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MALTREATMENT INVESTIGATION MEMORANDUM Minnesota Statutes, section 260E.01, paragraph (a), “The legislature hereby declares that the public policy of this state is to protect children whose health or welfare may be jeopardized through maltreatment.”
License Number and Program Type: 801274-CCC (Child Care Center) Investigator(s): Lindsay Arth Suspected Maltreatment Reported: It was reported that a staff person (SP) grabbed an alleged victim (AV) by the arm. The AV had “red marks,” bruises, and fingernail “imprints” on his/her arm. Date of Incident(s): March 17, 2022 Nature of Alleged Maltreatment Pursuant to Minnesota Statutes, section 260E.03, subdivision 15, paragraph (a), clause (1); subdivision 18, paragraph (a); and subdivision 23, paragraph (a): Failure by a person responsible for a child's care to supply a child with necessary food, clothing, shelter, health, medical, or other care required for the child's physical or mental health when reasonably able to do so. "Physical abuse" means any physical injury, mental injury, or threatened injury, inflicted by a person responsible for the child's care on a child other than by accidental means. "Threatened injury" means a statement, overt act, condition, or status that represents a substantial risk of physical or sexual abuse or mental injury. Summary of Findings: Pertinent information was obtained during a site visit conducted on April 21, 2022; from documentation at the facility and law enforcement records; and through four interviews conducted with two facility staff persons (P1 and P3), a supervisory staff person (P2), and the AV’s family member (FM). Attempts were made by phone and U.S. mail to contact and interview a staff person (SP) but the attempts were unsuccessful. Additionally, after speaking to the FM, attempts were made to set up a time to meet and interview the AV but the FM did not respond to this investigator’s attempts. The AV was almost five years old at the time of the incident and enrolled in the pre-K classroom. The Child Supervision Record showed that on March 17, 2022, at 4:45 p.m., the preschool and Pre-K classrooms were combined and there were 18 children present with the SP and P1. The FM and the City of Maplewood Police Department report provided the following information: · On March 18, 2022, the FM told a law enforcement officer (LEO) that on March 17, 2022, at approximately 5:20 p.m., the FM picked the AV up from the facility. When the FM picked the AV up, the AV told the FM that the SP grabbed him/her by the arm which “hurt” and made the AV cry. The FM saw red marks, bruises, and “fingernail imprints” on the AV’s upper right arm (Note: Photos the FM sent this investigator showed that the marks were on the AV’s left arm. The AV had approximately five red marks, including some with indents, on his/her upper left arm. It was difficult to tell in the photos if there was any bruising). The FM said that it looked like “someone grabbed [the AV] by [his/her] arm so hard.” The FM then told P2 about the incident. · The AV did not require any medical attention. However, the AV no longer liked going to daycare and needed “therapy.” · The FM also had similar concerns with the SP and the FM’s other child (C). This included that at some point when the FM was picking up the AV and the C, s/he saw the SP through the classroom window pulling the C by his/her arms. The FM told a prior supervisory staff person (P4) who said that s/he showed the SP the “proper way” to grab a child. However, the FM later saw the SP do the same thing a second time with the C. The FM did not see any injuries, including marks or bruises, on the C. · The SP had worked with the AV and the C since they were “babies.” The AV and the C “really liked” the SP so the FM “did not know what happened.” · The FM noticed changes in the AV’s and the C’s behaviors starting approximately two months prior to the incident. This included that the AV and the C would cry when the FM brought them to the facility. When this investigator asked the FM if anything had changed around that time, the FM said that one of the AV’s main teachers and P4 stopped working at the facility at that time. · On March 28, 2022, the LEO went to the facility to speak with P1 who was in the classroom with the SP at the time of the incident. P1 said that on March 17, 2022, the AV had been