Disability Rights Arkansas

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*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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Police Report

Information

Officer responded at approximately 1720 hrs for a runaway juvenile. Officer spoke with staff and responded to the area where the juvenile was located. Juvenile was on the side of the road speaking to a staff member. Officer transported the juvenile back to the facility.

PRLU or OLTC

Medical, Notice of Incident

  • Medical
    • Client was on sick status as of 02/18/23 due to not feeling well. Night shift reported client had trouble sleeping and had been refusing food. Nurse noted poor PO intake, asleep majority of the day, profound weakness, poor urination, c/o “not feeling well and N”, arouses to verbal/tactile stimuli but falls asleep shortly after. Client was taken to ACH ER. Diagnosis: Migraine (resolved with medications). Client returned to facility.
    • Licensing follow-up: Licensing was informed client was diagnosed with a migraine when discharged from ER. No licensing concerns noted.

PRLU or OLTC

Buildings and Grounds, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Facility visited from 11:15am – 1:30pm. Census: 31. Walkthrough completed of Mabee, Rose, Chestnut, and Sturgis houses. Areas observed: bedrooms, bathrooms, laundry rooms, milieus, comfort rooms, seclusion rooms, kitchen areas, grounds, and group rooms. Licensing and staff discussed chair at Mabee House that was worn out in the seat area; The chair was removed.

Medicaid Inspection of Care

Inspection of Care Report

Deficiencies were noted during the Inpatient Psychiatric Inspection of Care (IOC) conducted on 02/02/23.

PRLU or OLTC

Notice of Incident, Peer Altercation, Self-Injury

  • Peer Altercation, Self-inflicted Injury
    • Client began yelling at peer during a card game and hit his peer several times in the head. Staff stepped between them and asked client to go to his room. Once in his room, client punched his door several times and then punched his bed. Nurse noted R hand was swollen at the 3rd and 4th digits with redness/bruising noted. Client was taken to the ER for an x-ray. X-rays negative for fracture; Client has a splint to wear for comfort. Both residents were placed on freeze.
    • Licensing follow-up: Licensing reviewed camera footage on 02/17/23. No licensing concerns noted.

PRLU or OLTC

Notice of Incident, Self-Injury, Suicide Attempt, Visit Compliance Report

  • Suicide Attempt, Self-inflicted Injury
    • Client became upset due to being placed on pause for cursing and required locked seclusion due to physical aggression towards staff. While in seclusion, client wrapped a sweater and t-shirt around neck (staff removed both), scratched himself with his watch, bit his wrist, urinated on the door/floor, masturbated, and smeared and spit blood on the window. Order was obtained for client to be transferred for acute treatment, and wound care was provided for client’s wrist.
    • Licensing follow-up: Licensing reviewed camera footage on 02/06/23 and did not observe any licensing concerns. Client is scheduled for discharge on 02/07/23.

Police Report

Assist Ambulance

Staff advised officer upon arrival that juvenile was suicidal and acting out. Officer stood by while MEMS transported juvenile to the hospital.

Police Report

Disturbance

Officers responded due to 2 juveniles attempting to fight staff and another patient. Upon arrival, all juveniles involved were separated. Staff advised that J1 was antagonizing peers all day and calling J2 and J3 the “n-word”. Staff stated J1 hit J2 in the face, bit a staff’s arm, and bit another peer on the leg. Charges were not pursued at this time.

PRLU or OLTC

Accidental Injury, Notice of Incident

  • Accidental Injury
    • Client stated his knee popped out of place while playing basketball. Client stated he couldn’t walk, and staff assisted him to the nurse for assessment. Client was then transported to the ER for evaluation.
    • Licensing follow-up: Client diagnosed with acute knee pain at ER. No licensing concerns noted.

