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Posts Tagged ‘child care inspections’

This past week, the Secretary of the Department of Health and Human Services, Kathleen Sebelius, held a press conference at an early learning center in Washington, D.C.  to announce new rules to promote the health and safety of children in child care.  She said that in the absence of legislation to reauthorize the Child Care and Development Block Grant (CCDBG), the Administration is proposing to revise current regulations to better promote the safety and healthy development of children.

HHS Press Conference May 16, 2013

HHS Press Conference May 16, 2013

In addition to the Secretary, a child care center provider and an individual licensed to operate a child care program out of her home spoke about the need for quality child care. They talked about the importance of high quality care for children to both be safe and in a setting that leads to school readiness.  For millions of children, child care is their early learning program.

One of Child Care Aware® of America’s parent leaders from Virginia, Elly Lafkin, spoke at the press conference about the death of her baby in a child care program. She told everyone how she and her husband had limited access to child care because they live in a rural area. She said this was their first baby and they were doubly anxious and cautious. A background check was conducted but it was a name check NOT a check using a fingerprint match against state and federal records. Unfortunately, the name check searched for only that particular name and it was only after the death of her baby when a police investigation was conducted that she and her husband learned of multiple aliases her provider had and the list of offenses for which her provider was convicted. She looked right at the audience and told them – if she knew that the provider had those offenses, she never would have selected her among other providers to care for her baby.  For more information about state requirements on background checks, click here to see the latest information and state tables from our research.

The proposed HHS regulations include minimum training requirements like safe sleep practices and first aid, practices to prevent shaken baby syndrome and emergency evacuation or shelter-in-place planning.  The Secretary called them common sense requirements. She talked about the importance of continuity of care.  She is concerned that frequent recertification requirements means in many states that parents are losing access to care, not because they earned more money, but because they somehow did not comply with the paperwork.  Another key component of the proposed new rules is for states to ensure that parents have more information about the quality of care so that they can be informed consumers.  The Secretary said inspection reports should be posted on the Internet and parents should receive information about child care programs through the use of quality indicators that can be easily understood by the public.  This only makes sense. Parents really can’t make informed choices if they don’t have information.

Congress has not reauthorized CCDBG in 17 years.  It makes sense for HHS to review current regulatory authority to better protect children.  The proposed regulations are posted on the Internet and HHS is inviting public comment over the next 75 days.  There are several areas in the regulations that ask for specific comments with regard to aspects of quality care such as scope and hours of training, frequency of inspections, and an appropriate time-frame during which to phase-in the new requirements.

Child Care Aware® of America will be working in the weeks ahead to promote the best quality care possible. We’ll be holding webinars and preparing summaries of various aspects of the proposed regulations. The comment period of 75 days is a long time, but it will go by fast. HHS needs to hear from us about what we believe will promote the health and safety of children in child care.

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Child Care Aware® of America’s Affordable, Quality Child Care Campaign

We’re building a nationwide movement, a campaign to expand access to affordable, quality child care.  Every week, nearly 11 million children are in some type of child care setting – on average for about 35 hours.  Our studies show that the quality of child care varies greatly, not just between states but also within states – among different types of child care settings.  Children should be safe while their parents work.  Child care should offer an environment that promotes the healthy development of children.  Policymakers at the state and federal levels call for all children to start school ready to learn. They call for reducing the achievement gap among low income and other children as well as between children of different races. They call for strategies to better meet the challenges faced by children with special needs.  Most also call for increasing the high school graduation rate.

All of these goals have merit.  But, to reach them, we simply can’t ignore a child’s earliest years and the settings young children are in.  There is no magic wand to reduce the achievement gap and increase high school graduation rates.  However, we can strengthen child care settings to ensure that more children start school ready to succeed.

The cost of child care is unaffordable for most families.  If we are going to strengthen the quality of care, we need to design a better system to finance child care in this country.