climbing on furniture which was “unsafe” so the SP told the AV not to do so. The AV told the SP, “No,” and then continued to climb. P1 then saw the SP grab the AV by the arm to “pull” the AV down. · P1 said that the AV had been having “behavioral issues” since mid-February 2022, and recently the facility had implemented a behavior plan (Note: All other information showed that the facility was documenting the AV’s behaviors but had not yet implemented a behavior plan). This included that the AV “always” climbed on furniture and had to be taken off it for “safety precautions.” The AV “commonly” did not listen to staff person’s directions. The AV had also been physically aggressive with P1 “several times, including kicking, biting, and hitting P1. Additionally, on March 21, 2022, P1 rubbed the AV’s back to assist the AV during nap. The AV became “angry” because s/he did not want to sleep and “elbowed” P1 in the face which caused P1 to have a bloody nose. · On March 29, 2022, the LEO spoke to the SP. The SP said that s/he did not normally work in the AV’s classroom. However, in the evenings, the SP’s and P1’s classroom (where the AV was enrolled) combined. On March 17, 2022, the SP was “encouraging” the children to pick up their toys before having a snack but the AV did not want to clean up. The SP then grabbed the AV’s arm, “not hard,” to help “move” the AV and then the SP “accidently” scratched the AV at that time. The AV began crying and showed the SP the “marks.” The SP said that his/her nails were “really hard” and “long” at the time of the incident. The LEO asked the SP if s/he was trying to pull the AV off furniture at that time and the SP said, “No,” and that s/he had “never pulled” the AV off furniture. · The law enforcement report was sent to the county attorney for review of charges. The country attorney chose not to charge the SP or “prosecute.”
P1 provided the following information: · P1 began working with the AV in February 2022. A couple of weeks after P1 began working with the AV, the AV began displaying behaviors, “specifically with [P1] or around [P1].” This included that the AV hit P1 “so hard” that P1’s nose bled and bit P1 “so hard” that it “left marks.” P1 notified the FM of these behaviors and the FM said that the AV did not display similar behaviors at home. The FM thought that the AV displayed these behaviors because P1 was “newer” and the AV was “testing” him/her. Staff persons documented the AV’s behaviors and were “working on” creating a behavior plan for the AV. · At some point on an unknown date in March 2022, between 4:45 and 4:50 p.m., P1’s and the SP’s classroom were combined in the preschool classroom. The children were supposed to be cleaning to get ready for 5 p.m. snack. The SP asked the children, including the AV, to begin cleaning and the AV said, “No.” The AV started climbing on a shelf and the SP told the AV, “We don’t climb on shelves.” The SP then “grabbed” the AV by his/her left arm, near the AV’s armpit, and lifted the AV to “get [the AV] to safety.” P1 “thought” that the SP lifted the AV by one arm. The SP’s tone was “definitely frustrated” but P1 did not think that the AV could have gotten hurt due to the SP’s interactions. P1 did not have any concerns with the SP’s interactions and thought that the AV needed to get down for safety because otherwise the AV could “jump” and potentially hurt him/herself. · The AV had been crying before the SP “grabbed” the AV because the AV did not want to get off the shelf. It was normal for the AV to “cry and scream,” including times when the AV did not want to “listen.” · Around 5 p.m., the SP left the classroom to get the snack and the AV told P1 that his/her “arm hurt.” P1 looked at the AV’s left arm near the AV’s armpit and saw “two little [red] claw marks.” It “looked like someone scratched [the AV].” The scratch marks were near where the SP grabbed the AV to lift the AV off the shelf. There was no blood and P1 did not see any bruising (including on the day following the incident). P1 asked the AV what happened and the AV said that the SP “did it.” Approximately 10 minutes later, P1 again asked the AV what happened and the AV said that a “friend did it.” · Staff persons were trained to not lift children by their wrist or elbows. Staff persons typically lifted children underneath their armpits. However, P1 said that if staff persons did that with the