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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.” On June 18, 2025, most of the children and family work, including investigations of maltreatment at childcare centers, at the MN Department of Human Services (DHS) Office of Inspector General transferred to the new Minnesota Department of Children, Youth, and Families (DCYF), as directed by state law. While this investigation began under DHS, pursuant to Minnesota Statutes, section 15.039, subdivision 2, this Investigation Memorandum is being issued by DCYF pursuant to that transfer.
License Number and Program Type: 1117993-CCC (Child Care Center) Investigator(s): Judie Schwanke Minnesota Department of Children, Youth, and Families Judith.schwanke@state.mn.us Suspected Maltreatment Reported: It was reported that an alleged victim (AV) was left in a classroom without staff persons’ (SP1 and SP2) knowledge or supervision for approximately 25 minutes. Date of Incident(s): June 3, 2025 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 June 13, 2025; from documentation at the facility; and through six interviews conducted with the AV’s family members (FM1 and FM2), two supervisory staff persons (P1 and P2), SP1, and SP2. The AV was 14 months old and enrolled in a young toddler classroom at the time of the incident. The AV was not interviewed due to his/her age. The facility was in the lower level of a multi-level business complex. There were entrances to the facility from the exterior of the complex and from a parking ramp. Once inside the facility, there was a lobby area and a hallway that led to a gym and classrooms, including the young toddler classroom. The young toddler classroom was L-shaped with tables, chairs, toy shelves, and rugs. Upon walking into the classroom, to the right there was a children’s storage unit that was divided into individual sections, each of which had a top cubby, a bottom cubby and a longer middle portion with hooks for coats. To the left of the doorway were upper and lower cabinets with locked doors and drawers. At the back of the classroom was a door that led to a small vestibule and beyond the vestibule was a door that led to a fenced playground. In the classroom were restrooms with gates in their doorways. FM1 and FM2 provided consistent information that the AV was enrolled at the facility for five- and one-half days before the incident occurred. On June 3, 2025, shortly after 12 p.m., P1 called FM2 and told him/her that the AV had been “left alone” in the “locked,” young toddler classroom for approximately 20 minutes when staff persons “failed to follow protocol.” P1 told FM2 that video footage of the incident was reviewed, and it was determined that the AV was “safe.” FM1 and FM2 went to the facility and viewed approximately one third of the video footage and saw the AV standing near one of the staff persons. Then one of the staff persons opened the door and the group left the classroom. The staff person at the end of the line shut the classroom door behind him/her “without looking back.” When the door closed the AV “began to cry.” FM1 and FM2 stated the video was “hard to watch,” and saw the AV “self-sooth.” While the AV was unsupervised s/he looked at books, took out something from his/her bin, walked around the classroom, and cried at the door. Typically, the AV slept through the night and the night of the incident, the AV had a “very hard night” and did not sleep through the night. At the time of this investigation, the AV was no longer enrolled at the facility. The facility used a mobile application (app) platform used to communicate with families and streamline administrative functions. The app showed that on June 3, 2025, at 10:02 a.m., for the young toddler classroom, a “spot check” was completed and 14 children, including the AV, were checked at that time. P1 and P2 provided the following consistent information: · On June 3, 2025, at approximately 10 a.m., P1 and P2 were at the lobby desk. SP1 and SP2 transitioned the young toddler children from the classroom, past the lobby area, to the gym. After that, P1 heard “off and on” crying and assumed it was from a nearby infant classroom. At approximately 10:24 a.m., P1 heard “excessive crying,” and told a staff person that was about to walk into the infant room to be careful because a child was near the door. That staff person peeked through a window in the infant room door and told P1 that there was not a child near the door. P1 then “realized” the crying was coming from a different room and walked to the young toddler room and found the AV in the room “alone,” crying at the door. · P1 picked up the AV and the AV “calmed.” P1 carried the AV out of the classroom and told P2 that s/he had found the child alone while the rest of the class was in the gym and SP1, SP2, and the other children came out of the gym to transition back to the classroom. P1 told SP1 that s/he had the AV and P2 told SP1 that s/he had to do name to face and asked why it was not completed. · P2 stated that SP1 told him/her that s/he completed a name to face check in the classroom and s/he did not do a name to face check at the doorway to the gym before going inside. · P1 and P2 helped get the group back to the classroom and complete a name to face check with SP1 and SP2. · P1 and P2 reviewed video footage of the incident. P2 saw that SP1 completed the name to face check incorrectly because s/he did it while the children were in the classroom instead of as they walked through the doorway. SP1 and SP2 did not “realize” the AV went behind them. · P1 stated that staff persons received training in orientation and by reading policies. When P1 trained staff persons, s/he modeled proper name to face checks and counting. P1 did