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

Disturbance

QRTP – Juvenile became upset because he didn’t want to share a gaming console. After a peer had calmed down and began helping staff cook, juvenile attempted to touch everyone’s food and kicked the kitchen cabinets. Juvenile was put in a restraint, during which staff stated he accidentally head butted juvenile.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Self-inflicted Injury
    • A peer reported to staff that client had hurt herself with a razor blade she found in the trash at a hotel she was in with her grandparents (during her therapeutic home visit). Client had deep cuts in both her thighs. Wound care provided and client sent to the ER. Client returned from ER with new medication, 6 stitches to L lower extremity and R extremity was cleaned, no stitches required. Client placed on front of house and eyeball status.
    • Licensing follow-up: This incident did not happen at the facility.

PRLU or OLTC

Notice of Incident, Self-Injury, Visit Compliance Report

  • Self-inflicted Injury
    • Client received “Pause time” in his room for telling a peer that an elderly couple on a TV commercial were his parents. Client became upset and after refusing to calm down, he was restrained and placed in unlocked seclusion. Client was placed in locked seclusion after becoming defiant, hitting his fist against the door and threatening peer. Another restraint was initiated after client attempted to choke himself. Once client calmed down, nurse noted an injury to his index finger on his left hand from punching the window in the seclusion room (“sore left hand”). On 11/22/22, client was assessed and refused pain medication. Staff will monitor for changes.
    • Licensing follow-up: Licensing will follow-up with the facility regarding client’s behavior patterns and staff’s struggles with behavior management with this client. Licensing visited the facility and viewed camera footage; No licensing concerns noted.

Police Report

Battery Third Degree

QRTP – Juvenile stated that he and a peer got into a fight on the school bus, in which peer punched juvenile in the face. Peer initially stated he didn’t punch juvenile, but later admitted to punching him after juvenile was in his face and breathing on his neck. Juvenile was taken to a medical facility for evaluation of his injury.

PRLU or OLTC

Licensing Follow Up, Notice of Incident, Suicide Attempt

  • Licensing (Suicide Attempt)
    • Client became upset with staff after receiving consequences for his behavior. Client threw a laundry basket top at staff and threatened staff, then began focusing on a peer and walked towards peer. Client was placed in a restraint, then locked seclusion. Client attempted to choke himself while in seclusion and was restrained. Nurse assessed client after the incident and noted some redness to his upper arms. Client had a small bruise on his wrist that he stated was from something else, not the hold. Client denied pain medication and was placed on eyeball due to suicidal statements.
    • Licensing follow-up: Client was placed on eyeball (suicide precautions) and remains at facility.

PRLU or OLTC

Licensing, Notice of Incident, Self-Injury

  • Licensing (Self-inflicted Injury)
    • Client reported to staff that he had hit a wall the day before. Upon evaluation on 11/4/22, client’s knuckles were swollen/red. Facility will continue client’s current medications, provide ice packs, and monitor his injury to determine if an x-ray is needed.
    • Licensing follow-up: Specialist sent email to facility to determine if or when client will receive x-ray. On 11/7/22, the facility advised client was not x-rayed.

Police Report

Battery

Upon officers arrival, staff member stated he was punched in the shoulder by juvenile after staff told the juvenile he needed to go to bed. Juvenile admitted to punching staff member because staff was blaming stuff on him. A court date was set for juvenile.

PRLU or OLTC

Licensing, Notice of Incident, Self-Injury

  • Licensing (Self-inflicted Injury)
    • Client became upset after being placed on RS. Client was not following staff instructions to stay in his room, and began throwing items, yelling, & cursing at staff. Staff placed client in restraint due to unpredictable behavior, then in locked seclusion. Client began banging his head on the wall in seclusion and then placed his hands around his neck. Staff entered and client was placed in another restraint. After client calmed down, nurse noted a small, reddened area to client’s neck.
    • Licensing follow-up: Client remains at facility.

PRLU or OLTC

Licensing, Notice of Incident, Self-Harm

  • Licensing (Self-inflicted Injury)
    • Client self-harmed with a staple on her forearm and legs due to having suicidal thoughts. Client willingly gave staff the staple and she was placed on eyeball. Nurse noted superficial scratches to client’s forearm and upper thighs. Client denies pain/discomfort.
    • Licensing follow-up: Client placed on eyeball (suicide watch) and remains at facility.

