Punishments low and slow for problem day cares

Georgia’s day care rules cover everything from hygiene, healthy lunches and snacks to toys and learning opportunities.

But failing to meet those standards won’t cause a day care to lose its state license.

What will? In most cases it takes a child’s death or serious injury, abuse or serious neglect. Although Georgia’s day care rules are policed through inspections, the state rarely revokes a day care license even after years of violations. Fines are modest, and state day care inspectors, called consultants, have heavy caseloads.

But in recent years, Georgia’s Department of Early Childhood and Learning, also called Bright from the Start, has retrained and reorganized its inspectors, developed more detailed improvement plans for low-performing centers and has now embarked on an “intensive care” initiative to push those poor performers to a higher level.

Losing a license

Just 27 out of the roughly 8,000 licensed Georgia day cares have lost their licenses since 2007, according to the Bright from the Start Web site.

The state revokes day care licenses if a rule violation is not correctable with management or if a correctable violation hasn’t been fixed, said Kay Hellwig, assistant commissioner for childcare services at Bright from the Start.

New rules passed last year allow the state to deny a day care license for more reasons, such as making false statements or failing to pay a civil penalty. They also now provide for emergency license revocation or the emergency placement of a state monitor in a day care.

“A child doesn’t have to be harmed” for a center to lose its license, Hellwig said.

But in the majority of cases, they have been.

Seven licenses were revoked after children died. Most recently, a 3-month-old died on its first day at a day care center in Decatur, where only one staff member was supervising 11 infants. When the child was discovered struggling to breathe and turning blue, no one called 911 for half an hour, a Bright from the Start investigation concluded.

The day care had been cited three times previously for the same violations that contributed to the death. Its license was not revoked until six months after the episode.

In fact, revocations related to specific incidents like that usually happen from three to eight months afterward, an analysis of state records showed.

Some revocations are for less extreme, but repeated, violations. For example, a day care provider was given four chances before her license was revoked for locking children in a room with no supervision.

Another provider had three violations for failing to supervise children before finally losing her license when a 4-year old walked off and was found by the side of a busy road. The caregiver hadn’t noticed his absence, according to the state investigation report.

Bright from the Start records online show only one Middle Georgia day care provider losing a license: Delfina Spencer, who had a home-based day care in Warner Robins. In 2008, a 2-year-old sustained a serious spine injury resulting from a fall when the caregiver was not in the room, state records show.

A state investigation found that the day care had no parent or doctor contact information, as Georgia requires. The provider didn’t seek medical attention for the child.

When a child is seriously injured like this, day care providers are required to report it to the state. Sometimes they don’t.

“Institutions are responsible for reporting themselves, which is ridiculous,” said Marjorie Almand, director of the Bibb County Department of Family and Children Services. “And a lot of cases (parents) never report at all, because they’re scared they wouldn’t be able to get care elsewhere.”

License revocation policies vary widely among states. North Carolina, for example, does not automatically revoke a day care license even if a case of abuse or neglect is substantiated. It does, however, require all day cares to maintain at least 75 percent compliance with state rules over an 18-month period. Failure results in a penalty or demotion to a provisional license.

Staffing and oversight

The National Association of Child Care Resource and Referral Agencies ranked Georgia 32nd in the nation for its day care oversight.

The group gave the state high marks for posting inspection and complaint reports online and for requiring its consultants to have a bachelor’s degree in their field.

But Georgia lost ground in the rankings for several reasons. First, Georgia generally monitors all day cares once, rather than four times, a year. (However, state records show that Bibb and Houston county day cares with more violations often receive two to four visits a year.)

Second, Georgia inspectors have the highest caseload in the Southeast. The association report indicates that in 2008, each early childhood consultant in Georgia was responsible for monitoring an average of 146 day cares and/or preschools. The association recommends a caseload of no more than 50.

However, Bright from the Start Commissioner Holly A. Robinson said the state has reorganized its approach by training consultants to cover all types of day cares in a smaller geographic area. Now they spend less time on the road and more time in day cares.

