KeepHealthCare.ORG – Despite violations, many child care facilities stay in business – News – GoUpstate
Daniel J. Gross Staff Writer @danieljgrossZach Fox Staff Writer @ZachFoxSHJ
Kathryn Martin wears a small necklace with a fingerprint pendant on it nearly every day.
It’s the fingerprint of her 3-month-old daughter, Kellie Rynn, who was found dead from suffocation inside a crib at a Greenville child care facility in 2014.
The caregiver, Pamela Clark Wood, pleaded guilty to child neglect by a legal custodian, violation of child care licensing and obstructing justice.
Twenty-three children were found in Wood’s home, which was only licensed to care for six. Two of them were toddlers who were unattended in an upstairs bedroom with a loaded gun not far away.
The facility was shut down.
February marked four years since Kellie Rynn’s death. Since then, Martin has made it her mission to improve child care quality across the state, and she said more work is needed.
“I wanted her to be the last one, and she’s not. It’s still happening,” she said in her living room during a January interview. “It can happen to anybody.”
Child care centers across South Carolina are flagged for various violations each year. Issues with hazards, sanitation, playground deficiencies, improper supervision and poor staff records are common at some facilities.
While problems persist, many centers remain in business, a Herald-Journal analysis of state Department of Social Services data shows.
Of the 3,445 centers in business between January 2013 and June 2017, about 2,400 — 70 percent — had at least one violation each year. And 1,633 facilities had at least one violation ranking “high” in severity.
In that period, 129 centers were shut down statewide.
In Spartanburg County, 175 child care centers operated between 2013 and June 2017. Of those, 86 had one or more high severity violations.
Eleven were ultimately closed.
In Cherokee and Union counties, no child care centers were closed during that span.
Ranked by average number of violations per child care provider, DSS inspection data showed Spartanburg County was 21st in the state with 9.3 violations per provider during the time frame. Bamberg County saw by far the highest average number of violations, with 23.3 per facility.
Each year, Social Services workers are tasked with inspecting facilities, responding to reported complaints and, occasionally, pulling business licenses.
But the vast majority of centers have remained open in a cycle of low- or medium-severity violations and follow-up visits.
Some parents have started further investigating the quality of child care providers while advocates push for stronger incentives to increase quality.
“I wasn’t just looking for anything to put my child in. …I had some pretty high standards,” said Beth Thompson, whose 9-month-old son, Tate, goes to the Montessori Academy of Spartanburg.
Thompson said she struggled to find a center with high enough health, safety and educational standards that had open spots for infants.
“I found even among peers that the knowledge of quality is not well known. …I don’t think enough parents are demanding that from child care centers,” she said.
How it works
DSS issues licenses, inspects facilities and enforces regulations governing child care facilities, along with revoking or denying licenses.
Agency leaders said their goal is to work with facilities, not shut down those willing to improve.
Nia Gentry, owner of Growing Minds Learning Center in Moore, said the inspections are taken seriously.
“It’s very extensive. They make sure that the things they require are in place. There are policies your facility has to have in place and safety precautions and safety measures that have to be in place,” she said. “They’re very no-nonsense, and it’s for the safety of the children.”
For centers with regulatory issues, problems can be fixed by completing a “corrective action plan.” If the plan is violated, DSS sends a final warning letter. If that warning is violated, the agency acts.
Those consequences include revoking a center’s license. Facilities can then appeal and request a meeting to discuss problems and possible solutions.
If concerns can be corrected, DSS can rescind its revocation. Otherwise, it is upheld and the center will be closed, DSS spokeswoman Marilyn Matheus said.
Matheus said if appeals continue, an administrative court can be used for relief, and all the while the center can stay open.
Records showed many centers stayed open for years despite ongoing citations.
“We want to give them a lot of opportunity for correction,” Matheus said. “They are vital to every community. We understand their business. We want to help them as much as we can.”
Violations must be investigated within five days of a complaint unless it’s a severe issue, like a serious injury. In those cases, they’re checked out the next day, Matheus said.
High-severity violations, which pose risks to the health and safety of children, include improper supervision and failure to report an incident to DSS, among others.
Statewide during the four-year span, 8,537 serious violations were tallied, data showed.
The most common high-severity violation was improper supervision, reported 3,044 times. Out-of-ratio, meaning there were too many children per staff member, accounted for 2,605 high severity violations.
Licensed facilities have strict staff-to-child standards.
For newborns up to 1 year, it’s one provider per five children. For children 1 and 2 years old, it’s one provider per six children. For children ages 6 to 12, the ratio incrementally goes up to 1 provider per 23 children.
Vicki Hoover, operations director for Big Blue Marble Academy, which has a location in Boiling Springs, said out-of-ratio violations can be the result of things outside the center’s control.
“If you have a teacher held up in traffic or who called out sick, you could have a parent complain one or two too many kids were in a classroom, or the state could come in and say we’re out of ratio,” she said. “Most of the other things are controllable. We know what’s required by licensing (regulations).”
Ratio violations can become common if operators try to increase how many children they care for to make more money, said Martin, the Greenville mother whose daughter died in a child care facility.
“The child care industry is a greedy industry, and unfortunately there’s a lot of loopholes,” she said.
But some parents believe the inspection process isn’t tough enough based on repeat violators.
“There are violations and then they allow them to fix it on site,” said Thompson, the Spartanburg mother. “If every single year I come here, and this is a violation, then you’re not really fixing it, you’re just doing it in front of me as the inspector is here today. That’s not a real inspection.”