Police Report

Disturbance

Upon officers arrival, staff advised juvenile 1 was being disrespectful and threatening to jump on staff members. Staff also stated J1 turned over some chairs and tables, but fixed them once he was aware the police were called and had since calmed down. J1 stated he alerted staff that J2 got 2 juices, and when he opened the refrigerator, he hit J2s leg and he complained about it.

PRLU or OLTC

Monitor Visit, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Buildings & Grounds conducted for Sturgis for follow-up on deficiencies cited on 09/07/22. Deficiencies have been corrected.
  • TA –
    • 9.912.4 – Bathrooms had some rust on metal fixtures and some grime on the walls; Maintenance order was placed during visit.

Police Report

Suicide Attempt

Upon officers arrival, juvenile was awaiting transport on MEMS truck. Juvenile was alert and breathing, and officer observed a bright red mark encircling her neck. Staff advised that during shower time, juveniles 10 minutes was up and when she went to check on her, juvenile would not respond and staff found her laying in the floor, red and purple in the face. Staff called for help and removed a white string and towel from juveniles neck. Juvenile was transported to Children’s Hospital by MEMS.

PRLU or OLTC

Licensing, Notice of Incident, Suicide Attempt

  • Licensing (Suicide Attempt)
    • Client asked staff to set a timer for 10 minutes so she wouldn’t stay in the shower for too long. When the timer went off, staff went into the bathroom to let client know. When client didn’t respond, staff opened the door and found client lying on the floor with a piece of towel around her neck. The towel was removed from her neck and 911 was called. Nurse noted purple bruising to neck, petechiae to face, and numerous scratches & cuts to upper thighs. Client was transported to the ER via ambulance.
    • Licensing follow-up: Email from facility states client is being transported to an acute facility.

Police Report

Assault

QRTP – Upon officers arrival, staff stated 3 juveniles began causing a disturbance around 0330. J1 destroyed property (TV and monitor), J2 destroyed property (TV and monitor) and attacked staff, and J3 was not charged but did incite J1 & J2. Staff also stated she was struck with a piece of the TV screen, causing minor lacerations to her hand. Deputies detained J3 and arrested the other 2. All 3 were transported by MEMS to Children’s Hospital for mental evaluations.

PRLU or OLTC

Licensing, Notice of Incident, Suicide Attempt

  • Licensing (Suicide Attempt)
    • Client asked staff if she could talk to them, and staff said later. Client then went to the bathroom and sat there until staff asked if she was okay and she didn’t answer. Staff opened the door and client was sitting on the floor with her shirt over her face and a clothing string around her neck. Client was placed in a personal restraint to remove string from neck. Nurse noted a faint line to client’s neck. Client was placed on supportive status in addition to the already present 1:1 status.
    • Licensing follow-up: Client already on eyeball (constant supervision) status. Client was able to calm down without further incident and remains at facility.

PRLU or OLTC

Technical Assistance, Visit Compliance Report

  • Licensing Specialist: Clayton DeBoer.
  • Licensing discussed a concern that was brought to the attention of PRLU with agency staff. Licensing discussed that PRLU holds no position on the re-admittance of a resident after they have been to an acute placement.

PRLU or OLTC

Licensing, Notice of Incident, Self-Injury

  • Licensing (Self-inflicted Injury)
    • Client punched the floor last night and injured her right hand. Nurse noted limited range of movement due to pain and bruising/discoloration to hand. Client was transported to the ER; Recommendations forwarded to physician and treatment orders received.
    • Licensing follow-up: Client taken to emergency care for x-ray.

PRLU or OLTC

Maltreatment, Notice of Incident

  • Dual (Maltreatment)
    • Facility informed Licensing that video was reviewed on 9/6/22 of the evening of 8/24/22 and indicated a staff member pushed a client. The staff member was placed on leave after the video was reviewed but was allowed to return to work and was retrained. The staff member was later placed on leave after the hotline report was accepted for investigation.  
    • Licensing follow-up: Facility visited on 9/28/22 and incident was reviewed with Program Manager. Video review showed staff member push client into a wall inside the seclusion room.

