Disability Rights Arkansas

Youth Home

*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 rstanford@disabilityrightsar.org

Location: Little Rock, AR

Population Served: Adolescents 12-17 years of age in need of mental health services on a 24 hour a day basis.

# of residents per unit: 12 Residents per room: 1-2 Capacity: 54

Contact with family (Calls and visit schedule): Kids have daily contact with their family either via zoom, face time calls, or phone calls. In the evening they are given time to call families and their families are welcome to call anytime during the day. Outside of Covid-19 Restrictions families can visit on the weekends and once during the week.

Restraint utilized? Yes Chemical Restraint utilized? Yes Seclusion utilized? Yes

Treatment Components:

Clinical Director – LPC

Therapists: 8 full-time therapists (4 LAC, 3 LCSW, 1 LPE-1); 1 part-time/contract therapists (1 LCSW)

Treatment modalities offered: EMDR, TF-CBT, ARC, Brain Spotting, Trauma-Focused Family Therapy, Reactive Attachment Multi-Family Group

# of individual therapy sessions/week: 2-3x/week

# of group therapy sessions led by a licensed mental health professional/week: 2-4x/week

# of family therapy sessions/week: 1x/week

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PRLU or OLTC

Notice of Incident, Self-Harm

Client became upset due to a family session and began banging on the front walls of the seclusion room. Client banged head on the unlocked seclusion room door and was placed in a restraint to prevent self-harm. Client was released once she calmed down, but went down the hallway and hit her hand on the wall. Client was placed in another restraint to prevent further injury. Chemical restraint was administered per nursing.

Client complained of right hand pain and was given an icepack and Ibuprofen. Area was reddened, no swelling noted. Nursing will continue to monitor. Client was transported to Rivendell for an acute stay on 11/07/23 during the evening shift. She remains at Rivendell at this time. Licensing Specialist informed that it is unknown at this time if resident will be returning to the facility.

PRLU or OLTC

Notice of Incident, Self-Harm

Patient was putting a snake like fidget toy around her neck and a peer stated that she could get in trouble for playing around in that manner. She stated that she did not care as she was already on consequence. Staff informed her that unsafe behaviors would land her on other consequences. She was not pleased to hear this and threw the things down and ran out the door fleeing.

Patient was restrained to prevent elopement and escorted towards seclusion. Client was released from restraint after agreeing to remain calm. Patient voluntarily entered seclusion and began kicking and punching the wall. Client was restrained again to prevent self-harm. Additional staff arrived. Client began to process with staff but became annoyed that she was still at the school and not on her way to the house and she began digging her nails into her left arm leaving marks. Staff restrained her to further prevent this.

Patient was placed on Freeze, eyeball and FOH. Nurse noted fingernail marks to client’s left forearm where she dug her nails into arm in attempt to self harm (did not break the skin, superficial indentions noted to skin).

PRLU or OLTC

Accidental Injury, Maltreatment, Notice of Incident, Self-Harm, Visit Compliance Report

Client was upset after receiving a pause for being rude to staff, refused to take meds and started flipping over furniture. Client was placed in a personal restraint and taken to seclusion. While in locked seclusion, client broke a peers cup that was left inside and exposed sharp plastic edges around the cup that could be used to self-harm with. Staff entered to remove the item, and client threw the bottle at staff. Client was placed in another restraint and began kicking and scratching staff. Client was trying to bang her head on the floor and spit on staff as well. Once calm, client agreed to talk with nurse once released from restraint.

Nurse assessment: Client reported that her head was pulsating and 2 scratches were noted on client’s thumb from the personal restraint. Client also complained of knee pain, stating she hurt her knee earlier while outside.

On 10/26/23, client stated she was restrained improperly on 10/25/23 and that a staff member was digging his nails into her hand (stating abrasion on thumb was from this). She also reported that she was grabbed by the collar of her shirt and that it was tight on her neck and it was “choking her.” Patient stated that she tried to tell them that she was being choked but they wouldn’t listen. Patient had no marks on her neck/throat but is noted to have some petechiae around her eyes and cheeks that wasn’t there yesterday. Client was transported to Arkansas Children’s Hospital ER to assess petechiae rash on face and headache that has not responded to treatment. Diagnosis: Concussion. Client placed on activity restrictions and the allegation was reported to the Child Abuse Hotline and accepted.

Licensing Specialist: Kendra Rice.