Below are the top 10 reasons to join our movement.  Any one of them alone is enough to unite. But, together, they paint a picture policymakers can no longer ignore.  Join us and together we can make a difference!

Top 10 List

1)      The annual cost of center-based infant care exceeds the cost of college in 36 states.

2)      Eight states license or regulate child care without first conducting an on-site inspection.

3)      Only 13 states require comprehensive background checks on staff hired to work in a child care center.  A comprehensive background check includes a fingerprint check against state and federal records, a check of the child abuse registry and a check of the sex offender registry.

4)      Only 11 states require a comprehensive background check on family child care home providers before granting a license.

5)      Only 33 states meet all 10 health and safety standards in child care centers recommended by pediatric experts. Only 15 states meet them for family child care homes.

6)      Fewer than half the states require child care providers to have training in early childhood development.  In fact, training requirements vary greatly among the states and most states have weak minimum training and education requirements for child care providers.

7)      Many states do not require child care providers to have a written emergency plan – either to evacuate when necessary or shelter-in-place (or “lock-down”) in emergencies.

8)      Many states do not conduct routine inspections of child care programs. In fact, California inspects child care centers only once every 5 years. Montana and Iowa inspect family child care homes only once every 5 years; Pennsylvania once every 6 years.  Michigan only inspects family child care homes once every 10 years!

9)      Only one out of every six children eligible for a child care subsidy receives assistance. And, nearly one-fifth of those children (about 322,000) are in unlicensed care (which has no training required and no minimum health and safety protections for children).

10)   Eight states do not license small family child care homes (i.e, providers do not need a license until more than six children are cared for in the home).  In South Dakota, 12 children can be cared for in a home before a license is required with the 13th child.

It’s time for Members of Congress and State lawmakers to hear your voice. Join with us!  If you  have not yet signed up for Child Care Aware® Parent Network to receive our newsletters and connect with others in your state who want to make a difference, sign up today!

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The Year in Review

Child Care Aware®of America’s quality child care campaign kicks off another year today on the journey for affordable, safe, quality child care for all children.  How are we doing? What markers have we achieved to date?

The Child Care and Development Block Grant (CCDBG), the federal law that allocates funds to states to help families afford child care and to assist states in improving the quality of child care, marked another year without reauthorization (the enactment of legislation that reviews current law and makes improvements where necessary).  It’s been 16 years since the last reauthorization. That’s too long. Hopefully, 2013 will ring the reauthorization bell.  Noteworthy for sure:  The Senate Health, Education, Labor and Pensions (HELP) Subcommittee on Children and Families held three child care hearings in the 112th Congress:

  • (July 2012) CCDBG Reauthorization: Helping to Meet the Child Care Needs of American Families. You can watch the webcast and read the testimony here.
  • (September 2011) Examining Quality and Safety in Child Care: Giving Working Families Security, Confidence and Peace of Mind. You can watch the webcast and read the testimony here.
  • (June 2011) Getting the Most Bang for the Buck: Quality Early Education and Care. You can watch the webcast and read the testimony here.

Hearings lay the groundwork for reauthorization.  Thank you Senate HELP Committee Senators and staff for the work that you do.  Thank you also to the many parents, advocates, child care providers, and early childhood experts for your dedication and commitment to quality child care that helped make Senate hearings possible in our nation’s capital.

Short of national legislation, much progress has been made throughout the states.  Child Care Aware® of America has released six child care licensing studies since 2007.  The “We Can Do Better” series, which scores and ranks states based on their state child care center laws and regulations, was first released in March of 2007 and updated in 2009 and 2011. The report will be updated again in April of 2013. The “Leaving Children to Chance” series, which scores and ranks states based on their state small family child care home laws and regulations, was first released in March of 2008 and updated in 2010 and 2012. In reviewing our most recent reports with the initial reports when we first began on this journey, it is clear that states are making strides to improve the quality of child care.