PRLU or OLTC

Licensing, Notice of Incident, Suicide Attempt

  • Licensing (Suicide Attempt)
    • Client became agitated with staff due to being redirected from bullying a peer. Client then wrapped a sleeve around her neck in an attempt to commit suicide. Nurse noted red marks around the front and side of client’s neck. Client reported eyeball precautions aren’t enough for her, and physician ordered 1:1 observation and for staff to stay within 3ft with constant client contact.
    • Licensing follow-up: Client placed on eyeball (constant supervision) and client will remain 3ft from staff at all times.

PRLU or OLTC

Notice of Incident, Self-Injury

  • Licensing (Self-inflicted Injury)
    • Client was angry about having to remain at school and barricaded herself in the restroom. Staff opened the door, and client began hitting her injured/casted leg against the floor and walls of the bathroom.  Client was placed in a restraint and began banging her head against the floor. The restraint ended once client calmed down. Client was transported to the hospital for possible recast/evaluation, as client’s cast was damaged.
    • Licensing follow-up: Client taken by staff to hospital for recast.

PRLU or OLTC

Notice of Incident, Suicide Attempt

  • Licensing (Suicide Attempt)
    • Client felt peer was upset with her and went to her room, then informed staff she had a bandana tied around her neck in an attempt to choke herself. Client was placed in a personal restraint to remove bandana and again for being aggressive with staff. Once calm, client was assessed, and no injury was noted. Client denied continued desire to self-harm and was placed on eyeball.
    • Licensing follow-up: Client placed on eyeball (constant supervision) and remains at facility.

PRLU or OLTC

Accidental Injury, Licensing Follow Up, Notice of Incident

  • Licensing (Accidental Injury)
    • While client was on a recreational outing, client slipped off the monkey bars and landed on her ankle. Client complained of pain and nurse noted swelling to ankle. Client was taken to ER for an x-ray. Client has a follow-up appointment with Orthopedic Clinic in 1 week for a cast.
    • Licensing follow-up: Email sent to facility for x-ray results. Facility provided x-ray results on 9/21/22.

PRLU or OLTC

Complaint, Licensing Follow Up, Notice of Incident

  • Dual (Complaint)
    • Complainant advised of issues at facility with their child: 1) Facility informed guardian that psychological assessment was not completed because insurance didn’t cover it. Guardian followed up with the insurance company, who stated they do cover it. 2) Client was switched between medications due to negative side effects and was later placed back on a medication that client had a negative experience with, without guardian’s knowledge. Due to his behaviors while restabilizing from medications, client is facing time in juvenile detention. 3) Client complained that several staff members were too rough with him during restraints. Guardian reported this to staff, and never received any follow-up regarding the concerns.
    • Licensing follow-up: Facility visited on 9/28/22 and client’s file was reviewed. All restraint documentation was reviewed, and client did not report any rough restraint holds. Client is receiving face-to-face sessions for education that began the week prior. Facility reports their plan is to discharge the client. The client has received testing while at the facility for his mental health. The facility’s policy only requires guardian approval for an “initial dose”. Licensing was made aware of a rough restraint involving client on 8/24/22; Video footage was reviewed, and it was determined that staff pushed client with unnecessary force into the seclusion room, causing client to hit the wall and fall to the ground. The facility was cited for 905.4.g and 109.1.g regarding 8/24/22 seclusion incident. Staff member was placed on administrative leave on 9/28/22.

PRLU or OLTC

Accidental Injury, Licensing, Notice of Incident

  • Licensing (Accidental Injury)
    • Client was playing “Monkey in the Middle” and collided with peer after both started chasing a ball. This caused client to twist and fall on her back. Client couldn’t move to walk and was transported to the ER.
    • Licensing follow-up: Specialist requested update on client. Facility emailed on 9/15/22, stating client returned from the hospital in a wheelchair with no complaints.

Police Report

Citizen Assist

Officers made contact with caller, who stated she brought her son to place him in the facility due to his behavior, and while she was outside of the vehicle looking for admission, he ran off. Caller then stated juvenile was yelling and cussing, resulting in facility staff stating juvenile would not be accepted to stay. Officers located juvenile and he got back into callers vehicle.