Licensing viewed video footage of incident. Facility reported that the staff member was terminated on 10/26/23.

Facility cited 109.1.g: Staff member was observed grabbing the resident’s arm and it appeared that he pushed the resident.

Facility cited 905.15: A water bottle was left in seclusion room that resident destroyed into pieces.

This complaint was founded by Licensing. CACD investigation was unsubstantiated.

PRLU or OLTC

Notice of Incident, Self-Harm

Patient reported to nurse that two days ago she hit her arm against the wall and bruised it. Patient was assessed initially yesterday and today it showed continued discomfort and discoloration, orders received to be evaluated at urgent care. Ortho Arkansas had the following results: Right wrist is not fractured, some swelling noted to Ulnar side of right wrist.

10/18/2023 – Licensing Specialist informed there was no fracture but resident was placed in a cast for two weeks due to bruising and swelling. Resident has a follow-up appointment scheduled for 10/8/2023 at 3:40pm.

PRLU or OLTC

Notice of Incident, Self-Harm

The patient entered the seclusion room because she was unhappy and disobeyed staff directives, according to the staff. After being observed hitting her head while in seclusion, the patient was put in a personal restraint. The patient was eventually quiet enough to be taken out of the personal restraint after ten minutes. Nurse noted three self-harm marks: one bite mark just above the left wrist, one bite mark that penetrated the flesh on the wrist, and a superficial scar on the left lower arm. Patient rejected all medical attention and did not allow nurse to take vital signs. Patient placed on freeze, FOH, and eyeball. Patient received orders for transfer to acute facility.

Licensing Specialist informed that resident returned to the facility on 10/23/2023.

PRLU or OLTC

Medical, Notice of Incident

Patient was at OBGYN appt during snack BG (blood glucose) check. Upon returning to the facility, nurse did dinner Accu-Chek. Patient told nurse she had eaten ‘two rice krispies, original size’ and ‘two packets of cheese peanut butter crackers’. Carb count was estimated at 86 carbs, BG was 441. Patient was given 14 units Novolog (6 units per s/s 6 units per carb count, 2 units for additional BG correction). Patient was told to wait to eat dinner until BG could be rechecked. Pt refused and began to curse at this nurse and threatened to ‘fuck things up’. Patient then grabbed dinner and began eating it. BG rechecked a half hour after dinner was eaten. Patient told nurse that she was feeling ‘dizzy’ and ‘not well’. BG was 540. Ketones trace. Patient told nurse ‘I need to go to children’s.

Due to patient’s increasing BG and presenting symptoms, patient was taken to Arkansas Children’s Hospital ER. Upon patient’s return, no signs of distress noted. LPN recorded vital signs and blood sugar levels upon return. Will follow physicians orders for continued plan of care.

PRLU or OLTC

Notice of Incident, Self-Harm

Nurse informed that patient had punched the wall while she was agitated last night (10/7/23). Nurse noted swelling and purple discoloration at #5 proximal aspect of digit, with abrasions on prone aspect of right hand. Orders received to have her evaluated at urgent care. Diagnosis: Sprain of R fifth finger.

PRLU or OLTC

Accidental Injury, Notice of Incident

Patient was returning to house from outside activity and twisted her right ankle. Nurse noted swelling/bruising to area. Patient unable to stand and bear weight or perform active or passive range of motion. Orders received to transport to ACH for evaluation. ER findings: No fracture on x-ray, likely sprain/strain. Diagnosis: Acute R ankle pain.

Police Report

Caller reported his granddaughter went on a visitation with her father over the weekend and upon returning to the facility, the juvenile tested positive for THC. Caller complained there was no report of the drug screen completed by Youth Home staff. Officer provided details of report to DHS Hotline.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Kendra Rice.

Licensing reviewed 12 children files from 10:30am – 2:00pm. All complied with the minimum licensing standards.

PRLU or OLTC

Elopement, Notice of Incident, Peer Altercation

Peer (1) gave client a threatening quote on whiteboard saying “If you don’t stop you will not enjoy the consequences”. Staff encouraged client to allow them to de-escalate the situation. Client seemed accepting to the information. While staff was helping de-escalate another peer (2), the client went behind staff’s back and immediately started fighting peer (1). Additional staff were called due to the increased aggressiveness. Staff had to remove pt’s arms from peer’s neck. After staff was standing between client and peer, he quickly calmed down and walked out of the class with staff.

