discussed a history of substance abuse without documentation of any historical signs of aggression that would support interpretation staff’s that turning a shoulder indicated an intent to assault staff. Yet, when uncertain about a intentions, staff acted as if the student’s student’s motions were in preparation for an assault and erred on the side of escalating to the highest level of physical restraints. Yet another investigation participant experienced a restraint episode when staff observed the young person scratching the own person’s leg, which is not typically an action that could reasonably be viewed as creating a “danger.” Nothing in the initial and quarterly assessments for that student discussed a particular danger associated with scratching. Instead, the assessments for this student repeated listed presenting “current as being aggressive towards not self. others, issues” The assessments documented self-reports that the student had disclosed a history of engaging in self-harm, and at least one of the assessments stated that this student had been placed on close observations for expressing thoughts of self-harm while at the facility. But, the treatment plans had no descriptions of the signs of student’s self-harm or the types of self-harm that individual would be likely to attempt. Nor was there any information on the ESI form or other records about strategies other than the of intervention for “7 levels” or de-escalating when staff were concerned about possible self-harm. In a later interview, this person identified a handful of staff who were very skilled in helping to de-escalate without their “using but stated that other staff would go so far as to taunt with hands,” sarcastic questions such as, you just go and cut “why don’t yourself?” Finally, some ESI forms completely failed to document any actions that would indicate imminent or immediate as required by “an danger” Clarinda policy as well as Iowa and Washington regulations. Records documented episodes that escalated into a restraint after the student pushed through staff in an attempt to walk away from an with no logical explanation of any ongoing threat or risk “intervention,” of harm. __________________________________________________________________
discussed a history of substance abuse without documentation of any historical signs of aggression that would support staff’s interpretation that turning a shoulder indicated an intent to assault staff. Yet, when uncertain about a student’s intentions, staff acted as if the student’s motions were in preparation for an assault and erred on the side of escalating to the highest level of physical restraints. Yet another investigation participant experienced a restraint episode when staff observed the young person scratching the person’s own leg, which is not typically an action that could reasonably be viewed as creating a “danger.” Nothing in the initial and quarterly assessments for that student discussed a particular danger associated with scratching. Instead, the assessments for this student repeated listed “current presenting issues” as being aggressive towards others, not self. The assessments documented self-reports that the student had disclosed a history of engaging in self-harm, and at least one of the assessments stated that this student had been placed on close observations for expressing thoughts of self-harm while at the facility. But, the treatment plans had no descriptions of the student’s signs of self-harm or the types of self-harm that individual would be likely to attempt. Nor was there any information on the ESI form or other records about strategies other than the “7 levels” of intervention for or de-escalating when staff were concerned about possible self-harm. In a later interview, this person identified a handful of staff who were very skilled in helping to de-escalate without “using their hands,” but stated that other staff would go so far as to taunt with sarcastic questions such as, “why don’t you just go and cut yourself?” Finally, some ESI forms completely failed to document any actions that would indicate “an imminent or immediate danger” as required by Clarinda policy as well as Iowa and Washington regulations. Records documented episodes that escalated into a restraint after the student pushed through staff in an attempt to walk away from an “intervention,” with no logical explanation of any ongoing threat or risk of harm. __________________________________________________________________