  • Background Checks:  Screening out those who have a violent history of offenses (such as assault and battery, sex offenses, homicide, etc.) is key to promoting the safety of children in child care.  When we began our studies, only a handful of states required a comprehensive background check: a check of federal and state records using fingerprints, a check of the state child abuse registry and a check of the sex offender registry. Today, 13 states require a comprehensive background check for those working in child care centers (AK, CO, HI, ID, IL, MS, NH, NJ, NC, SC, SD, TN and WA).  In addition, 11 states require a comprehensive background check for small family child care home providers (AK, CO, FL, HI, IL, NH, NC, SC, TN, WA and WV).
  • Health & Safety Requirements: When we began looking at state health and safety requirements for child care, only 8 states met each of 10 health and safety requirements recommended by pediatric experts. Today, 33 states met all 10 health and safety standards recommended by pediatric experts for child care centers.  Also notable for child care centers, an additional 10 states met 9 of 10 health and safety standards. Far fewer, but still progress when measured against our first report, 15 states met all 10 health and safety standards recommended by pediatric experts for small family child care homes. Also notable for small family child care homes, 34 states met 9 of 10 health standards and 32 states met 9 of 10 safety standards.
  • Child Development: When we began looking at state required activities compared to developmental domains (i.e., social, emotional, physical, language/literacy, cognitive and cultural domains), only 13 states required activities in child care centers within each of the domains; 10 states had no requirements for activities in child care centers related to developmental domains. Today, 22 states require activities in child care centers within all 6 developmental domains; 3 states have no required activities in child care centers related to developmental domains (AL, CA, ID).  For small family child care homes, today 8 states require activities in all developmental domains (AZ, DE, GA, KS, MI, TN, WA and WV).
  • Inspections: When we began looking at state monitoring or oversight practices, only a handful of states conducted regular inspections and few posted inspection results on the internet for easy parent access. Today, 5 states conduct inspections of child care centers less than once per year (AL, CA, ID, MN, and VT).  Progress has been made but still too many states – 24 – conduct inspections of small family child care homes less than once per year. More than half the states post inspection reports on the internet so that parents can make informed decisions when selecting child care.

To review a table of progress made against key benchmarks on the roadmap for quality child care, click here.

Progress has been made. Numerous states have made important improvements to ensure that children are safe and in child care settings that promote their healthy development. However, much work remains at the national level to enact CCDBG reauthorization and within the states.

Thank you state child care administrators, parents, advocates, child care providers, child care experts and all those who work every day to ensure that progress toward quality child care is being made. We’re on the road, we’ve had some success.

With the start of 2013, our campaign continues. Keep up the good work. Progress can’t be made without you – and, together we can make a difference.  Nearly 11 million children in child care are depending upon you. Make 2013 a banner year!

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Playground accidents happen, just ask any parent.  A scraped elbow, a scraped knee, but on September 9,  19-month-old Faith Phillips died from injuries she sustained  just a few days before at a licensed child care center in Wasilla, Alaska.

What happened?  A parent’s worst nightmare.  The toddler’s head became stuck in a hole in some playground equipment and she strangled to death.  The staff of the center rushed around to find someone on staff who knew CPR, but their efforts were not in time.  An investigation is ongoing, but parents wanted to know why all staff did not know CPR,  how many staff were on the playground at the time and whether they were supervising the children or talking as if “on break” among themselves.

The Deputy Commissioner for Family, Community, and Integrated Services within the Alaska Department of Health and Social Services said an investigation of the center had previously been conducted based on  complaints from parents about a lack of supervision.  In June of 2011, the state found enough evidence to support the complaints related to the supervision of children and fined the center. A correction plan was required but until the current investigation is complete, it is unclear what set of circumstances led to the tragedy. The center is currently closed until further notice.

The Alaska DHSS (in addition to the area DHSS office) and the Wasilla Police Department are investigating the incident.  Gene Belden, Chief of the WPD, said that the death was accidental. State law provides for criminal charges in cases of accidents if it’s proven there was negligence.  Belden said, “It’s a sad thing to have all this interest after something happens instead of prior to it.”

