Monday, 8 November 2010

SIDS: Wisconsin: Child care regulations

By John Lee  October 31, 2010

In the spring of 2007, Craig and Georgia Ogden of Grand Chute were searching for a child care center for their two young children. They settled on Little Wonders Day Care.
A friend had recommended the in-home program that was licensed by the state. It was near the couple's home and seemed to be a good fit for their kids — daughter Lilyann, then 4, and son Grant, 5 months.
The Ogdens' good feelings didn't last, however.
In less than two months, they became unhappy with Patricia Frasier's operation and decided to enroll their children in a different program. But before they made the move, tragedy struck.
On the afternoon of May 9, 2007, Frasier found Grant unresponsive, not breathing and without a pulse in a crib. He was pronounced dead within an hour of being taken to a hospital.
Eventually, the Ogdens learned that Frasier violated several caregiver guidelines the day Grant died and was under orders from the state for previous violations.
"Our son Grant died because Patricia Frasier of Little Wonders Day Care was allowed to operate even after notification and citations were ignored," Craig Ogden told The Post-Crescent this fall.
Frasier closed Little Wonders the day Grant Ogden died and the state later revoked her license. No criminal charges were filed. Grant's parents, devastated by their loss and furious and frustrated about Frasier's conduct and the state's oversight, settled a wrongful death civil lawsuit against her last month that did not include money.
Frasier and her attorney, Jeffrey Oswald of Neenah, did not return messages from The P-C seeking comment.
Grant Ogden's death, while extreme and rare, demonstrates the potential dangers of child care facilities, the complex state rules laid out for care providers, and the challenges and high-stakes responsibilities of caregivers, state regulators and parents in keeping children safe.
State regulators have plenty to look after. During a 30-month period from Jan. 1, 2008 through June 2010, the Department of Children and Families, which tries to inspect all state-licensed day care operations in the state, took 104 enforcement actions among providers at the 201 day care sites in the Fox Cities, according to a P-C review of state records.
The state actions, which ranged from warnings to license revocations, arose from violations such as leaving a child unattended in a classroom, exceeding staff-to-child ratios, failing to pay a water bill or taxes on time, and improper discipline.
Operators themselves reported some of the violations.
Jill Chase, director of the Department of Children and Families' Bureau of Early Care Regulation, said the orders and forfeitures are "tools we use to gain compliance." Sanctions and penalties get progressively tougher if a day care provider fails to correct problems found during inspections. License denials and revocations are relatively rare, she said.

Tougher rules, more staff
After media attention about state public assistance fraud among day care operators and parents, mainly in Milwaukee, the state Legislature cracked down.
A new law that took effect Feb. 1 increased the list of offenses that can prevent someone from getting a license and provide grounds for revocation. It also requires more frequent background checks on care providers and increases some of those checks from every four years to as often as four times a year.
To conduct its background checks, the Department of Children and Families uses state Justice Department records, the state's Sex Offender Registry and child maltreatment records, which are kept by counties and may include offenses that were not criminal.
"Parents should feel real good about the fact that … we have been able to make advances," Chase said. "We have been able to do that and we should be proud of that.
"The steps we are taking are really recognizing now the importance of high-quality care for young children and the significant differences that can make."
In 2008, the state created the Department of Children and Families by combining some 30 services from the departments of Health and Family Services and Workforce Development. The agency, with a budget of $1.1 billion and 643 positions, licenses and monitors 5,300 child care facilities — including family providers, group providers and camps — that care for more than 217,000 children.
In addition to state-licensed operators, about 2,560 county-certified providers care for more than 15,000 children statewide. County-certified centers are inspected and regulated by counties and are limited to caring for no more than three children who are unrelated to the caregiver.
As part of the ramped-up effort, the state created a fraud detection and investigation unit and hired additional child care licensors, said Stephanie Hayden, a Department of Children and Families spokeswoman.
"These frontline workers are the eyes and ears on the ground. They visit when no one is expecting them. They look for the outlet covers and the latch on the gate."
Each of the agency's 59 licensors manages an average of 98 cases, Hayden said.
In the northeast region, which stretches from Marinette to Washington counties, and from Marquette County to Lake Michigan, 10.5 full-time equivalent licensors monitor 981 programs.
The region has offices in Fond du Lac and Green Bay.
Licensors are meeting the goal for twice-yearly visits to each facility except for a handful, most of which are in the Milwaukee area, Hayden said. A year ago, hundreds of facilities across the state were overdue for twice-yearly inspections. Today, that number is down to a handful, she said.
Last year, the agency conducted 10,068 child care site visits and investigated 1,541 complaints, Hayden said.

