Pros
Nothing good about the employer
Cons
The facility contained exposed wires, nails, and broken glass that were not properly repaired. These hazards created a risk of injury for staff and clients. Staff members were regularly injured by aggressive client behavior, with no effective safety protocols or environmental modifications. The environment was frequently unsanitary. Children regularly defecated, urinated, or vomited on the carpeting, which was only spot-cleaned rather than thoroughly cleaned. The carpet was never deep-cleaned despite children routinely sitting or lying on it. Surfaces were not sanitized regularly, and basic hygiene standards were not consistently adhered to. Clients were frequently overstimulated due to constant noise, bright lights, loud music, and children of all age groups being placed together in shared spaces. These environmental factors regularly contributed to behavioral escalations and made it difficult to maintain a calm and focused learning environment. Some children displayed severe aggression and violence toward staff and other children, including hitting, biting, and kicking. Older youth assaulted younger children. Children sometimes engaged in unsafe behaviors, such as taking items from other children, creating safety and hygiene concerns. Staff were instructed to remain within arm’s length of assigned clients at all times. If an incident occurred, staff were held responsible rather than the behavior being addressed at an environmental or systemic level. Some clients’ needs were too severe for the facility, and they did not receive the level of specialized care required. When clients became overstimulated or engaged in aggressive behavior, staff were told they “did not have instructional control” of their client. This placed responsibility on the techs rather than addressing environmental and structural factors contributing to behaviors. Despite being advertised as ABA therapy, sessions often functioned as unstructured babysitting. Many clients did not receive consistent, evidence-based ABA programs. Sessions primarily consisted of keeping children occupied rather than implementing planned therapeutic interventions. Toys and materials were broken or missing essential parts, making it difficult to run planned programs effectively. Basic supplies such as crayons and markers were often unavailable, contributing to disorganized and ineffective sessions. Client medications were not kept sealed or locked. Staff without medical training administered medications, which were sometimes stored in backpacks in rooms or in open office drawers. There were no consistent protocols for safe handling or administration. The children (clients) showed signs of neglect and required more specialized care than the facility could provide. Sick children were sometimes allowed to remain in the facility rather than being sent home, because client attendance directly affected billable hours. Staff were sometimes instructed to escalate behaviors to create incidents for documentation, which were then billed to insurance. Clients who made progress were sometimes reassigned to new staff, which induced behavioral regression and prolonged stress on the children. The reason for the reassignment was so that clients would act out with a new person and that would create incidents that were used to continue billing. As in, the clients could not make real progress because the insurance might cut the billable hours for the clients. Staff were instructed to arrive at work by 8:50 a.m., but shifts did not go “on the clock” until 9:00 a.m. or until the client arrived. If the client arrived late, pay was retroactively adjusted to $10 per hour. This system, tied to client billing, frequently resulted in reduced pay for factors outside staff control. The business model focused on maintaining billable hours. Decisions were often influenced by revenue rather than clinical needs, including allowing sick children to attend and creating scenarios that generated additional documentation for billing purposes. Staff had a base hourly rate, but if clients did not attend sessions, pay dropped to $10 per hour. Staffing levels were inconsistent — at times chronically understaffed, and at other times overstaffed with little productive work available. Overstaffed shifts often resulted in demotion to a lower pay rate for idle hours. Pay could also be adjusted if notes were not submitted on time or if staff arrived late, even when delays were caused by traffic or limited parking. There was no holiday pay, no overtime pay, and no guaranteed breaks. Hours were sometimes reduced without notice. Some employees smoked marijuana during breaks and returned to work smelling of it while working directly with children. Management was aware of these incidents but did not implement formal procedures to address them. Leadership frequently changed policies and job titles without clear explanation, creating instability and confusion. Staff turnover was high, and departing employees often expressed frustration with the working environment. There was a lack of consistent procedures or guidance for staff, contributing to operational chaos. The staffing model created ongoing instability in client care. Children were frequently shifted between different behavioral techs and BCBAs, disrupting progress and creating inconsistent treatment. Staff often worked entire shifts without breaks in high-stress, disorganized conditions. Additional locations were opened despite unresolved systemic and safety issues at the main facility, raising concerns about replicating these problems elsewhere. Parents should be aware of safety concerns, sanitation issues, high turnover, and inconsistent care before enrolling their child. Prospective employees should understand that Triangle ABA has unsafe conditions, unstable leadership, a billing-driven system, and limited support for staff.