In Alaska, like in many other states, state law requires only one staff person on the premises to be certified in CPR.  We think that’s not enough.  All staff working with children should know and be able to conduct CPR in an emergency.  There should be no rushing around to find someone who can perform CPR.  The child care center in Wasilla had previously been cited for its poor supervisory practices.  The center had been fined.  The center was supposed to implement an improvement plan requiring more effective supervisory practices.  Many states fine programs $200 or $1,000 for certain violations. What dollar amount is enough to ensure that child care providers actually change their behavior for the long-term – not just in the weeks after being cited, but forever?  We don’t know.  We have no studies on that. But, intuitively, the larger the fine, the less likely providers would risk the offense.  How much is a child’s life worth?

At a minimum, the tragic death of Faith Phillips is a wake-up call for training.  Providers need to know CPR and they need to engage in effective supervisory practices.  How did Faith stick her head in the hole in the playground equipment?  How long did she strangle in the equipment before being discovered?  How many adults were on the playground?  Where were they and what were they doing? No doubt the investigation will review these questions.

In the meantime, if we are to prevent accidents like the tragic incident with Faith, we need to call on policymakers to require appropriate training.  Urge your Members of Congress today to require minimum training that includes CPR as part of child care reauthorization legislation.

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Joshua Minton’s parents did what many parents do when looking for child care. They asked family, friends and neighbors for recommendations. They selected a provider for their son Joshua. They didn’t know that the provider had been cited over a period of years for numerous safety violations in state inspection reports. Several times, the provider had been cited for inappropriate discipline. Nevertheless, she remained licensed, and the Minton’s did not know of her history. They only knew that she had been caring for children for years and seemingly had good recommendations.

On the day that 2-year-old Joshua died, the provider had taped his mouth shut with masking tape presumably because he was whiney. After Joshua died, the state revoked the provider’s license. She was charged and found guilty. Given her history of repeat violations cited in inspection reports, what does it take to close down a child care provider? Oklahoma changed its law. But, many other states allow repeated violations without revoking a license or prohibiting children whose care is paid for with a federal or state subsidy from attending. It’s time to ensure that children are safe in child care.

Hear the story of Joshua Minton.

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Child Care Aware® of America (formerly the National Association of Child Care Resource & Referral Agencies, NACCRRA), has released a new research paper, Why Aren’t We Outraged? Children Dying in Child Care Across America.”

The Child Care and Development Block Grant (CCDBG), the law that allocates funds to states for child care and sets the framework for state child care laws, does not require the reporting of child fatalities in child care settings.  While most children may be safe in child care, children should not be left to chance.

Child Care Aware® of America’s new research paper reviews state requirements with regard to the reporting of the deaths of children in child care.  The paper calls for all child deaths in child care settings to be reported to state licensing offices and state child care administrators offices within 48 hours of their occurrence and that the data be aggregated and sent to the U.S. Department of Health and Human Services on an annual basis.

Child Care Aware® of America has been working with parents across the country whose infants or young children have died. Many of these deaths were accidents but as we listened to the stories told by the parents or relayed through newspaper accounts, we saw a pattern. Most of the tragedies could have been avoided with either some minimum training or more effective monitoring.

When we sought to calculate the number of deaths in child care, we saw that some states don’t require deaths in child care to be reported to state licensing agencies and that states that did require reporting varied in what information was reported.   Collecting data is not meant to sensationalize these tragedies in any way. Rather, the data would help inform policymakers and state administrators so that minimum  protections for children can be strengthened such as requiring basic safety and training that could prevent such tragedies from occurring.

Children should be safe in child care.  If we can collect information to better promote their safety, we should.  As the Child Care and Development Block Grant is reauthorized, let’s collect the data that will help prevent tragedies and ensure that effective health and safety, training, and monitoring is part of the law.

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