Federal audit finds hazards abound in Minnesota child care

Federal regulators found persistent safety and health hazards during random visits to 23 Minnesota child-care facilities last year and are calling for stronger state and county inspections.

Riding along with state and county licensers during routine inspections, federal regulators found one home day care that was over capacity — a situation that has been linked to neglect and even deaths — and one child-care center with four workers for whom required background checks were incomplete.

Uncovered electrical outlets and unlocked closets full of cleaning chemicals were also noted in the audit reports, released Monday by the U.S. Department of Health and Services (HHS), that blamed providers' noncompliance partly on inadequate state inspections.

"Limited oversight occurred because the inspectors were responsible for too many providers, resulting in high caseloads and limiting the amount of time spent on each inspection," according to the reports, produced by the federal HHS' inspector general.

The conclusion agrees with industry reports indicating that Minnesota child-care inspectors have some of the nation's heaviest caseloads.

Minnesota was one of nine states selected for an audit because of the amount of federal block grant funds it receives to help low-income families pay for child care.

The recommendations for more frequent inspections and lower caseloads only add pressure in Minnesota, where the current policy of at least one inspection of a licensed child-care facility every two years will soon be superseded by a new federal rule requiring annual inspections.

The changes were proposed by the Obama administration in 2013 following media coverage of child-care deaths in Minnesota and Missouri, including a Star Tribune series on children dying in day-care homes.

As a result, the audit recommendations "really are pushing us in a way that we're going already," said Jerry Kerber, state inspector general for the Minnesota Department of Human Services, which oversees child-care licensing.

In 2013, Minnesota had one state licensing worker for every 194 centers, the third highest caseload in the nation, according to Child Care Aware of America, a national advocacy group. Home-based child cares with licenses are the responsibility of county inspectors in Minnesota, with caseloads varying by county but averaging around one inspector per 150 homes.

The state caseload dropped last year after legislators increased funding to employ 12 rather than 8 child-care center inspectors. But in the next two years, Kerber said, the state and counties will have to find the money to hire the number of inspectors necessary to conduct annual visits to 1,500 child-care centers and 11,000 licensed homes.

"We're going to have to do a very serious review of our whole system," Kerber said.

A 2012 Star Tribune investigation found that child-care deaths had increased sharply in Minnesota, reaching nearly one per month, and that almost all of the deaths were occurring in licensed homes rather than larger centers. Inadequate supervision, overcrowding and lax adherence to safe-sleep guidelines for infants were causes identified in the series, which motivated the Legislature to require increased safety training for licensed home providers.

Deaths of children in care have since declined; just one was recorded in 2014. One also occurred this year, Kerber said, when an infant choked on a bean.

More inspections will yield more progress, said Mike Barton, who managed the federal HHS audit in Minnesota. "We need to be making sure children are getting safe and good quality care," Barton said.

Federal auditors in other states found day-care providers reluctant to let them in when they showed up on their own. So last spring in Minnesota, they instead rode along with state inspectors on unannounced visits to three centers, and with county inspectors to check on 20 licensed homes.

All but one home received at least one citation. Multiple homes had providers who were out of date on training to prevent sudden unexpected infant deaths. All three centers lacked documentation proving all their workers had undergone background studies.

The audited home that had too many children was penalized as well, he said. "Too many situations, where something went badly, a provider was found to be out of compliance with the capacity limits," Kerber said.