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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: 800379-CCC (Child Care Center) Investigator(s): Alice Percy 651-431-6569 Suspected Maltreatment Reported: It was reported that a staff person (SP) slapped an alleged victim’s (AV’s) face two times. Date of Incident(s): March 29, 2023 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 April 20, 2023; from documentation at the facility; and through four interviews conducted with a facility staff person (P1), an administrative staff person (P2), the SP, and the AV’s family member (FM) who was also a staff person. The AV was 17 months old and enrolled in the toddler classroom at the time of the incident. The classroom was a large square room. Two tables and several chairs were set up on the side of the room furthest from the door. A partial wall separated the majority of the classroom from a kitchen area behind the tables. The FM stated that on the day of the incident, P3 told the FM about the incident and the FM went to the AV’s classroom. The FM did not observe any injury or marks on the AV’s face. In the past, the FM was concerned about several small marks on the AV that were not documented or explained by the staff persons in the AV’s classroom. On one occasion, the FM asked the SP about a small scratch on the AV’s arm and the SP told the FM that the AV might have scratched him/herself. The FM had worked with the SP in the past and had not seen the SP be “aggressive” with the children. P1, P2, the SP, and the facility’s documentation provided the following information: · On March 29, 2023, P1 and the SP worked in the toddler classroom with 10 children. At approximately 12 p.m., P1 and the SP had the children sit at two tables where they served lunch to the children. P1 sat at one table with a group of children and the SP sat at the other table with another group of children including the AV. The SP sat next to the AV. At one point during the meal, P1 stood up and went to the back area of the classroom. As s/he returned to the table area, s/he saw the SP slap the AV’s cheek twice with his/her left hand. P1 stated that the slaps were loud enough that s/he heard the sound of the SP’s hand hitting the AV’s cheek, but the slaps did not leave any marks on the AV’s face. P1 did not know what occurred immediately before s/he walked around the corner and saw the SP slap the AV. The AV cried and “looked scared.” The SP did not say anything to the AV and did not attempt to comfort him/her. P1 did not say anything to the SP and sat in his/her chair to supervise his/her group of children. · P1 stated that in the past, the SP sometimes “yelled” at the children when s/he was frustrated with them, but prior to the incident, P1 never saw the SP “be physical” with the children. After lunch, P1 and the SP assisted the children with toileting and then got the children settled on their cots for naptime. After that, P1 went to the administrative offices and told an administrative staff person (P4) that s/he saw the SP slap the AV. P4 contacted P3 and told him/her what P1 said. P3 talked to P1, who provided information to P3 that was consistent with the information P1 provided to this investigator. P3 then talked to the SP, who told P3 that s/he never “put hands” on a child, including the AV. The SP stated that s/he “had no idea what [P3] was talking about” because nothing occurred during the day. During lunch, the AV was doing “abnormally good” and remained sitting, used his/her utensils, and did not require any assistance with eating, which was not always the case. The SP stated that s/he was not frustrated with any of the children, including the AV, and did not slap the AV. The SP stated that the AV did not cry during lunch. · P3 asked the SP to leave the facility, document everything that occurred in his/her classroom that day, and send the information to P3. The SP did not send any of the requested information to P3. P3 then talked to the FM about the incident. P3 and the SP each stated that they did not observe any marks on the AV’s face after the incident. The SP stated that P3 asked him/her to leave the facility and the SP did not hear from P3 after that, except for a termination letter that P3 sent to him/her. · The FM showed several photographs to P3 that s/he took of past unexplained injuries to the AV, including red marks on his/her hip. The following day, the FM told P3 that the SP sent a text to the FM saying s/he wanted “to explain” what occurred. The FM did not respond to the SP’s texts. · P2 stated that s/he frequently worked with the SP and that the SP “raised [his/her] voice really loud” at the children “pretty often.” P2 did not observe the SP hit any of the children, but believed that the SP was sometimes “rough” with the children. P2 also told the SP to “take a break” when it seemed like the SP was getting frustrated with the children. Recently, P2 brought up his/her concerns about the SP’s interactions with the children to P3. P2 stated that the SP discouraged the other staff persons from going to P1’s office and told them that s/he would communicate with P1. On one occasion, a child’s family was in the hallway and heard the SP yelling at the children in the classroom and talked to P1 about what s/he heard. · The SP stated that s/he had a “loud” voice and had been working with P3 on “toning down the volume.” On one occasion, a child’s family member told P3 that s/he heard the SP yelling at the children, but that the SP raised his/her voice to stop a child from landing on another child. The SP denied slapping the AV. According to the facility’s Employee Handbook, the staff persons were not allowed to use physical punishment, such as rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking biting, pinching, hitting, or spanking. A review of eight photographs supplied by the FM of past marks on the AV from unknown dates, showed a small round red mark on the AV’s left upper arm, a small red cut on the AV’s right thigh, a large red area on the AV’s left upper arm, and a red mark on the AV’s stomach. No information was provided to the FM by the staff persons about what caused the marks. Facility documentation showed that P1, P2, and the SP each received training on the Reporting of Maltreatment of Minors Act and on the facility’s policies prior to the incident. Relevant Rules and Statutes: Minnesota Rules, part 9503.0055, subpart 1, item A, states that the license holder must ensure that the policies and procedures are carried out. The policies and procedures must ensure that each child is provided with a positive model of acceptable behavior and provide immediate and directly related consequences for a child’s unacceptable behavior. 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 persons: 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: On March 29, 2023, P1 and the SP worked in the toddler classroom with ten children. At approximately 12 p.m., P1 and the SP each sat at a table with several children during lunch time. During the meal, P1 stood and walked to the kitchen area and as s/he returned to the tables, s/he saw the SP slap the AV’s face two times. The slaps were loud enough that P1 heard the sound of the slap, but it did not leave any marks on the AV’s face. Although the SP denied slapping the AV’s face at any time, the SP had reason to minimize his/her actions for fear of repercussions and no information was provided that there were any interpersonal conflicts between P1 and the SP that would give P1 a reason to provide incorrect information about the incident. The AV did not sustain an injury during the incident. However, the SP’s action of slapping the AV’s face was inconsistent with the standards of a professional caregiver in a facility licensed by the Department of Human Services; was a violation of the facility’s policies; and a violation of Minnesota Rules, part 9503.0055, subpart 1, Item A, and subpart 3, item A. Therefore, given that the AV was three years old, that the slap was loud enough to be heard a distance away, and that it caused the AV to cry, there was a preponderance of the evidence that slapping the AV on the face represented a substantial risk of physical or mental injury to the AV. 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 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 did not meet statutory criteria to be determined as recurring or serious because it was a single incident and the AV did not sustain an injury. 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 the facility’s policies were adequate, but were not followed by the SP. The SP no longer worked at the facility. Action Taken by Department of Human Services, Office of Inspector General: The SP was not disqualified from providing direct care services as a result of the maltreatment determination in this report. However, the SP was notified by the Office of Inspector General that any further substantiated act of maltreatment, whether or not the act meets the criteria for “serious,” will automatically meet the criteria for “recurring” and will result in the disqualification of the SP. The determination that the SP was responsible for maltreatment is subject to appeal. In addition, on May 19, 2023, the facility received 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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