Assistant Commissioner Mary Mazarky said day care consultants now have a caseload of 100 to 120 day cares.

Of course, Bright from the Start can only hire as many consultants as it can pay. Funding is limited.

About 70 percent of the department’s funding comes from the lottery, which pays for the Georgia Pre-K program administered by the agency. About 30 percent of its budget comes from the federal government, Robinson said, and the state of Georgia provides less than 1 percent.

Pat Willis, executive director of the advocacy group Voices for Georgia’s Children, said, “As a state, we don’t put money into kids under 4.”

Assistance at working toward quality

The state has tools besides license revocation for pushing day cares to shape up. Repeat violators may eventually be required to pay civil fines, Hellwig said.

State officials generally deal with the center’s director. They don’t approach business owners who have multiple violating day cares, Hellwig said.

Since early 2009, the state has begun working more closely with problem day cares, creating technical assistance plans that include specific action steps and reports to the state, Hellwig said.

Using stimulus funds, Bright from the Start is now partnering with the state Department of Human Resources to provide “quality intensive care” to 600 noncompliant day cares that receive a federal subsidy for serving low-income children. Among them are six in Houston and 18 in Bibb, according to Bright from the Start.

For the first six months, 11 teams across the state will spend time at these day cares offering help with planning and training, Robinson said. The day cares will then be given six months to achieve a higher level of compliance before being trained six more months to reach the next level of instruction, literacy and vocabulary building.

“We want to really raise the level of quality across the state for these groups that have struggled most with quality,” Robinson said. “It’s a big aircraft carrier we’re trying to turn around here.”

Positive Praise 24 Hour Learning Center in Warner Robins is among those receiving extra help. Katrina Haynes, the center’s director, said teachers there are learning about being more aware of their surroundings and providing more direct supervision to the children than might be expected in a home setting. Haynes said some teachers have left because they didn’t want to learn to do things differently, but her current staff is more active in trying to improve.

Robinson said if the day cares maintain a good compliance record, they will receive funding for books, playgrounds or other needs.

But the program depends on stimulus funds, which are a one-time shot in the arm.

And there’s no guarantee the approach will work. It’s been tried before.

In fiscal 2004 and fiscal 2005, the nonprofit Quality Care for Children received almost $50,000 to help Bibb County day cares meet state standards. According to a report that the organization created for local leaders, day care centers received training and advice during seven to 19 visits.

Fourteen of the 20 targeted centers achieved compliance, Quality Care for Children reported. But state records show that some of those centers slid back into a pattern of repeated violations within a few years.

Other enforcement options

When assistance doesn’t work, fines usually do, Hellwig said.

Until late last year, the maximum civil fine for the death or injury of a child was $500. That amount has increased to $500 a day for the length of time that the violation continued, up to $25,000. Reckless disregard for children’s safety carries a fine as little as $50 a day.

These penalties vary among states. Tennessee appears to have none spelled out in its day care regulations, while Alabama allows fines up to $1,000 and jail time for simply operating an unlicensed day care. In North Carolina, it’s a felony to operate an unlicensed day care or to allow death or injury to a child. That can be paired with a $1,000-a-day civil penalty.

Some states have less flexibility in issuing fines. In Florida, after a certain number of repeat violations the state is required to revoke a license (in the case of an immediate health or safety threat) or issue fines of a set amount.

Cyndey Busbee was longtime chairwoman of the early childhood committee of Bibb County-based Education First. She argues Georgia should designate what she calls “no never events”: problems that would automatically result in the immediate shutdown of a day care.

“That’s a tough sell politically, and it would be tough for parents to come in the next day and find their center shut down,” she acknowledged. “But what message does it send if you don’t? ... Conditions shouldn’t have to escalate to irreparable damage. As a culture, I think we wouldn’t tolerate that, but people just don’t know.”

To contact writer S. Heather Duncan, call 744-4225.

This story was originally published June 28, 2010 at 12:00 AM with the headline "Punishments low and slow for problem day cares."