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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: 1100328-CCC (Child Care Center) Investigator(s): Beth Virden 651-431-6572 Suspected Maltreatment Reported: It was reported that a staff person (SP) dragged an alleged victim (AV) on the floor causing a “rugburn.” Date of Incident(s): May 25, 2023 Nature of Alleged Maltreatment Pursuant to Minnesota Statutes, section 260E.03, subdivision 15, paragraph (a), clauses (1) and (2); 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. Failure to protect a child from conditions or actions that seriously endanger 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 or 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 June 15, 2023; from documentation at the facility; and through interviews conducted with the AV’s family member (FM), a facility staff person (SP), and a supervisory staff person (P). At the time of the incident, the AV was 27 months old and enrolled in the facility’s toddler classroom. The facility provided childcare services to children, infant to school age. On May 25, 2023, the AV attended the facility for most of the day. At some point between 4:45 and 5:15 p.m., the FM picked the AV up and brought him/her home. Once home, and shortly after, they were preparing to play outside. The AV started “screaming” and “squirming in pain.” The FM lifted the AV’s shirt and saw “scabbed-over … bruising” on the AV’s right side in-line with his/her bellybutton. It looked like “two adult size fingers” or like the AV’s ribs were “punched.” The FM did not see this injury prior to going to the facility that morning, and the FM was not aware of anything occurring at home, which might have caused the injury. The FM took photographs of the AV’s injury on May 26, 2023, which showed two abrasions on the AV’s right side. The P provided the following information: · On May 30, 2023, the FM showed the AV’s injury to the P. The FM did not know where the injury occurred but wanted staff to be aware in case the AV expressed discomfort when being picked up. The P described the injury as being “right on [the AV’s] torso … It looked like two triangles maybe like the size of a piece of scotch tape … It appeared to be a scabbed-over rugburn.” The P took photographs of the AV’s injury on May 30, 2023, which showed two abrasions with scabs on the AV’s right side. · The P reviewed camera footage for the AV’s classroom on May 25, 2023, and observed that around 8 a.m., the SP moved the AV across the floor by pulling his/her foot. “This movement caused [the AV] to fall backwards. [The AV’s] shirt moved up [his/her] body, and [s/he] appears to scrape the right torso on the carpet. [The SP] stands [the AV] up, pulls [his/her] shirt down, and sets [him/her] on a different spot on the carpet.” · The P asked the SP about this incident. The SP said that the AV was not listening and was “bothering” another child. The SP grabbed the AV’s foot and pulled him/her to a different spot on the carpet. The SP did not believe his/her actions caused injury to the AV. Note: There were two other staff persons in the room at the time of the incident. For the facility’s Internal Review, one of the staff persons told the P that they did not witness the incident. The other staff person was on vacation at the time of the investigation. The P wrote in the facility’s Internal Review, “From video footage, it is unlikely that [this other staff person] witnessed this given scenario.” The video footage showed the AV sitting on the floor with other children facing the SP. The SP leaned forward and pulled the AV’s right foot, making him/her fall backward and appearing to hit his/her head on the floor. The SP then continued to drag the AV, on his/her back/side, about four to five feet across the carpet to where the SP was sitting. The SP then lifted the AV into a standing position and the AV immediately placed his/her hands on either side of his/her mid-section near the injury location. The AV’s skin tone on his/her face was red and s/he appeared to be crying. The SP provided the following information: · On the day of the incident, the SP was “in (physical) pain” and “lazy” due to an unrelated medical condition. · The SP wanted the children to sit on the carpet for group time. The AV “was messing with” and “pushing or grabbing” another child, who was “just sitting there.” · “I grabbed [the AV] by [his/her] ankle and pulled [him/her]. [The AV] fell back and caught [him/herself] on [his/her] elbow.” The SP then stood the AV up and “pulled [his/her] shirt down.” The SP did not see the AV rub on the carpet and added, “I didn’t think I was aggressive.” An unknown time later, the SP checked the AV from injuries by lifting his/her shirt and did not see any. · On May 30, 2023, the SP saw the AV’s injury. The SP said that it was on the AV’s “right side … The same side [s/he] caught [his/her] elbow” on the carpet. It looked like a “rugburn.” · The SP said, “What I did was wrong. I should not have been lazy. This could have been prevented.” The SP said that s/he should have stood up and then picked the AV up by lifting under his/her arms. The facility’s Behavior Guidance Policies and Procedures stated that the facility provided children with “a positive model of acceptable behavior,” and used “positive guidance techniques.” Staff persons were prohibited from subjecting a child to corporal punishment, including rough handling. Facility documentation stated that the SP and the P received training on the facility’s Behavior Guidance Policies and Procedures and the Reporting of Maltreatment of Minors Act. Relevant Minnesota Statutes and Rules: 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: Video footage and the SP provided consistent information that on May 26, 2023, around 8 a.m., the SP pulled the AV about four to five feet across carpet by his/her foot causing the AV to fall back and cray. The SP stood the AV up and “pulled [the AV’s] shirt down” before directing him/her to another area of the carpet. The AV was not a danger to him/herself or others at the time and the conduct of pulling a child across the floor by their foot was not accidental; was inconsistent with the facility’s Behavior Guidance Policies and Procedures; a violation of Minnesota Rules part 9503.0055, subpart 3, item A; and was a failure to supply the AV with reasonable and necessary care and a failure to protect the AV from conditions or actions that seriously endangered the AV’s physical health when reasonably able to do so. In addition, given that the appearance of the AV’s injury was consistent with and described as being “a rugburn;” that the location of the injury matched the circumstances and video footage; that the SP said the AV’s injury was on the “same side” the AV “caught [his/her] elbow” when being pulled on the carpet;” and that there was no information the AV’s injury was sustained by other means, there was a preponderance of the evidence that a staff person’s conduct inflicted a physical injury on the AV. It was determined that neglect and physical abuse occurred (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. Failure to protect a child from conditions or actions that seriously endanger 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). 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. The SP was responsible for the AV’s care and supervision. The SP received training on the facility’s Behavior Guidance Policies and Procedures and the Reporting of Maltreatment of Minors Act. 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 neglect and physical abuse for which the SP was responsible was not “recurring” but was “serious” maltreatment. The SP was responsible for a single incident for which the AV sustained tissue damage. 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 but not followed. The SP was no longer working at the facility. Action Taken by Department of Human Services, Office of Inspector General: The SP was notified that s/he was responsible for serious maltreatment and that any future background studies for facilities, 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, will result in his/her disqualification. The determination that the SP was responsible for maltreatment is subject to appeal. On July 14, 2023, the facility was issued a Correction Order for the violation 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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