AV, the AV would often “hit” or bite staff persons. At the time of the incident, P1 said that s/he would have lifted the AV by the waist to “gently” get the AV off the shelf. · When this investigator asked P1 if there were other ways the AV could have sustained the injury, P1 said that the AV “fights with a lot of the other children,” including the C, so could have sustained the marks that way. · P1 did not have any concerns with the SP’s interactions with children, including at the time of the incident. If P1 had concerns, s/he would have “stepped in and reported.” P2 and the Incident Reported to Center provided the following information: · On March 17, 2022, around 5:30 p.m., the FM picked up the AV and the C from the facility. As they were leaving, the FM told P2 that the AV had scratches on his/her “right” arm and that the AV told the FM that the SP scratched him/her. The FM pointed to the AV’s right arm and P2 saw some “scratches and bruising [Note: Although the Incident Reported to Center said that P2 observed bruising, P2 told this investigator that s/he did not see bruising].” P2 described the scratch as a “small line” on the back of the AV’s upper right arm that was “red” or “brown.” P2 did not think that the injury had just occurred because the scratch mark was not “bright red.” However, it was also not “scabbed over.” · The FM then asked the AV what happened and the AV said that the SP “scratched [him/her] on the arm.” [Note: Although the Incident Reported to Center said that P2 heard the AV say that the SP scratched him/her, P2 told this investigator that s/he did not hear the AV say that the SP scratched him/her] The FM asked the AV, “Are you sure that’s what happened?” and the AV said, “It was a toy.” The FM then asked the AV, “How did a toy scratch you on the arm?” The AV said that s/he and a friend were picking up toys and that the AV “had a toy and a friend had a toy” and that s/he “did not know.” P2 said that it was a “really scattered” conversation. · The FM also told P2 that this was not the “first incident that [s/he] had seen.” The FM said that at some point, s/he saw the SP pulling the C’s arm on two occasions through the classroom window. · The FM then left the facility and told P2, “I am concerned about what happened. I just want to know what is happening to my babies.” · The following morning, P2 spoke to P1 about the incident. P1 said that on the date of the incident, around 4:50 p.m., the SP and P1 began having the children clean up to get ready for snack. P1 heard the SP ask the AV to clean up but saw that the AV “was choosing” not to clean up. P1 heard the AV say to the SP multiple times, “No.” P1 then saw the SP “grab” the AV by the arm to have the AV help clean up. Around 5 p.m., the AV told P1 that his/her “arm hurts.” P1 looked at the AV’s arm and saw some “little scratches.” The children then ate snack and after snack, P1 heard the SP ask the AV, “Why does your arm hurt?” The AV told the SP that it was a “toy.” P1’s shift then ended around 5:20 p.m. · At some point, P4 and a supervisory staff person (P5) spoke to the AV about the incident. P4 told the AV that s/he “heard” the AV had an “owie.” The AV said that s/he did and then pointed to his/her right knee. The AV said that s/he was “climbing the window and slipped off.” P4 then asked the AV if s/he had any other “owies” and the AV said yes and pointed to his/her left arm. P4 and P5 observed “two major scratches” similar to “fingernail marks and a bruise.” The AV said that the SP “did it.” · The AV attended the facility since s/he was an infant and the FM had not brought up similar concerns prior. The FM had always “loved” the SP and had no other concerns. · The AV had had a “lot” of behaviors, including hitting other children, throwing toys, and climbing on things. The AV attended another school program and had similar behaviors there. The facility was working on implementing a behavior plan for the AV. P2 did not know if the SP was trying to stop the AV from displaying behaviors at the time of the incident. When the AV displayed behaviors, staff persons would try to talk to the AV and if that did not work, they would redirect the AV to another activity. If the AV was climbing on something, staff persons would “pick” the AV up and get the AV off the furniture. P2 said that it “scared” him/her when children climbed on things because it was “dangerous.”