not know if that was “missed” in training SP1 or there was a “misunderstanding.” · P2 stated that staff persons were trained to complete a name to face check in the app on a tablet. On the app there was a roster of the children signed into the classroom. Staff persons were trained to “tap” each child’s name in the app as they walked through a doorway during a transition. · P2 “recommended” to staff persons to “just” do name to face checks because only counting the number of children was not a safe way to ensure they were all accounted for. SP1 provided the following information: · On June 3, 2025, at approximately 10 a.m., SP1, SP2 and 12 children, including the AV, were in the classroom preparing to go to the gym. SP1 stood by the door and completed a name to face check in the app on a tablet. SP1 saw the AV near the door with all the other children. Then SP1 put down the tablet, opened the classroom door, and asked SP2 to hold the door open. SP1 then walked out, leading the group out of the room. SP2 was at the end of the line and when s/he thought all the children were out of the room, s/he closed the door and the group walked to the gym. · When the group arrived at the gym, SP1 opened the door and the children walked in. SP1 did not complete a name to face check or count the children at that time because s/he was “not taught correctly.” · At 10:28 a.m., SP1, SP2, and the group of children were getting ready to leave the gym. SP1 was in the gym doorway and started to complete a name to face check. S/he “freaked out” when s/he saw P1 and P2 with the AV. P1 held the AV and the AV looked “calm.” The group went back to the classroom and P1 and P2 helped SP1 complete a name to face check and “physically” make sure each child was there. · SP1 stated the AV was unsupervised for 28 minutes. · SP1 was taught how to complete name to face checks during a transition by observing a previous staff person. That staff person completed a name to face check on the app while the group was still in the classroom. Then as the group walked through the door, s/he counted the children. Once the group arrived at the destination, s/he counted the children again but did not do another name to face check. · After the incident, there was a staff meeting and SP1 was trained on how to complete a transition “correctly.” SP2 provided the following information: · SP2 stated that on the day of the incident, s/he went into the young toddler classroom at 10 a.m. SP1 had the children by the door ready to transition to the gym. SP1 had the tablet and SP2 did not complete a name to face check and did not count the children when transitioning to the gym. SP2 did not recall seeing the AV in the classroom before transitioning. SP1 carried one child and SP2 carried another child, and the group left the classroom. · When the group arrived at the gym, SP2 did not count the children. SP2 stated s/he “always” counted the children but on the day of the incident, s/he “missed” counting. SP2 did not know if SP1 counted the children. · After approximately 25 minutes, SP1 and SP2 were getting the children ready to leave the gym and P2 approached them with the AV. P2 was “screaming and mad” and told SP1 and SP2 that they had left the AV in the classroom. Between 10:27 and 10:28 a.m., the group arrived back in the classroom. SP2 “felt bad” and held the AV. The AV did not cry at that time. · SP2 stated s/he was trained that it was both staff persons’ responsibility to complete a name to face check and count the children when transitioning. The facility provided two video segments of the June 3, 2025, incident from a camera in the classroom. The videos did not contain audio. The videos provided the following information: o The first video segment was 15 minutes and started with SP1, SP2, and children, including the AV, standing near the door in the young toddler classroom. SP1 and SP2 each held a child in their arms. SP1 opened the classroom door and walked through it. SP2 held the door open and children walked and crawled through the door. SP2 stood in between the door and the camera so this investigator was not able to count all the children as they walked through the door. The AV stood directly behind SP2. SP2 walked through the door and the door shut with the AV still inside the classroom. o 11 seconds later, the AV walked to the classroom door. The AV stood at the door for approximately ten seconds and then turned and walked toward the back of the classroom. For approximately seven and one have minutes, the AV walked back and forth in the classroom and picked up two books. Then the AV walked toward the back of the classroom, placed a book on the floor, sat down and put his/her head on the floor. o The AV then sat up and picked up the book and put the book in his/her lap. After approximately one minute, the AV stood up and walked to the middle of the classroom. The AV’s face was red and s/he placed both of his/her hands over his/her eyes. Then the AV put his/her hands down, turned and walked back and picked up one of the books and held it for approximately 30 seconds while standing in the middle of the classroom. The AV then dropped the book, walked a few steps away, turned, sat on the floor and put his/her head on the floor. o After approximately one minute and 13 seconds, the AV stood up and walked to the front of the classroom. S/he stood near the children’s storage area. The AV attempted to climb into the storage area and both of his/her feet left the floor. The AV then stood back on the floor and walked toward the classroom door and that video ended. o The second video segment was 11 minutes and 4 seconds and started where the first video ended with the AV standing near the classroom door. The AV laid down on the floor for approximately 