National evaluation

In a 2009 report, the National Association of Child Care Resource and Referral Agencies, which works with child care resource and referral agencies to improve child care, gave Wisconsin a score of 73 out of 100, sixth best in the country, for its child care regulations, with particularly high marks for posting of inspection information online, requirements for directors' credentials and staff orientation rules.
However, the state ranked just 41st in child care oversight. Chief weaknesses, the group said, were regulations that allow small centers to operate without a license, not requiring an associate degree for licensing staff, low requirements for lead teachers and not requiring fingerprint or sex offender registry checks as part of background checks.
The association recommended that the state increase inspections to more than twice a year, conduct federal background checks using fingerprints, and further increase requirements for center directors, head teachers and new staff orientation.
For oversight, the association said each licensor should be responsible for no more than 50 programs, and that all licensing staff members should have a bachelor's degree in a related field.
The state also received low rankings for not requiring four inspections a year.
The Wisconsin agency would have to nearly double its licensing staff to meet the 50-program threshold, said Chase, the Bureau of Early Care Regulation director.
She said the agency, and not the Legislature, set the twice-yearly goal.
"Even though we might have higher caseloads than we like, statewide we did conduct more than 10,000 inspections. We are meeting our own internal standards."
Lilly Irvin-Vitela, executive director of Supporting Families Together Association, a statewide agency that works with 11 child care resource and referral centers and 20 family resource centers, said the state does not have enough inspectors to check every "red flag."
"I actually have a lot of respect for the (state) licensing staff," she said. "I think they do an incredible job and have a huge caseload. There is not enough of them, in my ideal world. It is hard for them to get out there enough."

New rating system

This year, state lawmakers approved YoungStar, a rating system meant to help and encourage day care providers and to give parents more information in choosing a provider. It will begin Jan. 1.
Irvin-Vitela likes the idea.
"I think parents will have a way of knowing what a decent quality program is and what a high-quality program is," she said.
Still, she warned, parents should turn to resource and referral agencies for help, and consider more than location and cost.
"Just because a center is licensed doesn't mean that is a place you want your children. Even with that, there are questions about what is right for your family and what is right for your children," Irvin-Vitela said.
Chase, too, encourages parents to be proactive before and after they pick a provider.
"We need to encourage parents to really be the eyes and ears and research child care centers before making a selection, and visit the child care centers often," she said. "The tough reality of needing to find child care is a harsh reality for young parents. Sometimes young parents need child care immediately."

Ogden case

State licensing specialists found several violations at Little Wonders Day Care the day Grant Ogden died. Frasier had been notified of other violations previously.
The state investigation, reviewed by The P-C through a public records request, said Frasier violated guidelines the day of the baby's death by:

  • Putting a quilted blanket in the crib with the child, not tucking the blanket under the mattress, and not keeping it away from the child's mouth and nose.

  • Having a fluffy blanket, a stuffed animal and bumper pads in the crib.

  • Not having safety gates at an open stairway leading from the kitchen to the living room.
    At the time of the boy's death, Frasier already was under a state violation order issued Feb. 12, 2007, because the results of an Aug. 30, 2006, licensing visit were not posted and visible to parents, as required.
    During the Aug. 30 visit, licensors found that one child was missing an emergency medical phone number and another child did not have a follow-up health exam, as is required every two years after admission to a day care facility.
    In her investigation into the death, Erin Mancoske-Anderson, a regional state licensing chief, also said there were "inconsistencies on what happened (on the) day of death."
    She said Frasier fed the baby between noon and 1 p.m. and did not notice problems, then laid him on his stomach in the crib, which was in an upstairs bedroom. Babies are required to be placed on their backs in cribs unless specified in writing by a doctor, state rules say.
    Frasier checked him at 3 p.m. and "found him on his stomach, but with a large amount of vomit around his face, not breathing. She attempted to turn him over and cleared the vomit."
    Frasier told investigators she tried to call 911 five or six times but her phone didn't work, and said she eventually ran to a neighbor's home to get a cell phone.
    The phone provider reported no problems with phone lines that day, but records show Frasier was on the phone nearly constantly in the hour before the lifeless baby was found, according to state and Grand Chute police reports.
    State inspectors delivered a temporary closure notice, pending the investigation, and checked the home at other times to make sure Frasier was not operating as a care provider.
    She was unable to provide the certificate that showed she had taken required Sudden Infant Death Syndrome training, and stopped talking to police and licensing officials during a May 10, 2007, interview, saying she wanted her attorney present.
    Craig Ogden said the civil lawsuit against Frasier was not financially motivated. In the settlement, she admitted "some responsibility" for Grant's death, he said.
    "There was an agreement made and there is no money at the end of the trail, and there were things I wanted and (Frasier) agreed to them, and that was it," Ogden said.
    The end of the civil suit, however, may result in re-opening the police investigation into Grant Ogden's death.
    Grand Chute Police Chief Greg Peterson said he has talked to Craig Ogden, and is waiting to review information from the civil case to see if there is something that could cause police to take another look.
    "We have talked about that," Peterson said of reopening the case. "It is very possible new information could surface in a civil action."
    Save for having his son back, Ogden had two goals: "I have no intention to start pointing fingers at anyone," he told The P-C before the lawsuit was settled. "I want an admission (of responsibility) and I want to make sure this lady isn't baby-sitting anymore."
    John Lee: 920-993-1000, ext. 362, or

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