM-6:15 PM. Staff/Client ratio: 5:12. Grounds clean and free of safety hazards. Buildings and furnishings clean, safe and in good repair. Bathrooms clean and sanitary with functioning sinks, toilets and hot water. Room 8 had one pair of sweatpants with a drawstring in the waistband. Staff immediately removed the drawstrings from the pants. No other strings observed in clothing in sleeping areas. All sleeping areas furnished and reasonably clean.

MAR checked for: [REDACTED]. All initialed and up to date. Consultation had with director of pediatric services. Facility will design and implement a Zero-Tolerance policy/Protocol for licensing regulation 911.15F. This will be provided to licensing no later than 7/19/23. Regulations out of compliance: 911.15.F – room 8 had one pair of sweatpants with drawstring in the waistband. Licensing Specialist: Clayton DeBoer.

Medicaid Inspection of Care

Inspection of Care Report

Deficiencies were noted during the Inpatient Psychiatric Inspection of Care (IOC) conducted at the facility.

PRLU or OLTC

Visit Compliance Report

Buildings & grounds conducted for PRTF building from 9Am-10:30Am. Client/Staff ratio: 8:12. School observed to have staff/Client ratio 7:12. All sleeping areas furnished, safe, clean and in good repair except room 7, had one pair of pants with tie strings in them, room 8 had 3 pairs of pants with tie strings in them. The gaming area had a toy bag with a long string in it. The items were immediately given to the PRTF supervisor. They stated that all staff will inventory clothing for strings today. They stated that weekly checks will start being conducted to inventory for strings in clothing. All 6 bathrooms functioning, clean and sanitary with good working sinks and toilets.

MAR checked for: [Redacted]. All initialed and up to date. Americana building observed to be furnished, clean and in good repair. Bathrooms clean and sanitary. No grounds safety concerns. Client ratio residing in Americana: 5, staff present 2. Clients were at the pediatric school today. Regulations out of compliance: 911.15.F – at PRTF building room 7, one pair of pants with strings, room 8 had 3 pairs of pants with tie strings in them. Licensing Specialist: Clayton DeBoer.

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.