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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: 1049204-CCC (Child Care Center) Investigator(s): Tessa Ripka Suspected Maltreatment Reported: It was reported that a staff person (SP) bit an alleged victim (AV) leaving a mark on the AV’s arm. Date of Incident(s): June 3, 2022 Nature of Alleged Maltreatment Pursuant to Minnesota Statutes, section 260E.03, subdivision 18, paragraph (a), and subdivision 23, paragraph (a): "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 December 12, 2022; from documentation at the facility; and through four interviews conducted with three facility staff persons (SP, P1, P3), and the AV’s family member (FM). This investigator spoke with the AV but s/he was not able to provide any information about the incident. Another facility staff person (P2) did not respond to this investigators requests for an interview. The AV was two years old at the time of the incident and enrolled in the Twos Classroom at the facility. The Incident/Accident Report for Parent/Guardian stated that on June 3, 2022, the SP went into the AV’s classroom to put away a jacket and received a hug from the AV. The AV bit the SP on his/her leg and the SP then bit the AV’s arm. There was a red mark near the AV’s elbow on his/her right arm. The FM said the facility contacted him/her on the date of the incident and explained what had happened. The AV had a bruised mark on his/her forearm that was a quarter to half inch long. When the FM asked the AV what happened to his/her arm, the AV said “[The SP] bit me.” The Incident Investigation Summary & Checklist, P1, and P3 provided the following information: · On the date of the incident, P1 and P2 worked in the Twos classroom with the AV. The SP came into the classroom to say hello to the children and it looked like s/he crouched down to hug the AV. P1 looked away and then heard the SP say, “Oh my gosh, I shouldn’t have done that.” · The SP then showed P1 that s/he had been bit by the AV on the upper thigh as there was a wet area on the SP’s pants. The SP said s/he bit the AV back. The AV had a quarter to fifty cent sized mark on the top of his/her forearm that turned darker as the day went on. The SP then went to tell a supervisor what had occurred. The AV was crying, so P1 comforted the AV and gave the AV an ice pack. · On the date of the incident, sometime after breakfast, the SP came up to P3 and said that s/he was embarrassed but s/he bit a child. The SP said s/he went to hang up a jacket in the AV’s classroom. The AV came running up to the SP, hugged the SP’s legs, and bit the SP on the thigh. The SP said “ouch that hurts” and then grabbed and bit the AV’s arm. · The SP said s/he might have bit the AV harder than s/he should have. The SP apologized and then P3 and the SP called the FM and explained what had happened. The SP felt “very bad.” The AV had a bruise on his/her arm that was discolored but not a “deep bruise.” · P3 stated that on another occasion, the SP had accidentally scratched a child while trying to grab something. P3 had no other previous concerns with the SP. P1 had no previous concerns with the SP. The SP provide the following information: · On the day of the incident, the SP went into the AV’s classroom to return a jacket that was left in the SP’s classroom. The AV called the SP’s name and the AV came over to give the SP a hug. · The AV bit the SP in the leg and the SP said, “Ouch. That hurts.” The AV started to laugh and the SP got down and put his/her mouth on the AV’s arm. When the SP “pulled away,” there was saliva on the AV’s arm. The SP took the AV over to the sink and washed the AV’s arm and talked with the AV about biting and why the AV should not bite. There was no mark on the AV’s arm and no break in his/her skin. · The SP left the classroom and felt “awful” so s/he went and discussed the incident with his/her supervisor. Although the SP’s mouth and teeth were on the AV’s arm, the SP said s/he did not bite the AV. The SP was trying to show the AV that biting hurt but as soon as the SP’s mouth touched the AV’s arm, s/he pulled away. The SP said that was, “Not who I am.” The SP loved his/her job and had never harmed any children. The Guidance, Protection of and Respect for Children policy indicated that physical discipline or corporal punishment including hitting, pinching, pushing, biting, or gabbing a child was unacceptable. All staff persons interviewed for this investigation received training on the facility’s policies and on the Reporting of Maltreatment of Minors Act prior to the incident. 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 following actions by or at the direction of a staff person: Subjection of a child to corporal punishment, which includes, but is not limited to, rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting, pinching, hitting, and spanking. Conclusion: A. Maltreatment: Information was consistent that on June 3, 2022, the SP entered the AV’s classroom. The AV approached the SP to hug the SP and then bit the SP on the leg. The SP provided conflicting information regarding his/her actions. The SP told this investigator that s/he then bent down and put his/her mouth on the AV’s arm. However, P1 and P3 each said that the SP told each that s/he bit the AV. The AV sustained a bruise and/or mark on his/her right forearm. The SP’s action of biting the AV was not accidental; was inconsistent with the standards of a professional caregiver in a facility licensed by the Department of Human Services; a violation of the facility’s policies; and a violation of Minnesota Rules 9503.0055, subpart 3, item A. Therefore, there was a preponderance of the evidence that a physical injury was inflicted on the AV other than by accidental means. It was determined that physical abuse 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). 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, including the behavior guidance policy, 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 for which the SP was responsible was serious maltreatment as the AV was bit and sustained a bruise. 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 policies and procedures were adequate but not followed by the SP. The SP was 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 January 25, 2023, the facility was issued a Correction Order for the violation outlined in this report and failing to report maltreatment as required. 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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