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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: 1011981-CCC (Child Care Center) Investigator(s): Tessa Ripka 651-431-6612 Suspected Maltreatment Reported: It was reported that a staff person (SP) hit an alleged victim (AV) in the face and had also hit the AV in the past. Date of Incident(s): September 12, 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 September 25, 2023; from documentation at the facility; and through five interviews conducted with four facility staff persons (SP, P1, P2, P3), and the AV’s family member (FM). The facility was a building with ten classrooms. On the right side of the building there were three similar sized classrooms that were adjacent to each other. The middle classroom was the Infant C classroom. The Infant C classroom had a carpeted area through the door and a tiled area at the back of the room. There was a diaper changing station on the tiled area and a small table with child sized chairs. There was a door at the back of the room that led out to a playground. On each side of the classroom were three large windows that looked into the classrooms on each side. The AV was 15 months at the time of the incident and enrolled in the Infant C classroom. P1-P3 provided the following information: · P1 was covering a staff person’s break in the Infant B classroom (adjacent to the Infant C classroom). P1 was feeding an infant when s/he heard a loud noise from the Infant C classroom. When P1 looked through the window into the Infant C classroom s/he saw the AV sitting in a chair and the SP next to him/her. The SP slapped or “smacked” the AV’s right cheek. P1 saw the AV’s head move and s/he started to cry. · P1 did not see anyone else in the classroom and thought the rest of the classroom was outside. P1 walked away from the window to try to find someone to come into the classroom so that s/he could go talk to P3 about what had just happened. · P2 worked in the classroom with the SP on the date of the incident. The AV started biting some children in the classroom. P2 continued to play with the AV and everyone had breakfast. · At approximately 9 a.m., P2 started changing children’s diapers. The SP came up and P2 told the SP that the AV had bit three children. The SP seemed a “little frustrated” and grabbed the AV and put him/her into a chair with no toys in front of him/her. · When the SP left the area, P2 took the AV out of the chair and put him/her on the diaper changing station to change his/her diaper. The SP came back up and slapped the AV’s right hand and pinched his/her nose for a “second or less.” P2 asked what the SP was doing but the SP just walked away. · Later the SP and P2 took the children outside to play. P2 went to P3 to report what had happened and ask for the AV to be removed from the classroom. When P2 returned outside, the SP was already going inside with some of the children. P2 came into the classroom and saw the AV was already sitting in a chair at the table. · P2 did not notice any marks or injuries on the AV. In the past, P2 felt the SP put the AV in the chair more often than other kids and sat him/her “harder” in the chair. · P1 did not notice any marks on the AV. P1 said the SP was loud but never thought the SP would go to the “point” that s/he did. · P3 said that on the day of the incident, P1 reported that s/he had seen the SP “smack” the AV in the face through the glass window of the classroom. The AV had been sitting in a highchair with a tray. · Approximately 10-15 minutes later P3 removed the AV from the classroom. P3 did not notice any marks on the AV. That same day, P2 reported that the SP was being “aggressive” and P2 did not like the way the SP was treating the AV. The SP provided the following information: · The AV had a soft cast put on his/her leg on Monday evening (September 11, 2023). On Tuesday (September 12, 2023) when the AV returned to the facility, s/he had a hard time walking with the cast on but could crawl. · In the morning the AV bit a child and then later on fell and hit his/her chin on a bookshelf. The SP went and made sure the AV was okay. When the SP set the AV down, the AV crawled over and bit another child. The bite caused the other child to bleed. The SP and P2 had the child sit down in a chair and play with toys while they took care of the other child. · Later on, the SP, P2, and all the children in the classroom went outside for 30-45 minutes. They all returned inside at the same time and did arts and crafts. At some point the AV was put into a different classroom. P3 said that it was because the AV’s family member was coming to get him/her. · The SP said s/he never hit the AV in the face or slapped his/her hand or pinched his/her nose. The SP did not know why someone would say that but thought it may be so that the facility did not have to pay the SP his/her bonus. Several Incident/Accident Report for Parent/Guardian forms showed that the AV bit other children on the date of the incident at 8:50 a.m. and 9 a.m. The AV also fell and hit the right side of his/her chin on a bookshelf at 8:48 a.m. The Employee Handbook indicated that certain discipline methods were not acceptable including: spanking, grabbing, pinching, or any physical punishment or restraint, withholding food, water, sleep, bathroom access, or other basic needs, isolation or separation as punishment, including time outs, emotional abuse including humiliation, and disrespectful communication such as yelling. 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 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 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: On the date of the incident, P1 said that s/he was in the adjacent classroom and heard a noise and when s/he looked into the classroom, s/he saw the SP slap or “smack” the AV’s right cheek causing the AV’s head to move and s/he started to cry. P2 said that on the same day after s/he told the SP that the AV had bit others several times, the SP came over and slapped the AV’s hand and pinched his/her nose for a “second or less.” There were not any visible marks on the AV from either incident. The SP said s/he never hit the AV in the face, slapped his/her hand, or pinched his/her nose. Although the SP said s/he never hit the AV, slapped the AV, or pinched the AV’s nose, both P1 and P2 said they each witnessed a separate incident where the SP was aggressive with the AV. The AV was biting other children that day and P2 said the SP seemed “frustrated.” Given that the SP had reason to minimize his/her actions, it was likely that both incidents occurred which 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. Although there were two separate incidents of aggressive behavior by the SP, the slap on the hand and the pinch to the AV’s nose did not rise to the level of physical abuse but given the aforementioned and that P1 saw the SP slap or smack the AV on the face causing him/her to cry, 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 Employee Handbook, 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 abuse for which the SP was responsible did not meet statutory criteria to be determined as recurring or serious because there was no injury and the slap or smack to the AV’s face was a single incident. 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 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. On October 31, 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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