· P2 had no concerns with the SP and said that the SP was “great.” The SP would “get on the floor” and play with children. The children, staff persons, and parents “loved” the SP. If a child was crying, the SP was “very good” at “soothing” and “calming” the child. P2 had never seen the SP grab a child and the SP had never “rough handled” a child or had “negative speech.” P2 had only seen the SP pick up a child under their arms to keep them safe. · P2 thought that the AV sustained the injuries from another child or the C. Additionally, the AV and the C were together at the end of the night and P2 had seen the AV and the C scratch one another on prior occasions.
· The SP told P2 that on the date of the incident, around 4:15 or 4:30 p.m., the children were playing and then began getting ready for snack. The SP said that the AV and another child were climbing on furniture. (Note: The SP did not mention anything to P2 regarding assisting the AV off the furniture.) Then they began cleaning up for snack and the AV “refused” to clean up so the SP “grabbed” the AV to “help” the AV pick up toys. After snack, the AV told the SP that his/her arm hurt. The SP saw that the AV’s arm was red but did not think that s/he “scratched” the AV. P3 provided the following information: · P3 was not at the facility at the time of the incident. However, on March 18, 2022, P3 saw that the AV had “two little [red] scratch marks” on the back of his/her arm. The marks looked like fingernail marks. They marks were “pretty small” so P3 did not know if they could have been caused by the SP or a child or something else. P3 “would not have been surprised” if the C or another child caused the marks. P3 did not recall which arm the marks were on. P3 never saw bruises. · If the AV were climbing on furniture, staff persons would assist the AV down so that the AV did not hurt him/herself. · P3 worked with the SP for approximately three months. P3 did not have any concerns with the SP’s interactions with children. P3 was “surprised” when s/he heard the concerns and did not think that the SP would “intentionally” hurt a child. The SP was typically “good” with the children and was not “mean or rough.” At times, P3 had seen the SP be “frustrated” but said that “all” staff persons would get frustrated from time to time. When the SP was frustrated, s/he would “raise” his/her voice but P3 had never seen the SP touch a child inappropriately, including grabbing them by the arm. The Behavior Guidance Policy said that staff persons were to model and reinforce appropriate behavior. Staff persons were to redirect children and provide verbal interventions if children displayed “inappropriate” behaviors. The Employee Handbook and the Policy on Corporal Punishment said that staff persons were not to grab, rough handle, shake, slap, kick, hit, or spank a child. Personnel files from the facility showed that the SP, P1, P2, P3, P4, and P5 each received training on the Reporting of Maltreatment of Minors Act prior to the incident. Additionally, the SP, P1, P2, P3, P4, and P5 were trained on facility policies and procedures, including the behavior guidance policy and the policy on corporal punishment. Relevant Rules and/or Statutes: Minnesota Rules, part 9503.0055, subpart 3, item A, states that the license holder must have and enforce a policy that prohibits the subjection of a child to corporal punishment. Corporal punishment includes, but is not limited to, rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting, pinching, hitting, and spanking. Conclusion: A. Maltreatment On March 17, 2022, around 5:20 p.m., the FM picked the AV up and the AV told the FM that the SP grabbed him/her by the arm. The AV said that it “hurt.” The FM observed red marks, bruises, and “fingernail imprints.” Although the law enforcement report and P2 said that this occurred on the AV’s upper right arm, P1 and photos the FM sent this investigator showed that the injuries were on the AV’s left arm. Additionally, although the FM, P4, and P5 said that they saw bruises, it was difficult to tell in the photos if the AV had any bruising and P1 and P3 said that they did not see bruising. The AV did not require any medical attention. The FM had also seen the SP grab the C by the arm on two occasions. However, there were no injuries to the C as a result. P1 worked with the AV and the SP at the time of the incident. P1 initially told P2 that P1 heard the SP ask the AV to clean up but saw that the AV “was choosing” not to clean up. P1 heard the AV say to the SP multiple times, “No.” P1 then saw the SP “grab” the AV by the arm to have the AV help clean up. Around 5 p.m., the AV told P1 that his/her “arm hurts.” P1 looked at the AV’s arm and saw some “little scratches.” Then P1 told this investigator and law enforcement that the incident occurred when the AV had been climbing on furniture and the SP told the AV not