Daily fights that staff allegedly fail to stop. Teenagers with large, open self-harm wounds. Two riots that ended with arrests and hospitalizations.

Those are examples of the “shocking” conditions Utah’s Disability Law Center says its employees discovered after four days of visits to Provo Canyon School’s Springville and Provo campuses.

The watchdog group is now calling on state regulators to consider stronger intervention for the embattled teen treatment center — including shutting it down.

In a letter to state licensing officials, the nonprofit wrote that children described feeling unsafe in a chronically understaffed facility where violence, self-harm and inadequate medical care had become routine.

Provo Canyon School’s boys program has been under fire in recent weeks after a 13-year-old boy was seriously injured in a fight, and state regulators say staff didn’t call 911 or seek immediate medical care. Since then, a chorus of voices has demanded the program’s closure — including celebrity Paris Hilton, who went to Provo Canyon School in the 1990s and alleges she was abused there, and state Sen. Jen Plumb, who, as a physician, initially treated the 13-year-old boy.

After he was hurt, Utah’s Department of Health and Human Services put strict restrictions on the Provo program, which were expected to be lifted last week. But state officials announced an extension Friday with even stricter conditions.

That includes that every teen or parent’s safety concerns must be reported to regulators, and Provo Canyon School must revise its emergency policies to “permit and encourage staff to call 911” when someone’s safety is at risk.

The program still can’t take in new clients. It was also required to post the state’s Notice of Agency Action on its website and notify current clients’ parents and guardians about it.

But the Disability Law Center said those new restrictions don’t get at the root of the problem, which they assert stems from the program’s high employee turnover and too-small staff made up of largely unqualified workers.

Provo Canyon School’s girl’s program, which is in Springville, has a separate license and is not affected by the state’s latest action. But the Disability Law Center said its observers saw similar and disturbing conditions at both locations.

“DLC staff documented an abnormally high level of danger at the Springville and Provo locations,” the letter reads, “and the state must take immediate action to protect the children residing in their care.”

Teens describe violence and neglect

The Disability Law Center is Utah’s protection and advocacy agency, a federal designation that allows the nonprofit to visit facilities like Provo Canyon School to monitor conditions.

Its four days of visits happened in May and June, according to the nonprofit’s letter to the state.

The watchdog group alleges in its letter that Provo Canyon School staff didn’t appear trained in de-escalation techniques. The letter states some yell at the teenagers when their behavior escalates or don’t intervene until a physical fight breaks out.

Before the 13-year-old boy was hurt, other teenagers who saw the fight told Disability Law Center workers they saw one kid antagonize the other for several hours, and that it was “evident the situation was becoming unsafe.” Staff didn’t intervene, the teens reported, until fighting started.

When there are fights, according to the teens, staff are more likely to use restraints. “A child at the Springville campus reported difficulty breathing,” the letter reads, “after she was put in a restraint on the ground with her arms stretched above her head while staff physically sat on her legs.”

A lack of staff has also led to long restroom wait times, since restroom use is supposed to be supervised, the Disability Law Center alleged. One child reported they were forced to urinate in a cup in front of other teens after staff refused to let them use the restroom for hours, the letter states.

The issue has also led to children being unable to shower, the letter alleges.

“One child shared that she had not been able to shower or change her clothing for 3 days,” the Disability Law Center wrote. “She specifically asked DLC if we could help her gain access to clean underwear.”

State scrutiny intensifies

The nonprofit urged state leaders to take swift and strong action against Provo Canyon School, suggesting either a court-appointed takeover of the facility’s operations or a shutdown of the program.

DHHS spokesperson Josh Loftin confirmed Monday that the state received the Disability Law Center’s letter. He said the agency takes “seriously any concerns and complaints reported to the agency, regardless of the source.”

When the Division of Licensing and Background Checks announced Friday that it would continue its restrictions on the Provo campus, its director, Shannon Thoman-Black said: “No child should ever be harmed in programs meant to protect them.”

“Our role,” she continued, “is to hold providers to the highest standards of safety, and we will use every regulatory tool available to ensure vulnerable youth are protected.”

Provo Canyon School is owned by Universal Health Services. Provo Canyon CEO Tim Marshall did not respond to a request for comment on Monday. In a previous statement to The Salt Lake Tribune, Marshall said: “Provo Canyon School maintains comprehensive safety procedures and ongoing monitoring practices designed to protect and support our residents.”

He declined to speak specifically about the 13-year-old boy’s medical care, citing medical privacy laws.

The boy’s mother, Aleah Corona, filed a lawsuit against the treatment program last week. The Montana woman told The Tribune that her son had said during therapy sessions in the weeks prior to the fight that he was scared for his safety. She alleged Provo Canyon staff dismissed his concerns and told her he was trying to manipulate her so he could go home.

Corona said she sent her son, who was struggling with ADHD and depression, to Provo Canyon School at the advice of his probation officer. There were no similar programs in Montana with bed space, she said.

Montana state officials have since suspended referrals to Provo Canyon School after Corona’s son was hurt.

Utah has long been the epicenter of the so-called “troubled teen” industry, and most of the young people who come to these programs for treatment are from out-of-state. Some parents pay, while other teenagers’ stays are funded through Medicaid, state adoption assistance programs, foster care agencies or their state’s juvenile justice system.

Provo Canyon School is one of Utah’s oldest troubled teen programs — and it has long faced allegations about its treatment of young people.

Just a few years after it opened in the 1970s as a boys school, the American Civil Liberties Union of Utah sued over its practice of using lie detector tests on boys and pulling students’ hair to get them under control, called a “hair dance.”

The school defeated the lawsuit; allegations of abusive tactics have continued in the years since.