PRLU or OLTC

Maltreatment, Notice of Incident, Visit Compliance Report

  • Maltreatment
    • Client reported to his therapist that a staff member grabbed him by the arm and left a bruise. Therapist noted a small mark on client’s arm. Child Abuse Hotline was called and accepted. Two staff members were suspended pending investigation.
    • Licensing follow-up: Licensing requested witness statements (none), reviewed nursing notes, and reviewed camera footage on 01/18/23. CACD investigation was unsubstantiated. Licensing informed facility that staff would need to be retrained (physical restraint) before returning to work. Training roster received on 02/21/23.

PRLU or OLTC

Notice of Incident, Suicide Attempt, Visit Compliance Report

  • Suicide Attempt
    • Client began to “severe limit test” after dinner and began instigating peers, slamming doors, turning lights on and off, and continued to be oppositional with staff. Client was walked to the seclusion room, where he attempted to choke himself with his clothing; Staff intervened and removed clothing. Client agreed to take PRN to help him calm down. No injuries were noted and client was placed on close observation.
    • Licensing follow-up: Licensing reviewed camera footage on 01/18/23 and did not observe any licensing concerns.

Police Report

Assist Ambulance

Officer responded to assist MEMS with transferring juvenile to the hospital.

Police Report

Battery

Officer responded for a disturbance between 3 juveniles. Upon arrival, officer observed several staff restraining J1 with their combined body weight. J1 was placed in hand restraints and inside patrol unit. Witnesses stated J1 attempted to attack J2 and was placed in a restraint, during which he assaulted staff.

Police Report

Assist Citizen

Staff advised officer that juvenile was throwing books, being openly defiant, and won’t follow instructions. Staff stated juvenile hit him prior to being placed in a restraint and attempted to cut herself with plastic. After talking with officer, juvenile began picking up the books she had thrown. Staff stated they were attempting to get juvenile transferred to an acute facility.

Police Report

Disturbance

Staff advised officer that juvenile was aggressive, throwing items, and attempting to hit staff. Juvenile made multiple statements about wanting to die. MEMS transported juvenile to hospital for evaluation.

Police Report

Disturbance

Staff advised officer that juvenile assaulted staff after refusing to return to his room. Juvenile was also bullying a peer, and kicked another peer.

PRLU or OLTC

Medical, Notice of Incident

  • Medical
    • Client woke up to use the bathroom and when he was about to exit the bathroom, he collapsed on the floor. Client stated he was hot and nauseous. When client stated he was ready to get up, staff helped client into a rolling chair and brought him to the nurse’s station. Upon nurse assessment, hives were noted to upper thighs, and client reportedly bumped his head during the fall (no bleeding or swelling noted). Client received Benadryl (50 mg) and was transported to the ER.
    • Licensing follow-up: Licensing was provided with client’s ER discharge paperwork (Diagnosis: Vasovagal Syncope). No follow-up visit recommended. No licensing concerns noted.

PRLU or OLTC

Notice of Incident, Suicide Attempt, Visit Compliance Report

  • Suicide Attempt
    • Client became upset with peer and began to yell, scream, flip chairs, and began to walk towards peer as if to fight him. Client was placed in a restraint and then locked seclusion. Client was placed in another restraint after attempting to choke himself. Client was able to calm down shortly after. Upon nurse assessment, no injury was noted and client denied any pain or injury.
    • Licensing follow-up: Licensing viewed camera footage. A ball was observed in the seclusion room where client was, and client picked it up and began biting the ball and spitting out pieces. Staff asked client to stop biting the ball, and after client threw the ball against a wall, he began choking himself and staff entered to intervene. Licensing spoke with staff regarding the ball that was left in the seclusion room. Facility cited for R911.6.

