In response, DHS dispatched an investigator to Chad - three months later.

According to the investigator's report, just 14 Philadelphia youths were at Chad at that time. All had been restrained - some as many as five times, the investigator found.

In one case, DHS staffer Haiying Xi reported, a youngster had been cut on the chin in a restraint, requiring stitches. Chad had not reported this to regulators, DHS learned.

Finally, DHS official Stephen Rosenberg wrote to Chad.

"The investigation could not determine any pattern for the use of illegal physical restraints," Rosenberg wrote. "However, the investigation did validate the allegations that some residents were being harshly and improperly restrained."

In a reply, Chad administrator McDuffie assured DHS that Chad was a "nurturing and positive environment." He said the facility had hired more staff and made children's safety a priority.

The former owners of Chad also said it was a safe and therapeutic place for children when they handed over the keys to Universal Health in October 2005.

"Our goal was to effect treatment in as nonphysical a way as possible," former chief executive officer Michael G. Lindley said.

Al Smith, another former top executive with Chad's former owner, said: "Did untoward events happen? Absolutely. But was it a culture? I don't believe so."

After Universal Health purchased Chad, regulators continued to flag problems.

In 2006, the state complained again that Chad wasn't reporting serious incidents to regulators. Another boy went to an emergency room for cuts sustained in a restraint. And a mental-health associate quit after she got into an argument with a youth and shoved her, records show.

According to a Tennessee investigation, other youths were injured this year.

On Jan. 2, Tennessee officials disclosed, staff broke the left arm of a 16-year-old boy during a restraint.

Later in the year, Chad told regulators, another teenage resident was "taken to the floor" in a restraint that required four stitches for cuts on the lips.

In May, Edith Ruland pulled her son, Dennis, 10, out of Chad after she found numerous bruises on him, she said.

Ruland, who lives near Chad, took photographs of the bruises, which the boy said staff had inflicted in a restraint hold. Though Tennessee had stopped sending children in state custody, it still permitted families to use it.

"They treat people wrong," Dennis said in an interview. "And they shouldn't be having a facility that would bruise people and stuff."

In response, a spokesman for Chad said Tennessee had investigated and had been "unable to substantiate these complaints."

Rob Johnson, a spokesman for regulators in Tennessee, agreed that investigators couldn't unravel the episode.