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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: 1106266-CCC (Child Care Center) Investigator(s): Anna Parkin 651-431-6225 Suspected Maltreatment Reported: It was reported that two alleged victims (AV1 and AV2) were alone in a bathroom for approximately five minutes. Date of Incident(s): July 14, 2023 Nature of Alleged Maltreatment Pursuant to Minnesota Statutes, section 260E.03, subdivision 15, paragraph (a), clauses (1) and (2): 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. Summary of Findings: Pertinent information was obtained during a site visit conducted on July 25, 2023; from documentation at the facility; and through five interviews conducted with two supervisory staff persons (P1 and P2), and three facility staff persons (P3, SP1, and SP2). According to AV1’s enrollment information, AV1 was four years old and enrolled in the preschool B room at the time of the incident. According to AV2’s enrollment information, AV2 was three years old and enrolled in the preschool A room at the time of the incident. The facility had a preschool playground area that was adjacent to the building. The playground was enclosed by a chain link fence. There was a gate attached that led to a long walkway that was also enclosed by the chain link fence along the side of the building that had a door. Inside the door was a hallway with multiple individual bathrooms. Consistent information was provided that on July 14, 2023, at approximately 4:30 p.m., SP1 and SP2 were on the preschool playground with the preschool A, preschool B, and school age children. P3 stated on July 14, 2023, P3 (who was working in a toddler room) brought a child to one of the bathrooms that was near the door to the playground. P3 found AV1 alone and crying inside the bathroom. AV1 had already used the toilet and put his/her diaper on backwards so P3 assisted AV1 with putting it on correctly. P3 did not know how long AV1 had been alone inside the bathroom but AV1 did not have any injuries. P3 stated it was less than two minutes from when s/he found AV1 until s/he brought AV1 back outside to the preschool playground. When s/he got to the playground, SP2 was “distraught” and trying to call SP1 on a phone. P3 asked what happened and SP2 said that SP1 brought another child (C) inside to use the toilet and because AV1 and AV2 also needed to use the bathroom, SP2 sent them inside to the bathroom. SP2 told P3 that s/he did not know where SP1 went. P3 spent a few minutes outside until another staff person came out.
SP1 provided the following information: · While outside on the playground, the C needed to use the bathroom. While walking inside to the bathroom, the C was incontinent so SP1 brought the C upstairs to one of the preschool rooms to change. SP1 assisted the C with cleaning him/herself, finish going to the bathroom, and changing the C’s clothes. During that time, SP1 had a missed phone call from SP2 but SP1 was not able to answer it because s/he was wearing gloves and assisting the C with cleaning him/herself. SP1 stated it was approximately 15 to 20 minutes that s/he was inside assisting the C. · SP1 then brought the C back out to the playground. At that time, AV1 and AV2 were on the playground and SP2 told SP1 that while SP1 was gone, SP2 sent AV1 and AV2 inside to use the bathrooms because s/he thought SP1 and the C were there. SP2 provided the following information: · Prior to the incident, SP1 told SP2 s/he was taking the C inside to use the bathroom. After SP1 and the C went inside, AV1 and AV2 told SP2 that they needed to use the bathroom. SP2 thought it was “okay” to send AV1 and AV2 inside since SP1 was in there with the C. SP2 stood at the gate of the fence and watched AV1 and AV2 walk down the sidewalk, open the door, and walk inside the building. A few minutes went by and AV2 came outside alone and told SP2 that AV1 needed help with his/her diaper. SP2 then realized that SP1 was more than likely not in the bathroom. · SP2 went to a window on the playground and knocked to get a staff person’s attention but no one responded. SP2 tried calling SP1 on the phone to see where SP1 was, but SP1 did not answer. P3 then brought AV1 outside on the playground. SP2 stated it was less than five minutes from when AV1 and AV2 went inside to when P3 brought AV1 to the playground. AV1 and AV2 did not have any injuries. “Not too long” after, SP1 came back with the C and said the C was incontinent so SP2 had to take the C to the preschool room. P2 stated on July 17, 2023, at approximately 10 a.m., P3 came to P2 and told him/her about finding AV1 alone in the bathroom. P2 went and spoke to SP2 and then SP1 about the incident and each provided information to P2 that was consistent with the information each provided during their interviews. P2 said based on the attendance roster, it appeared SP1 and SP2 had 16 children with them at the time of the incident. Later that afternoon, P2 called and informed P1 about the incident. According