PRLU or OLTC

Notice of Incident, Self-Injury, Suicide Attempt, Visit Compliance Report

  • Suicide Attempt, Self-inflicted Injury
    • Client was instigating another peer attempting to fight and was placed in a restraint after continued behavior. Client was placed in locked seclusion due to unpredictable behavior. Client began banging on the door, threatened to kill peer, and attempted to put a piece of a ball he found in the seclusion room down his throat to choke himself. Staff initiated restraint to retrieve object and client threw it on the floor. Client received an oral chemical restraint shortly after. Nurse noted micro-abrasions to client’s hands and forearms from scratching and hitting the walls and door (no bleeding or swelling noted).
    • Licensing follow-up: Client was placed on close observation. Licensing viewed camera footage and observed client picking up a piece of a ball off the floor from a previous incident. Staff entered and client was placed in a restraint while staff picked up the remaining pieces of the ball off the floor. Facility cited for R911.6.

Police Report

Assist Agency

Officer stood by while MEMS transported homicidal juvenile to acute facility.

Police Report

Battery

Officer spoke with staff, who stated a juvenile was yelling and threatening another student and staff intervened. Shortly after, juvenile hit staff, resulting in injury (wound to ear, sore and swollen jaw).

PRLU or OLTC

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

  • Maltreatment, Self-inflicted Injury
    • Client exited school building and refused to return inside; Staff initiated a personal restraint and escorted client inside. After continuing unsafe behaviors, client was placed in locked seclusion. Client broke his glasses and punched the door several times while in seclusion. Client calmed once a different staff member spoke to him. While placing the client in seclusion, client hit a staff member in the face and staff pushed client back into the seclusion area, then client slipped and fell. The push was called in to the Child Abuse Hotline. Nurse noted abnormality to client’s left pinky finger and was sent to the ER. Diagnosis: Closed nondisplaced fracture of 5th metacarpal bone. Soft cast placed on client’s hand.
    • Licensing follow-up: Licensing reviewed camera footage and witness statements. Licensing observed staff member blocking the seclusion room doorway to prevent client from leaving. As the staff member was attempting to close the door, the client was swinging at staff, and both lost their balance. When client lost his balance, staff was able to place the client in locked seclusion. Complaint unfounded. 

PRLU or OLTC

Buildings and Grounds, Children's Records Review, Personnel Record Review, Visit Compliance Report

  • Licensing Specialist: Kendra Rice.
  • Buildings & Grounds conducted from 11:45am – 12:45pm. Census: 34. Chestnut, Mabee, and Sturgis House observed. Chestnut House had 3 visible holes in the ceiling due to a pipe busting in the sprinkler system; Repairs were completed on 12/1/22 and the contractor is scheduled to repair the ceiling on 12/6/22 or 12/7/22. In Mabee House, a noise was heard in a bathroom vent when the light was turned on; Specialist informed staff.
  • Licensing reviewed 6 resident files from 12:45pm – 2pm. No licensing concerns noted.
  • Licensing reviewed 4 personnel files from 2pm – 3:15pm. No licensing concerns noted.
  • Regs out of compliance –
    • 9.911.6 – Light cover had visible crack in bedroom #7 and bathroom #1 had a black substance on the shower curtain (Chestnut House). Correct by 12/9/22.  
    • 9.911.7 – Licensing shall be notified of any changes to buildings that affect usage, size, capacity, or structural changes.

PRLU or OLTC

Notice of Incident, Suicide Attempt, Visit Compliance Report

  • Suicide Attempt
    • Client refused to take his evening medication and began banging his head against a door and kicking walls. After behavior continued, client was placed in a personal restraint and then locked seclusion. While in seclusion, client attempted to choke himself. Client later received chemical restraint (injection of Chlorpromazine 25 mg). Nurse assessed client after incident; No injuries noted. Client placed on eyeball precaution due to his suicidal remarks and actions.
    • Licensing follow-up: Licensing reviewed camera footage on 12/07/22 with no licensing concerns noted. As of 12/07/22, client was taken off eyeball precautions and remains on close observation precautions.

Police Report

Disturbance

QRTP – Staff advised officer he was threatened by a juvenile, who stated “I’ll burn ya ass up.” Juvenile admitted to stating that, but meant “burn” to mean he would insult staff.