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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: 800446-CCC (Child Care Center) Investigator(s): Lindsay Arth/ Samantha Wueste 651-431-6537 Suspected Maltreatment Reported: It was reported that a staff person (SP) used a pizza cutter to cut an alleged victim’s (AV’s) face. Date of Incident(s): June 13, 2024 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 June 26, 2024; from documentation at the facility, medical records, and law enforcement records; and through five interviews conducted with three facility staff persons (the SP, P1, and P2), a supervisory staff person (P3), and a medical doctor (MD). P2 was also the AV’s family member. The facility had multiple classrooms including a school age, preschool, toddler, and infant room. The kitchen was located near the front entrance of the facility and was diagonal from the school age room. The facility had a hallway that led from the kitchen to the preschool room. The infant room was in the back corner of the facility and could only be accessed through the preschool room. The AV was 14 months old and enrolled in the infant classroom at the time of the incident. P2 provided the following information: · On June 13, 2024, P2 worked with the preschool children who had combined with the toddler room during nap time. At some point after 2 p.m., P2 went to the kitchen to tell the SP that s/he needed to stop doing the dishes and go back to the toddler room because children were waking up from nap and staff-to-child ratio requirements needed to be maintained. The SP told P2, “I am not doing that,” and pushed the kitchen door towards P2. P2 held onto the door to “not fall back or trip” and the SP “slammed” P2’s fingers in the door. P2 and the SP began fighting, including “smacking” one another. P2 told the SP that they needed to stop fighting for multiple reasons, including that they could “both go to jail” or “get in trouble.” However, the SP thought P2 was “threatening” him/her so the SP continued “fighting” P2. · During this, P2 called out for help to both P1 and P3 and at some point, was able to walk away from the SP. P2 told the SP that s/he “will go to jail” and then P2 called law enforcement. While on the phone with the dispatcher, P2 was in the front entryway behind a glass door. P2 saw the SP approaching him/her with a pizza cutter and tried to hold the entryway door shut while the SP “banged” on the glass. The SP then left the front entryway and walked down the hallway towards the infant room. · After the SP left the front entrance, P2 entered the school age room where P3 was working. At some point after entering the room, P2 saw the SP and the SP’s children preparing to leave the facility so P2 asked P3 to check on the AV. Shortly thereafter, P3 ran out of the infant room saying, “[S/he’s] bleeding.” P2 went to the infant room and saw that the AV had a cut on his/her face and that P1 was holding paper towels against the AV’s face. · P1 told P2 that the SP came into the infant room “swinging the pizza cutter” at the AV and that P1 tried to “stop” the SP. P2 was “upset” that the SP hurt the AV and called law enforcement a second time. After the call, P2 took the AV from P1 and administered first aid to the AV. When law enforcement arrived, P2 and the AV were taken to the hospital via ambulance where the AV was treated for his/her injuries. · On June 14, 2024, around 4 or 5 p.m., the AV was discharged from the hospital. The AV received treatment that included dissolving stitches to the cut on the AV’s face and skin glue for cuts on the AV’s left wrist and left leg. P2 told this investigator that as of June 25, 2024, the AV was doing “really good” and that the injuries were healing “good.” · Prior to the incident, there were no concerns between the SP and P2. On the day of the incident, P2 stated that the SP was “in a mood” and not acting like “[him/herself].” P2 asked the SP if s/he was “okay” and the SP told P2 that s/he was “just having an off day.” Law enforcement records were obtained but at their request were not included in this report. The SP was arrested and charged with first, second, third, and fifth degree assault and “terroristic threats.” The MD stated that on June 13, 2024, the AV was transported to the hospital emergency room (ER) and examined for vital signs and stability. The MD stated that the SP “sliced [the AV’s] face with a pizza cutter” that left a “laceration” on the AV’s face that was “six centimeters long, by one centimeter deep.” The AV was given pain reliever medication in the ER and transferred to the operating room for cleaning, repairing, and treating the AV’s injuries after initial examination. The MD stated that due to the AV’s young age, s/he was “hopeful” that the AV would not remember the incident in future years. However, the AV had “potential long-lasting impacts,” including the “mark” (scarring) on his/her face from the injury received. Medical records provided the following information: · On June 13, 2024, at approximately 3:30 p.m., the AV was transported by ambulance from the facility to the hospital after a staff person “assaulted” the AV with a pizza cutter. The AV received a laceration on the right side of his/her face approximately 4.5 centimeters (cm) deep, a 3 cm laceration to his/her left leg and left hand, and scratches “scattered” throughout the AV’s body. · The AV had a skeletal survey which