to the Risk Reduction Plan: · There were hallway bathrooms that were installed with door stops to “ensure” supervision of toddler and preschool children. School age children were allowed to use the bathroom alone, but staff persons knew the location of the child and checked on the child at least every five minutes. · No children were allowed to be unattended by staff persons. The “only exception” was school age children use of hallway bathrooms. Facility documentation showed that staff persons, including SP1 and SP2, received training on the Risk Reduction Plan and Maltreatment of Minor’s Act prior to the incident. Relevant Rules and Statutes: Minnesota Statutes, section 245A.02, subdivision 18, and Minnesota Rules, part 9503.0045, subpart 1, item A, stated that a child must have supervision at all times and that supervision is defined as occurring when a program staff person is within sight and hearing of a child at all times so that the program staff person can intervene to protect the health and safety of the child. Conclusion: Information was consistent that on July 14, 2023, AV1 and AV2 were inside a bathroom without the knowledge or supervision of a staff person for at most five minutes, which was a violation of Minnesota Statutes, section 245.02, subdivision 18, and Minnesota Rules, part 9503.0045, subpart 1, item A. Minnesota Statutes, section 260E. 30, subdivision 3 states that rather than making a determination of substantiated maltreatment by an individual, the commissioner of human services shall determine that a nonmaltreatment mistake was made by the individual. A nonmaltreatment mistake occurs when: (1) at the time of the incident, the individual was performing duties identified in the center's child care program plan; (2) the individual has not been determined responsible for a similar incident that resulted in a finding of maltreatment for at least seven years; (3) the individual has not been determined to have committed a similar nonmaltreatment mistake under this paragraph for at least four years; (4) any injury to a child resulting from the incident, if treated, is treated only with remedies that are available over the counter, whether ordered by a medical professional or not; and (5) except for the period when the incident occurred, the facility and the individual providing services were both in compliance with all licensing requirements relevant to the incident. At the time of the incident, SP1 was assisting the C with incontinence and was unaware that SP2 sent AV1 and AV2 into the facility. SP1 left the playground prior to SP2 sending AV1 and AV2 into the building. Therefore, SP1 was not responsible for the supervision of AV1 and AV2 and his/her responsibility was mitigated. However, SP2 was responsible for the care and supervision of the rest of the children on the playground, including AV1 and AV2. Although SP2 did not confirm SP1 was in a position to take over supervision of AV1 and AV2 when they entered the facility, SP2’s actions or conduct was determined to be a nonmaltreatment mistake for the following reasons: (1) At the time of the incident, SP2 was performing job related duties, as required by the facility’s policies, by supervising children on the playground. When AV1 and AV2 each needed to use the bathroom, SP2 was not able to leave the playground and made a reasonable assumption that SP1 was in the bathroom directly inside the door. (2) SP2 had not been determined responsible for any previous incident that resulted in a finding of maltreatment. (3) SP2 had not been determined to have committed a nonmaltreatment mistake under this paragraph. (4) AV1 and AV2 were uninjured and did not require medical care after the incident; and (5) Except for the period when the incident occurred, the facility and SP2 were each in compliance with all licensing requirements relevant to the incident. The nonmaltreatment mistake to the AV by SP2 was not maltreatment. Pursuant to Minnesota Statutes, section 260E.35, subdivision 6, paragraph (b), the investigative data in this report will be maintained by the Department of Human Services for a period of five years. Action Taken by Facility: The facility completed an internal review and determined that policies and procedures were adequate but not followed. All staff persons received additional training on the risk reduction plan program plan regarding supervision and ratios. Action Taken by Department of Human Services, Office of Inspector General: SP2 was not determined as a perpetrator of maltreatment of the AV because the Department of Human Services found that the incident for which SP2 was responsible met the criteria to be determined a nonmaltreatment mistake. SP2 was notified by the Office of Inspector General that any future incident of possible neglect of an alleged victim for which s/he is responsible might not be considered a nonmaltreatment mistake. On September 15, 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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