Staff discussed patient going to Chestnut House for the afternoon to separate the residents, and patient refused and stated they would have to restrain him to get him there. As staff went to get help, patient ran out of the D-Zone and out the side door and eloped. Staff pursued patient but lost sight of him. Run protocol was initiated and the Pulaski County Sheriff’s Office was notified. At approximately 10:20 am, patient arrived back to campus via the police.

Client was placed on house restriction and “freeze” for aggression. Nurse assessment: Erythema noted to posterior neck and (L) ear. He endorsed some soreness of bottom tooth, #24 as he reported hitting his head on the wall while striking his peer. He reports 6/10 pain and requested orajel. Orajel administered. This tooth appears pushed back and not aligned with others. Client reports this is WNL for him except the sensitivity.

PRLU or OLTC

Complaint, Notice of Incident, Visit Compliance Report

Licensing received complaint: Reporter stated resident returned home from a weekend pass with her non-custodial parent and was reportedly acting “strange”. RN reportedly drug tested the resident and she came back positive for marijuana. The reporter suspected that the non-custodial parent provided the resident with the marijuana as he has a known history of substance abuse. The reporter states that the facility failed to call the Child Abuse Hotline and instead stated that they will be doing their own investigation internally. The family has filed a police report with the Pulaski Co. Sheriff’s Office. The incident occurred on 10/1/23 and it is reported that no call to the hotline has been made by the facility as of 10/6/23.

Licensing Specialist: Kendra Rice.

Licensing requested nursing notes for 10/1/23 and inquired of lab results. Lab results received. Resident tested negative for marijuana and positive for nicotine.

This complaint has been unfounded by Licensing.

PRLU or OLTC

Medical, Notice of Incident

Resident was transported by staff to Baptist Urgent Care for them to examine her bruised tailbone as she was experiencing leaking from the area, which was also producing an odor. Baptist Urgent Care advised staff that resident needed to be taken to the ER to ensure proper drainage and further assessment. Resident was then taken to Arkansas Children’s Hospital ER and diagnosed with Pilonidal Cyst.

Orders: Dressing applied to tailbone to collect drainage (will need to be changed frequently), [REDACTED] by mouth 3x a day for 10 days, and follow-up with Surgery Clinic.
Licensing Specialist inquired about follow-up appointment for resident. Licensing Specialist informed resident is scheduled to discharge on 8/5/23. A call was made to expedite the resident’s surgery appointment. No call had been returned to the nurse charge.

Police Report

Welfare Check

Officer responded to the facility in reference to a welfare concern. Caller advised he wants to know his son is alive (resident at the facility).

Upon arrival, staff informed officer that resident’s father had been calling to speak with his son for his birthday, but that his parental rights were taken away and he can receive no information regarding his son and his well-being. Officer informed caller that he can no longer call the group home demanding to talk to his son.

Police Report

Assist Ambulance

Officer was dispatched to facility in reference to an ​assist MEMS with a juvenile. ​Prior to arrival,​ I was advised that the juvenile was actively being restrained. ​Upon arrival,​ juvenile was located asleep in his bed unrestrained. Officer was advised he was restrained several hours ago and had since been unrestrained. ​MEMS responded to the scene and transported the juvenile without incident.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Kendra Rice.

Licensing completed building and grounds at Chestnut House from 9:30am – 10:15am. Areas observed: Comfort room, seclusion room, staff bathroom, bedrooms, bathrooms, storage closet, game room, visitation/therapy room, laundry room, library, and dining area.

The Chestnut House flooring had been repaired, baseboards replaced, and walls were painted. A date has not been determined when residents will move back into the house.

Police Report

Elopement

Officer was dispatched to facility in regards to a runaway juvenile. Officer canvassed the area and located the missing juvenile walking through a field. ​Upon making contact with the juvenile, she stated she ran away from the youth home because she has felt trapped and just needed to get away. Staff arrived on scene and transported the juvenile back to the facility.

PRLU or OLTC

Elopement, Notice of Incident

Resident returned to the house with staff after dinner, and once staff attempted to open the door, client sprinted into the woods. Staff attempted to pursue resident but was unsuccessful. Pulaski County Sheriff’s Office was contacted and located the resident. Resident stated she ran b/c she has been having ‘unwanted thoughts to harm self’ and ‘impulsive thoughts’, but denies plan to harm self at this time. Resident was assessed and the nurse noted superficial cuts on R shoulder and on L shin. Resident stated these are from running through the woods. Denies any other pain/injuries.

