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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: 800577-CCC (Child Care Center) Investigator(s): Danielle Morrison 651-431-5647 Suspected Maltreatment Reported: It was reported that an alleged victim (AV) wandered away from the group while walking from a Young Toddler classroom (YT1) to a large muscle room, without staff persons’ (SP1’s, SP2’s, and SP3’s) knowledge or supervision and walked into the facility’s office where another staff person (P1) saw him/her. The AV was unsupervised for approximately two minutes. Date of Incident(s): January 27, 2023 (Reported to the Department of Human Services on September 27, 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 October 12, 2023; from documentation at the facility; and through six interviews conducted with two supervisory staff persons (P1 and P2), and four facility staff persons (SP1, SP2, SP3, and P3) (Note: P3 was also the AV’s family member). At the time of the incident the AV was 21 months old and enrolled in the YT1 classroom. Due to his/her age the AV was not interviewed for this investigation. The facility served children ages 6 weeks through school-age. Upon entering the facility into a lobby there was an office to the left. Inside the office there was a door that led to a staff person prep room. From the lobby there was a staff person break room to the right. The staff person break room had an interior door that led to a conference room. There was a short hallway from the lobby that led to the main part of the facility and was perpendicular to a long hallway that ran the length of the facility with classrooms on both sides. The YT1 and Young Toddler 2 (YT2) classrooms were on one side of the long hallway and the muscle room was on the other approximately 80 feet away. The entrance to the muscle room was on the other side of the long hallway from where the short hallway joined it. There was also an entrance to a garbage room (where staff persons could throw away the garbage from their classrooms) across from the long hallway from the conference room. P1, P2, SP2, and SP3 provided consistent information that name to face was to be done when leaving an area and upon arrival at a new location. SP1 stated that the staff person in the front or the back of the line was supposed to perform a head count. P3 stated that name to face was to be done at every threshold. P1 provided the following information: · On January 27, 2023, a little after 4 p.m., P1 said s/he was working in the office when the AV walked in and said, “Hi [P1],” so P1 responded, “Hi [AV].” This was pretty common for the AV to walk into the office as s/he was leaving for the day. The AV was holding a decorative snowman that sat in the lobby. P1 thought P3 was with the AV, but s/he was in the staff person room prepping for the next day. P3 heard P1 say, “Hi,” to the AV and went into the office to see why the AV was in there. · P1 and P3 went to the large muscle room with the AV and saw SP1 sitting on the floor taking pictures of the other children using “Hi Mama” (an application to communicate with family members). SP3 was also in the muscle room. · When asked if they knew the AV was not in their care, SP3 responded that the AV was not with his/her class that day (SP3 worked in the YT2 classroom). SP1 said that s/he did name to face when the group left the YT1 classroom, but only did a head count when they entered the muscle room (Note: The “Hi Mama” application showed that a name to face count was done prior to leaving the YT1 classroom but not once in the muscle room). · P1 thought SP1 and SP2 met with SP3 in the hallway and both classrooms walked into the muscle room together and then SP2 left to assist in another classroom. SP3 said s/he had all of his/her children (the AV was not one of them), SP3 did his/her count, and “trusted” SP1 and SP2 had done theirs. · P1 was able to piece together that SP1 was in the back of the line when the YT1 classroom walked to the large muscle room and stopped to drop off a bag a garbage in the garbage room along the long hallway. Across from the garbage room was the conference room that led to the staff person break room. The staff person break room had a door that led to the lobby. In the staff person break room there was a wicker basket of plastic utensils for staff persons to use and this was found in the lobby where the decorative snowman usually sat. Based on this, P1 determined that the AV wandered away from the group while SP1 threw the bag of garbage in the garbage room, then the AV walked through the conference room, through the staff person break room, out into the lobby, and to the office. · P1 said s/he called P2 and the facility’s owner to let them know about what had happened. P1 stated that SP1 and SP2 did not return to work after the incident and SP3 received a