16 seconds. S/he then got up and walked to the children’s storage area and climbed into the storage area and then out again. The AV then walked to the classroom door, reached his/her hands up, and threw his/her head back. The AV walked to the children’s storage area again and picked out either a small blanket or an article of clothing from a lower bin. The AV held it and walked to the classroom door. The AV placed the item on his/her right shoulder and walked away from the door and back. S/he then walked back to the storage area and picked something else out of the bin. S/he then pulled the bin out and replaced the item. The AV then walked to the classroom door and sat down near the door with his/her back to a wall for approximately four minutes. The AV’s right shoe came off and the AV attempted to put it back on. Then the AV stood up and placed his/her left hand on the door and looked up. The AV then walked to the storage bin with his/her right shoe partially on his/her foot. S/he took out three items from the bin and placed them on the floor. S/he threw one of the items back into the bin and then sat down near the other two items and attempted to put his/her shoe on. The AV then stood up and lifted his/her shoe over his/her head three times. o After approximately 26 minutes from when the first video started, the door to the classroom opened and P1 walked into the classroom. P1 picked up the AV and walked toward the back of the classroom and the video ended. The facility’s Risk Reduction Plan stated that when children transitioned from one area to another, staff persons supervised children at all times and completed name-to-face counts. One staff person led the group and the second staff person followed the group to “ensure nobody” was left behind. All dangerous items were stored out of the reach of children. The facility’s Name to Face Policy/Supervision Policies stated that name to face practices were done hourly as well as during transitions from destination to destination. Staff persons were required to know the names and number of children in their care at all times, use name to face hourly checks to account for children in their care, and conduct an additional head count when transitioning to different areas. Proper name to face practices included saying children’s names out loud and “physically having eyes on them.” Name to face checks were completed by staff persons before groups left an area, when they arrived at the doorway of the new destination, and when lined up to leave that destination. Children were supervised by sight and sound at all times. Facility documentation showed that P1, P2, SP1, and SP2 each received training on the Reporting of Maltreatment of Minors Act and on the facility’s policies, including the Risk Reduction Plan, and the Name to Face Policy/Supervision Policies. Relevant Rules and Statutes: Minnesota Statutes, section 142B.01, subdivision 27 and Minnesota Rules, part 9503.0045, subpart 1, item A, state that “supervision” means 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; and that children are required to be supervised at all times. Conclusion: Information was consistent that on June 3, 2025, the AV was left in the young toddler classroom for approximately 26 minutes without the knowledge or supervision of SP1 and SP2 which was a violation of Minnesota Statutes, section 142B.01, subdivision 27, and Minnesota Rules, part 9503.0045, subpart 1, item A. P1 found the AV and brought the AV to the group.
Minnesota Statutes, section 260E. 30, subdivision 3 states that rather than making a determination of substantiated maltreatment by an individual, the commissioner of children, youth, and families 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 required under Minnesota Rules, part 9503.0045; (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. Although the AV was unsupervised for approximately 26 minutes, it was determined SP1’s and SP2’s actions were a nonmaltreatment mistake for the following reasons: (1) At the time of the incident, SP1 and SP2 were performing job-related duties. (2) SP1 and SP2 each had not been determined responsible for any previous nonmaltreament mistake under this paragraph; (3) SP1 and SP2 each had not been determined responsible for any previous incident that resulted in a finding of maltreatment; (4) The AV was not injured and did not require medical care after the incident; and (5) Except for the period when the incident occurred, the facility and SP1 and SP2 were each in compliance with all licensing requirements relevant to the incident. The nonmaltreatment mistake to the AV by SP1 and 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 Children, Youth, and Families for a period of five years. Action Taken by Facility: The facility completed an internal review and determined that their policies and procedures were adequate but not followed by SP1 and SP2 because they completed the name to face while standing in the classroom rather than as they walked through the doorway. On June 5, 2025, all staff persons were retrained on how to properly conduct a name to face check. Action Taken by Department of Children, Youth, and Families, Office of Inspector General: SP1 and SP2 were not determined as perpetrators of maltreatment of the AV because the Department of Children, Youth, and Families 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 or SP2 are responsible might not be considered a nonmaltreatment mistake. On January 30, 2026, the facility was issued a Correction Order for the violation outlined in this report and not complying with medication storage requirements. 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 Children, Youth, and Families.
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