to do so. The AV told the SP, “No,” and continued to climb. The SP then grabbed the AV by the arm to “pull” the AV down. P1 “thought” that the SP grabbed the AV by one arm. The SP’s tone was “definitely frustrated” but P1 did not have any concerns with the SP’s interactions and thought that the AV needed to get down for safety because otherwise the AV could “jump” and potentially hurt him/herself. The AV then told P1 that his/her arm hurt and P1 saw “two little [red] claw marks” near where the SP grabbed the AV. The AV said that the SP caused the marks but later said that a “friend” caused them. Although the AV told the FM that s/he cried as a result of the SP’s interactions, P1 said that the AV had been crying “before” the SP “grabbed” the AV because the AV did not want to get off the shelf. P1, P2, and P3 did not have any concerns with the SP’s interactions with children. P2 and P3 had never seen the SP grab a child. The SP did not respond to this investigators attempt for an interview, but the SP told law enforcement and P2 that on the date of the incident, the SP was “encouraging” the children to pick up their toys before having a snack but the AV did not want to clean up. The SP then grabbed the AV’s arm, “not hard,” to help “move” the AV and the SP “accidently” scratched the AV. The AV began crying and showed the SP the “marks.” The SP denied pulling the AV off furniture. However, the SP also told P2 that on the date of the incident, the SP said that the AV and another child were climbing on furniture but did not mention anything to P2 regarding assisting the AV off the furniture. In the Incident Reported to Center, the SP said that s/he “grabbed” the AV to have the AV help pick up toys. The SP did not think that s/he scratched the AV but said that the AV’s arm was red. Given that P1 and the SP each provided information regarding two incidents, it was more likely that the SP intervened with the AV twice on the date of the incident. One involved the AV climbing on furniture which required intervention to get the AV off for safety. The other involved the AV choosing not to clean up which did not need physical intervention. P1 told P2 that after the cleaning incident the AV had “little scratches” and P1 told this investigator and the LEO that after the shelf incident the AV had “claw marks.” The SP told law enforcement and P2 that after the cleaning incident the AV had “marks.” The SP’s actions of grabbing or pulling the AV by the arm, hard enough to cause red marks, fingernail “imprints,” and possibly bruising on the AV, were inconsistent with the standards of a professional caregiver in a facility licensed by the Department of Human Services; was a violation of Minnesota Rules 9503.0055, subpart 3, item A; and a violation of the facility’s Behavior Guidance Policy, the Employee Handbook, and the Policy on Corporal Punishment. Given that the SP engaged in interactions with the AV including grabbing or pulling the AV by his/her arm and that the AV sustained a red mark, “claw marks,” scratches, and/or bruising by the SP’s actions of grabbing or pulling the AV’s arm which was not accidental, there was a preponderance of evidence that the SP’s interactions with the AV were not accidental; caused injury to the AV and represented a substantial risk of physical or mental injury or threatened injury; and failed to supply the AV with necessary care. It was determined that physical abuse and neglect occurred ("physical abuse" means any physical injury, mental injury, or threatened injury, inflicted by a person responsible for the child's care on a child other than by accidental means. "Threatened injury" means a statement, overt act, condition, or status that represents a substantial risk of physical or sexual abuse or mental injury. Failure by a person responsible for a child's care to supply a child with necessary food, clothing, shelter, health, medical, or other care required for the child's physical or mental health when reasonably able to do so. ). B. Responsibility pursuant to Minnesota Statutes, section 260E.30, subdivision 4, paragraph (a), clauses (1) and (2): When determining whether the facility or individual is the responsible party, or whether both the facility and the individual are responsible for determined maltreatment in a facility, the investigating agency shall consider at least the following mitigating factors: (1) whether the actions of the facility or the individual caregivers were according to, and followed the terms of, an erroneous physician order, prescription, individual care plan, or directive; however, this is not a mitigating factor when the facility or caregiver was responsible for the issuance of the erroneous order, prescription, individual care plan, or directive or knew or should have known of the errors and took no reasonable measures to correct the defect before administering care; (2) comparative