written warning because P1 “assumed” SP3 entered the large muscle group with SP1 and SP2 and was also responsible for the AV’s supervision. SP3 provided the following information: · SP3 did not remember the date, but thought it was a Friday. SP3 said that the staff persons who normally work in YT1 were out that day so SP1 and SP2 were in that classroom and SP3 was in YT2 with his/her children. Around 4 p.m., SP3 left the YT2 classroom with his/her three children and entered the hallway to make their way to the large muscle room. SP3 saw SP1 and SP2 at the large muscle room door with their group of children. · When SP3 got down to the large muscle room a group of older toddlers was leaving and SP2 went with that classroom as SP1 and SP3 were in ratio between the YT1 and YT2 classrooms. SP3 checked that his/her children were there and asked SP1 if s/he had all of his/her children and SP1 responded, “Yes.” · About two to three minutes later, P1 and P3 entered the large muscle room with the AV. SP3 said the AV was not with him/her that day. P2 took the AV and they left. SP1 told SP3 that when the YT1 classroom came down to the large muscle room, SP1 stopped and opened the door to the garbage room and threw a bag of garbage in there. · SP3 stated that SP1 and SP2 were responsible for the AV during the transition from YT1 to the large muscle room. SP3 did not remember if anyone had asked him/her if the classrooms were combined, but SP3 thought s/he told them they were not. SP3 stated that SP1 “felt awful” about what happened and was “worried” about what was going to happen. SP1 and SP2 provided the following consistent information: · SP1 and SP2 were both “subbing” in the YT1 classroom on the day of the incident. When it was time to go to the large muscle room, SP1 and SP2 met SP3 in the hallway with his/her children from YT2. SP2 was in the front of the line, SP1 was in the middle of the line, and SP3 was in the back of the line. · SP2 said the AV was towards the middle or the back of the line and SP1 said the AV was behind him/her in line so SP1 thought SP3 was watching the AV. Neither SP1 nor SP2 remember a stop along the way at the garbage room. · When they arrived at the large muscle room, another classroom was exiting and SP2 left with that classroom so that another staff person was able to go home. SP1 and SP3 were in ratio between the YT1 and YT2 classrooms. SP2 stated that SP1 had the tablet when they left the YT1 classroom. SP2 said another staff person talked to him/her when the classrooms arrived at the large muscle room about SP2 going back into another classroom as SP1 and SP3 were in ratio. SP2 went to the other classroom, and it was a “few minutes” later that P1 came in and told SP2 that the AV did not make it to the large muscle room. SP2 said that the lead [staff person] “usually” performs the name to face count (referring to SP3). SP2 stated that s/he, SP1, and SP3 were all responsible for the AV. SP1 stated that SP2 was “distracted” when they arrived at the large muscle room by another staff person and did not count. SP1 stated that SP3 was responsible once they arrived at the large muscle room as SP3 was the leader. SP1 said SP3 did not ask SP1 if s/he performed a count because SP3 “always” did it and SP1 “never” had the tablet. SP1 said that a name to face had not been started before P1 and P3 came to the large muscle room with the AV about two to three minutes after the YT1 and YT2 classrooms entered. SP1 said during the transition s/he and SP3 were responsible for the AV. SP1 thought the AV got curious and wandered away from the group. P3 provided the following information: · P3 said s/he was off early around 4 p.m. so s/he was in the room next to the office doing some prep work. P1 was in the office and P3 heard P1 say, “Hi [AV], so P3 went into the office and asked where the AV came from because s/he was not with P3. · P3 said the AV was holding a snowman that was usually out in the lobby so P3 and P1 tried to figure out what happened, then they went to the large muscle room. · P3 said SP1 was on the floor with the tablet, and SP3 was by the door and stated the AV was not one of his/her children. SP1 stated s/he did name to face when the classroom came into the large muscle room. P2 stated that s/he had already left the facility for the day when P1 called to tell P2 about the incident regarding the AV. P2 said that it was “typical” for the AV to come in to say goodbye to him/her as well at the end of the day. P2 said the AV was a “wandering soul” and tried to walk away from the group before. P2 stated that it was an “assumption” that SP3 was with the group in the hallway, but SP3 told P2 the day before this investigator’s site visit that s/he walked in separately. P2 had no prior concerns with SP3. The facility’s Risk Reduction Plan stated, “When [a] class[room] is transitioning