Licensing Specialist informed resident was placed on close observation, run risk, freeze, and house restriction.

PRLU or OLTC

Notice of Incident, Peer Sexual Contact, Visit Compliance Report

Two residents accused peer of going into their room and touching them inappropriately. A hotline report was filed and residents were placed on 6 ft. peer limit from the accused. On 9/7/23, facility was informed the call was accepted for investigation.

Facility informed licensing that 1 resident attempted to tell staff but staff did not understand that it was touching. This staff member received disciplinary action. It was reported that there were no witness statements. Licensing inquired about late reporting, and received an email with correspondence on when the hotline was submitted and accepted.
This complaint was unsubstantiated by Crimes Against Children Division (CACD) and Licensing.

PRLU or OLTC

Notice of Incident, Peer Sexual Contact, Visit Compliance Report

Resident reported that while waiting to enter her classroom, a peer touched her inappropriately. Child Abuse Hotline was called and accepted for investigation. Residents were placed on peer limit and resident was moved to a different classroom.

Licensing Specialist: Kendra Rice.
Licensing visited facility and reviewed camera footage on 9/6/23. Licensing Specialist observed what appeared to be a peer touching resident on her back area in the hallway. Staff member was present at the classroom door as the group then entered the classroom.
9/29/23 – Complaint was unfounded by Licensing. Crimes Against Children Division (CACD) case was closed unsubstantiated.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist: Kendra Rice.
Time of visit: 11:00 am to 12:30 pm. Census: 35. Licensing Specialist completed buildings and grounds and observed the following houses: Hickory/Chestnut, Sturgis, Rose, and Mabee. The following areas were observed: bedrooms, bathrooms, common area, kitchen area for staff, laundry rooms, family rooms, seclusion rooms, game rooms, and milieus.
Licensing observed that the gazebo has been painted and picnic tables have been added to the outside area, new game tables in all the houses, grievance boxes were located for the residents in the houses, and water fountains were observed for residents to have drinking water. Clients’ rights, escape plans, and fire extinguishers, and smoke detectors were observed.
Licensing observed contractors working on Chestnut house. The flooring was pulled up, baseboards were removed, and toilets were not in the bathrooms. Plumbing was repaired on the outside of the building.

PRLU or OLTC

Accidental Injury, Notice of Incident, Visit Compliance Report

Client fell off her bed on Saturday and was taken to Urgent Care on 7/27. The physician stated the coccyx area was swollen, bruised, and needed to be x-rayed. X-rays were not able to be conducted at Urgent Care, so client was taken to the ER the following day. An x-ray at the ER determined there was no fracture, but the area was badly bruised. ER instructions: Apply ice or heat therapy for 15 minutes 3-4x day, use a donut pillow while sitting, and alternate Tylenol and Ibuprofen for pain as needed. Client is to follow up with PCP if area has not improved after 1 week. Client was instructed to reduce activity and rest injury as needed.
Licensing received provider reported incident on 8/2/23. Licensing inquired about late entry, and facility reported it was an oversight. Facility cited 110.17 (Facility failed to notify Licensing by the next business day of a provider reported incident).

PRLU or OLTC

Visit Compliance Report

Licensing Specialist conducted an annual review of policies and procedures. Census: 40. Policies and procedures for Youth Home PRTF complied with minimum licensing standards.

PRLU or OLTC

Visit Compliance Report

Licensing Specialist Kendra Rice completed buildings and grounds. Census: 42. Observed residents playing basketball and in the game rooms and day areas watching tv. The grounds were well-Kept with no debris. All bedrooms were clean and organized. The bathrooms were clean with running water.

Licensing Specialist reviewed five (5) personnel files. Personnel files reviewed complied with the minimum licensing standards. Licensing Specialist reviewed the following minimum licensing standards: 103 central registry and criminal record checks and part of 105 staff qualifications. Licensing Specialist reviewed eight (8) children files: all children’S files reviewed complied with the minimum licensing standards.

Police Report

Disturbance

Juvenile caused disturbance on van. She ripped the plexiglass light fixture off of the ceiling, threatened to assault another student, and threatened to jump out of the van into oncoming traffic. Juvenile transported to ER by MEMS for evaluation for acute placement.