was negative for non-accidental trauma and skeletal fractures, with a follow up skeletal survey scheduled for June 27, 2024. The AV had “wound debridement and laceration repair.” The AV was prepared for surgery that included intravenous therapy (IV), pain and anesthesia medications delivered through the IV, oral endotracheal tube intubation, and cleaning the AV’s injuries prior to surgery. The AV had surgery for his/her facial laceration with dissolvable stitches, Steri-strips, and surgical skin glue. The lacerations to the AV’s leg and hand were repaired with Steri-strips and surgical skin glue. The AV was prescribed an antibiotic and pain relieving medications post-operation. The AV’s condition and recovery were monitored by the hospital throughout the evening and into the following day. · On June 14, 2024, the AV was discharged from the hospital. Follow-up medical visits were required to ensure the AV’s injuries were healing as expected and that no further concerns resulted from the injuries or procedures in repairing these injuries. P1 provided the following information: · On June 13, 2024, at approximately 2:35/2:40 p.m., P1 was working in the school age room preparing snack when s/he overheard noises coming from the kitchen. P1 looked out his/her classroom door and saw the SP and P2 on the floor “fighting.” P1 immediately left the school age room to seek help from P3 who was working in the infant room. There were four infants, including the AV and the SP’s child, in the classroom at this time. P1 remained in the infant room while P3 responded to the incident with the SP and P2. · P1 then began changing a child’s diaper and had his/her back facing the door when the SP “swung open” the door to the infant room. P1 turned around and saw the SP with a pizza cutter “going after” the AV who was sitting by the classroom door. P1 yelled for the SP to “stop” several times and then the SP “threw” the pizza cutter onto the floor, picked up her/his own infant child who was in the room, and left the classroom. P1 immediately put down the child s/he was holding and picked up the AV. The AV was crying and his/her face was bleeding. P1 then “yelled” out the door for P3. · P3 came into the infant room and assisted P1 in carrying the AV to the changing table to assess and attend to the AV’s injuries. P3 gave P1 paper towels that were then used to apply pressure to the AV’s face. · While attending to the AV, P2 entered the infant room crying and yelled, “No, my baby.” P1 lifted the paper towels to show P2 the cut made to the AV’s face and stepped aside to let P2 care for the AV. P1 stated that P3 had called emergency services. P1 left the infant room to check on the other staff and children present within the facility. · P1 stated that after going back into the school age room, some children were “scared” or crying and everyone seemed “pretty shaken up” by the situation. During this time, an ambulance arrived and transported the AV and P2 to a hospital where the AV was treated for his/her injuries. · P1 was not aware of any interpersonal conflicts between the SP and P2 prior to the incident and said that s/he thought they “got along.” P1 did not have any concerns with the SP’s interactions with children prior to the incident. P3 provided the following information: · On June 13, 2024, P3 was working in the infant room and at approximately 2:30 p.m., returned from a lunch break. Shortly thereafter, P1 “ran” into the infant room and told P3 that s/he “needed to get to the kitchen.” P1 remained in the infant room and P3 immediately left the room to go to the kitchen. P3 saw the SP on top of P2 and children from the nearby school age room were watching the SP and P2. P2 told the SP to “think of the kids” who could hear and/or see the incident. P3 stated that s/he could “tell they were mad” but was able to “finally separate” the SP and P2. Some “words were exchanged” between the SP and P2, and P3 saw P2 take his/her phone and go to the front entry way. Due to the incident, there was not a staff person in the school age room and P3 could see that some of the children were crying. P3 went into the school age classroom and “tried to get them calm.” · Shortly after arriving in the school age room, P3 heard the SP and P2 fighting again in the front entryway. From the classroom doorway, P3 could see the SP with a pizza cutter trying to push open the entryway door to get to P2. P3 could “see the fear in [P2’s] eyes” as the SP was “pounding” on the glass door trying to get to P2. P3 “screamed” the SP’s name and told the SP to “stop.” The SP left the entryway and turned to walk down the hallway. P3 heard the SP say s/he would “hurt” or “cut” P2’s children. P3 told the SP to “calm down” but remained in the school age room with the preschool and school age children. P3 was the only staff person working in the school age room and needed to console the children who were upset by the incidents they overheard and witnessed. P3 stated that s/he did not know the SP would “snap.” · P3 then saw the SP getting ready to leave the facility with his/her own children and during this time, P2 entered the school age room. P3 left the school age room to help get a stroller for the SP’s child and saw P1 standing in the infant room doorway holding the AV. P1 told P3 that s/he needed help because the SP cut the AV with the pizza cutter and the AV was hurt and bleeding. P3 observed a “huge cut” or “laceration” on the AV’s cheek, as well as other “scratches” on the AV’s leg. The “scratches” on the AV’s leg “didn’t seem deep” compared to the laceration on the AV’s face. P3 helped carry the AV to the changing table, gave P1 paper towels, and told P1 to apply pressure to the AV’s injury. During this, the AV was crying. P3 stayed in the classroom while calling emergency services, stating to the dispatcher that the SP “attacked a baby” and the AV had “a huge cut on [his/her] cheek.” P3 left the infant room and went to the school age room to notify P2 of the incident and the AV’s condition. · An ambulance arrived and the AV, accompanied by P2, was transported to a nearby hospital. P1, P3, and another supervisory staff person visited the AV in the hospital later that evening. The AV received stitches to the cut on his/her face that was covered by gauze, as well as medical wraps had been placed on the AV to both arms and both legs. The SP provided the following information: · On June 13, 2024, the SP was working in the toddler room and had asked P3 if s/he could start washing dishes after returning from a lunch break and P3 said that the SP could do so. At approximately 2 p.m., the SP was in the kitchen when P2 came in and told the SP to go to the toddler room. The SP stated that there was a staff person already in the toddler room and that s/he was completing the “routine” tasks that P3 said was “ok for me to do.” P2 told the SP, “No, get your kids.” The SP stated s/he was frustrated and “slammed” the kitchen door. The SP and P2 started “hitting” one another and “fighting.” P2 then “ran off” from the kitchen and told the SP that s/he was going to call the police. · The SP saw P2 by the facility’s entryway doors talking on the phone and the SP started “banging” on the doors trying “to get” P2. The SP stated that P2 “whispered” threats to hurt and “stab” the SP’s children who were also present at the facility (Note: There was no additional information that this occurred), which made the SP “mad.” The SP then went to the kitchen, found a pizza cutter in a kitchen drawer, and “went to go cut [P2’s] kid [the AV].” · The SP went to the infant room and opened the door and saw the AV sitting by the door. P1 was the only staff person working in the infant room at this time. The SP went to the AV and cut multiple areas of the AV’s body with the pizza cutter, including “a big gash on [the AV’s] face, legs, and arm.” The incident lasted for approximately one minute. The SP stated that the AV was not crying. P1 then “got” the AV. · The SP told this investigator that s/he was “done talking” and refused to answer any further questions or provide additional information. According to the facility’s Behavior Guidance Policies, staff persons were to ensure that each child was provided with a positive model of acceptable behavior, taught acceptable alternatives to problem behavior in order to reduce conflict, and protect the safety of the children. Staff persons were prohibited from subjecting a child to corporal punishment, including rough handling, shoving, shaking, slapping, kicking, biting, pinching, hitting, or spanking. According to the facility’s Employee Handbook, meaningful relationships, including those between staff persons, were to be maintained in building trust and good working relationships. Staff persons were responsible to ensure that work interactions were kept professional, both verbally and in their interactions, modeling behavior that reflected healthy growth and development for young children. Facility documentation showed that P1, P2, P3, and the SP each received training on the Reporting of Maltreatment of Minors Act and on the facility’s policies, including Behavior Guidance Policies, prior to the incident.
Conclusion: A. Maltreatment: Information was consistent that on June 13, 2024, after a verbal and physical altercation between the SP and P2, the SP used a pizza cutter to cut the AV’s face, hand, and leg. Medical records showed that the AV sustained a “significant laceration” to his/her face and cuts and scratches throughout his/her body. The AV was hospitalized from June 13 through June 14, 2024, and received surgical “repair” to lacerations on his/her face, hand, and leg. Information provided by the MD, medical records, and P2 also showed that the AV was to continue to have follow up medical appointments to monitor the healing progress of the AV’s injuries. Given that the SP cut the AV with a pizza cutter and that the AV sustained a “significant laceration” to his/her face and “cuts and scratches” throughout his/her body that required surgical repair as a result of the SP’s actions, there was a preponderance of evidence that the SP’s actions were not accidental and caused injury to the AV. 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. The SP received training on the facility’s policies, including Behavior Guidance Policies, and the Reporting of Maltreatment of Minors 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 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 skin lacerations that required the care of a physician. 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 found their policies and procedures 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 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. 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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