to another location staff [persons] will have [children] line up at the door and conduct a name to face count. One staff person will be at the front of the class[room] line and one at the end of the line. Once the class[room] has reached the new location, staff [persons] will do another name to face count to ensure all children are accounted for. Relevant Rule and/or Statute Minnesota Statutes, section 245A.02, subdivision 18, and Minnesota Rules, part 9503.0045, subpart 1, item A, states 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: Consistent information was provided that on January 27, 2023, the AV walked away from the group while walking from the YT1 classroom to the large muscle room. The AV was found by P1 after the AV walked into the office. P1 and P3 stated that when they entered the large muscle room with the AV, they saw SP1 on the floor with the classroom tablet and SP3 was also in the large muscle room. The AV was without staff person supervision for approximately two to three minutes. SP3 stated that s/he left his/her YT2 classroom and entered the hallway at which time s/he saw SP1 and SP2 entering the large muscle room. The AV was not in SP3’s classroom that day. SP1 and SP2 stated that SP3 was with them in the hallway and was at the back of the line. SP2 thought the AV was towards the middle to the back of the line and SP1 stated that the AV was behind him her and that SP3 was watching the AV. SP3 stated that when s/he entered the large muscle room s/he asked SP1 if s/he had all of his/her children and SP1 responded “Yes.” SP3 trusted SP1 and SP2 had performed a head count. P1, P3, SP2, and SP3 stated that SP1 had the tablet with him/her while SP1 stated that s/he “never” had the tablet. 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 individuals were performing duties identified in the center's child care program plan; (2) the individuals had not been determined responsible for a similar incident that resulted in a finding of maltreatment for at least seven years; (3) the individuals had 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 individuals providing services were both in compliance with all licensing requirements relevant to the incident. Although SP1 and SP2 stated that SP3 was with them in the hallway, and P1 and P3 stated that SP3 was in the large muscle room when they arrived with the AV, and that SP1 stated s/he “never” had the tablet to perform name to face, given that the AV was not enrolled in SP3’s classroom and was not in SP3’s care prior to SP3 entering the large muscle room, that SP3 stated that s/he did not walk down the hallway with SP1 and SP2, that SP3 asked SP1 if all of his/her children were there to which SP1 responded, “Yes,” and that P1, P3, SP2, and SP3 all stated that SP1 had the tablet, SP3 was mitigated from his/her responsibility of supervision of the AV during the transition. Although the AV was unsupervised for approximately two to three minutes without staff persons’ knowledge which was a violation of Minnesota Statutes, section 245A.02, subdivision 18, and Minnesota Rules, part 9503.0045, subpart 1, item A, SP1’s and SP2’s actions and conduct were determined to be a nonmaltreatment mistake for the following reasons. (1) at the time of the incident, SP1 and SP2 were performing job related duties as required by the facility’s policies; (2) SP1 and SP2 had not been determined responsible for a similar incident that resulted in a finding of Maltreatment; (3) SP1 and SP2 had not been determined to have committed nonmaltreatment mistake under this paragraph; (4) there were no injuries to the AV as a result of this incident; and (5) except for the period when the incident occurred, the facility, SP1 and SP2 were in compliance with all licensing requirements relevant to the incident. The nonmaltreatment mistake to the AV by SP1 and SP2 was not maltreatment. It was not determined that neglect 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). 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 found their policies and procedures adequate but not followed by SP1, SP2, and SP3. SP3 received a written warning and SP1 and SP2 no longer worked at the facility. Action Taken by Department of Human Services, Office of Inspector General: SP1 and SP2 were not determined as perpetrators of maltreatment of the AV because the Department of Human Services found that the incident for which SP1 and SP2 were responsible met the criteria to be determined a nonmaltreatment mistake. SP1 and SP2 were notified by the Office of Inspector General that any future incident of possible neglect of an alleged victim for which SP1 and SP2 are responsible might not be considered a nonmaltreatment mistake. On December 15, 2023, the facility was issued 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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