responsibility between the facility, other caregivers, and requirements placed upon an employee, including the facility’s compliance with related regulatory standards and the adequacy of facility policies and procedures, facility training, an individual’s participation in the training, the caregiver’s supervision, and facility staffing levels and the scope of the individual employee’s authority and discretion; and (3) whether the facility or individual followed professional standards in exercising professional judgment. Facility documentation showed that the SP received training on the Reporting of Maltreatment of Minors Act and on the facility’s policies and procedures, including behavior guidance and policy on corporal punishment, prior to the incident. The SP was responsible for maltreatment of the AV. C. Recurring and/or Serious Maltreatment: The Office of Inspector General is required to evaluate whether substantiated maltreatment by an individual meets the statutory criteria to be determined as “recurring or serious.” Individuals determined to be responsible for recurring or serious maltreatment are disqualified from providing direct contact services. Minnesota Statutes, section 245C.02, subdivision 16, states: “Recurring maltreatment” means more than one incident of maltreatment for which there is a preponderance of evidence that maltreatment occurred and that the subject was responsible for the maltreatment. Minnesota Statutes, section 245C.02, subdivision 18, states: "Serious maltreatment" means sexual abuse, maltreatment resulting in death, neglect resulting in serious injury which reasonably requires the care of a physician whether or not the care of a physician was sought, or abuse resulting in serious injury. For purposes of this definition, "care of a physician" is treatment received or ordered by a physician, physician assistant, or nurse practitioner, but does not include diagnostic testing, assessment, or observation; the application of, recommendation to use, or prescription solely for a remedy that is available over the counter without a prescription; or a prescription solely for a topical antibiotic to treat burns when there is no follow-up appointment. For purposes of this definition, "abuse resulting in serious injury" means: bruises, bites, skin laceration, or tissue damage; fractures; dislocations; evidence of internal injuries; head injuries with loss of consciousness; extensive second-degree or third-degree burns and other burns for which complications are present; extensive second-degree or third-degree frostbite and other frostbite for which complications are present; irreversible mobility or avulsion of teeth; injuries to the eyes; ingestion of foreign substances and objects that are harmful; near drowning; and heat exhaustion or sunstroke. Serious maltreatment includes neglect when it results in criminal sexual conduct against a child or vulnerable adult. It was determined that the substantiated physical abuse and neglect for which the SP was responsible was not recurring because it was a single incident that met two definitions. However, it was serious maltreatment because while the AV did not require the care of a physician, the AV sustained tissue damage which included red marks, fingernail “imprints,” and possibly bruising on the AV’s arm. The SP was disqualified from providing direct contact services. Pursuant to Minnesota Statutes, section 260E.35, subdivision 6, paragraph (c) all investigative data maintained in this report will be kept by the Department of Human Services for at least ten years after the date of the final entry in the report. Action Taken by Facility: The facility completed an internal review and determined that policies and procedures were adequate and followed. The incident was not similar to prior incidents. The SP no longer worked at the facility. Action Taken by Department of Human Services, Office of Inspector General: The SP was disqualified from a position allowing direct contact with, or access to, persons receiving services from programs, organizations, and/or agencies that are required to have individuals complete a background study by the Department of Human Services as listed in Minnesota Statutes, section 245C.03. The determination that the SP was responsible for maltreatment and the disqualification of the SP are each subject to appeal. On June 15, 2022, the facility was issued a Correction Order for the violations outlined in this report. Certification: The information collection procedures followed in this investigation were pursuant to Minnesota Statutes, section 260E.30, subdivision 6, paragraph (c). All individuals that are subjects of data in this investigation have the right to obtain private data on themselves which was collected, created, or maintained by the Department of Human Services.
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