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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: 1064797-CCC (Child Care Center) Investigator(s): Anna Parkin 651-431-6225 Suspected Maltreatment Reported: It was reported that a staff person (SP) grabbed an alleged victim (AV) and put the AV back in a chair and the AV sustained marks on his/her back. Date of Incident(s): June 26, 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 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 July 5, 2023; from documentation at the facility; and through six interviews conducted with two supervisory staff persons (P1 and P2), three facility staff persons (P3, P4 and the SP), and the AV’s family member (FM). This investigator met and spoke to the AV but the AV did not provide information about the incident. According to the AV’s enrollment information, the AV was four years old and enrolled in the preschool room at the time of the incident. The facility had a preschool room that had three tables and each table had approximately ten chairs. There was a yellow table, a blue table, and a red table. Consistent information was provided that on the day of the incident, the SP assisted the children, including the AV, at the yellow table. P1-P4 and the SP provided the following information: · On June 26, 2023, P3, P4, and the SP were working in the preschool room. After the children were finished eating lunch, P3 began excusing each table to go to the next activity. The yellow table had not yet been called and the AV was “jumping around” and “dancing.” The SP asked the AV “a few times” to stay seated at the table. The SP was “frustrated” and had been “crabby” because of a change in his/her medication. The SP did not recall if his/her voice was raised. The AV did not listen so the SP “grabbed” the AV under his/her armpits, picked him/her up, sat the AV down in his/her chair, and scooted the AV’s chair under the table. The SP did not think it was “aggressive” and walked away. · P4 saw the AV sitting “perfectly fine” before P4 began cleaning. The AV was “goofy” and P3 and P4 each stated that the SP was “frustrate[d].” P3 saw the SP pick up the AV by his/her biceps but did not hear what the SP said to the AV. P3 and P4 did not see the SP set the AV in the chair. · At one point, P4 turned around and saw the AV sitting in a chair “bawling” and holding his/her back. P4 lifted up the AV’s shirt and saw a “huge red mark” down the AV’s back. P4 called over to P3 and they both looked at the red mark. When P3 and P4 asked the AV if s/he was okay, the AV responded, “[The SP] did it.” The AV said the SP “threw” the AV into the chair. P4 brought the AV to the bathroom and looked at the mark again and saw scrapes but there was no broken skin or bleeding. P4 then placed an ice pack on the AV’s back. · The SP stated once s/he “calmed” him/herself and thought back s/he realized the AV sustained the marks from when the SP sat the AV on the chair. The SP was trained to redirect children but in a “gentler” and “positive” way and his/her actions on were not in line with the training. · P4 went and asked P2 if s/he could look at video footage to see what interactions took place between the SP and the AV. The memory card was full so P2 was not able to view video of the incident. P2 then went to the preschool room and saw the SP talking to and comforting the AV. P2 looked at the AV’s back and saw a red mark that was “a couple inches” wide. P2 asked the SP what happened and the SP said that the AV was “messing around” during lunch, the SP tried verbally redirecting the AV, and then the SP went over, picked up the AV under the arm pits, and while putting the AV back in his/her chair the AV’s back hit the chair. After nap time, P2 went back and looked at the AV’s back and saw “small bruising.” Three days later when P2 looked at the mark on the AV’s back it was gone. · Later that day, P2 told P1 about the incident. P1 spoke to the SP who provided consistent information about putting the AV on the chair. P1 looked at the AV’s back and saw a “very faint little mark” that resembled a rug burn. There was no broken skin and the following day P1 looked and did not see a mark. The FM stated that s/he was made aware of the incident the day it happened. Later that day, the FM saw two red marks on the AV’s back that eventually turned into bruises. The FM asked the AV where the SP grabbed the AV and the AV pointed to his/her waist. The AV said that the SP “put me down and the chair hit my back.” The FM did not take photos of the marks. According to the facility’s behavior guidance policy, staff persons ensured children were provided a “positive model of acceptable behavior.” Staff persons used appropriate language, positive reinforcement, redirected children away from problems, and brought them toward constructive activities to reduce conflict. Staff persons also protected the safety of the children. According to the facility’s unacceptable behavior policy, if a child had “a behavior problem,” staff persons provided immediate and “directly related” consequences for a child’s unacceptable or persistent behavior. Staff persons redirected the child within the group to avoid conflict; talked to the child and provided two choices to remain in the activity; if a child chose to not to be part of the activity, the staff person used “less intrusive methods” or gave them a second choice; if the child did not chose then the staff person chose for them; and if the results were “ineffective” then the staff person separated the child from the group. There was a list of prohibited actions which included “rough handling.” Facility documentation showed that the SP and other staff persons interviewed in this investigation received training on the facility’s behavior guidance policy, unacceptable behavior policy, and the Reporting of Maltreatment of Minor’s 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 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 June 26, 2023, the AV was “jumping around” and “dancing” after lunch. The SP asked the AV “a few times” to stay seated at the table. The SP was “frustrated” because the AV did not listen so the SP “grabbed” the AV under his/her armpits, picked the AV up, and sat the AV down in his/her chair. P3 provided information that the SP picked up the AV by his/her biceps but P3 and P4 did not see the SP set the AV down on the chair but prior to the SP picking up the AV, the AV was being “goofy.” After being put in the chair by the SP, the AV “bawled” and consistent information was provided there was a red mark on the AV’s back as a result of the incident. The SP’s action was not accidental; was inconsistent with the standards of a professional caregiver in a program licensed by the Minnesota Department of Human Services; were violations of facility policies and procedures; and a violation of Minnesota Rules, part 9503.0055, subpart 3, item A. Given that there was no information provided that at the time of the incident the AV was a danger to him/herself or others, it was unlikely that the AV required physical intervention. The SP picked up the AV and set him/her in the chair with frustration which resulted in a red mark on the AV’s back, therefore, there was a preponderance of the evidence that there was a failure to supply the AV with reasonable and necessary care, a failure to protect the AV from conditions or actions that seriously endangered the AV, and that a person responsible for the AV’s care inflicted an injury on the AV other than by accidental means. 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 626.556, subdivision 10e, paragraph (i): 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 trained on the facility’s behavior guidance policy, unacceptable behavior policy, and the Reporting of Maltreatment of Minor’s Act 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 neglect and physical abuse for which the SP was responsible was not “recurring” because it was a single incident but was “serious” maltreatment because the AV sustained a red mark that P2 and the FM stated turned into bruising that lasted a few days. 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 received additional training and was suspended for one day. 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 August 18, 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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