Hoover said, however, some violations can be easily corrected on-site.
“Let’s say (an inspector) walks into a room and there are a pen and papers with ink sitting on the changing table. That’s a violation because nothing is supposed to be on that table where you change a diaper,” she said. “(The inspector) would write us up for a violation and then write that we changed the violation on site.”
Law changes alter oversight
In 2014, lawmakers voted to improve child death reports by coroners and to require DSS to provide detailed caseload and visitation information.
Family-home-run child care homes were added to DSS oversight, and they now require inspection just like other child care businesses.
Because of the increased load on DSS workers, lawmakers changed the number of annual inspections from two planned DSS visits to one unannounced visit.
“When we started doing inspections of registered families and child care homes, we did increase the staff at each regional office to allow everyone to have a manageable caseload,” said Charlene Caldwell, who handles DSS childcare licensing and regulatory services.
DSS caseworkers now each have 50 to 55 centers to inspect annually, visiting as needed. The agency reported 14 specialists were working in each of the state’s four regions.
Rep. Rita Allison, R-Lyman, said unannounced inspections can help centers learn what’s needed to improve.
“I think it is moving forward. We still have a way to go,” she said. “Lots of times, the agency would call ahead. Now, to be able to walk in on a day and see what regulations are being carried out, it puts daycares on notice that you could be tested in those areas.”
The re-licensing process happens every two years. All staff members at licensed centers must complete 15 hours of training each year.
In July 2017, policies were strengthened for family child care providers, as well. Staff have to complete 10 additional hours of training for those facilities to earn a license.
Stringent licensing is a good thing, Allison said, but the state aims to work with facilities to ensure they’re meeting standards without harming their business.
“The main thing is that with a private child care center, that is a business, they have a bottom line,” she said. “One thing is that we want to make sure they are safe and healthy places for children to be cared for, but we don’t want to burden our private sector.”
A spectrum of problems
Violations can come from inspections or complaint-driven visits, with the highest-severity violations leading to quicker follow-up visits.
Data showed some facilities were repeatedly cited with serious violations.
The Executive Park Learning Center in Florence County has racked up 211 violations since 2013. Unqualified caregivers, electrical outlet concerns and sanitation violations persisted over the years.
In God’s Care Learning Center in Charleston County tallied 132 total violations, 69 of which were high severity. Of those, nine were out-of-ratio cases and 23 were for improper supervision.
In Spartanburg County, the most common issues were records violations, improper supervision, improper staff records, ratio violations and playground deficiencies.
Countywide, the three centers with the most violations were Bright Angels at Trinity Kids Learning Center, which had 52 violations, 19 of which were high severity; Maximum Child learning center, which also had 52 violations, 8 of which were high severity, and Growing Minds Learning Center, which had 50 violations, 13 of which were high severity.
The majority of the violations Growing Minds Learning Center earned came in 2014 and 2015, data showed.
Gentry, one of the owners of Growing Minds in Moore, said she and other facility owners work to address DSS violations, even if they disagree a violation should’ve been handed down.
“When you first start off, you’ll feel like it’s very unfair. But when you continue and make the changes on a consistent basis, it’ll become like second nature. Their job is to push you to another level of excellence. Their job is to push you to help you comply with DSS standards,” she said. “Once you get in a rhythm and correct the things they tell you need corrected, you shouldn’t have any more issues.”
Raising the bar
Whitney Tucker, a Children’s Trust policy research associate, said the agency is working to shrink the number of reported violations and is taking a closer look at the severity of those violations.
“DSS is very thorough when checking it out. Some are things like one too many children in a room, but if it was five too many, that’s an issue,” she said. “It’s important when you look at violations that it’s not necessarily the number, but what type they are and if they’re health and safety related.”
DSS, through partner agencies, offers a voluntary quality-improvement program that child care center operators can use to receive special services designed to boost quality through additional visits.
More than half the state’s child care centers don’t participate in that voluntary system, though.
Martin and other advocates are pushing for better quality and accountability among child care centers, with some looking to incentivize the way facilities run their business.
Some programs include tax breaks for centers agreeing to higher standards. If those facilities complete specific forms and meet safety requirements, they can earn a tax break.
“We have taken a position that child care needs to adhere to a certain set of standards, whether standards are voluntary or whether they sort of come about through participation in what people call quality rating system,” said Bett Williams, a spokeswoman for Children’s Trust, a statewide program focused on preventing child abuse and neglect. “Knowing what South Carolina is like, you can’t always impose standards, so a lot of times it has to be voluntary.”
Facilities enrolling in the voluntary quality-improvement program, known as ABC, are added to a list of providers sent to parents to help them choose which centers to use. They’re also given free training materials, among other resources.
Quality Counts is a Spartanburg County program funded through First Steps featuring a free quality improvement program. Grant money lets caseworkers work with facilities hoping to improve through checkups.
“We’re your partner. We’re going to work on this together,” said Barbara Manoski, Quality Counts program director. “It’s a fact that 90 percent of a child’s brain is formed before age four. All of those pieces are being formed, you can’t go back and redo these times.”
Martin said the 2014 law was a step in the right direction, but only a start. For example, she said home caregivers still aren’t required to have CPR training.
Parents should always research child care centers, violations and the severity of each, Martin said. She helped DSS reconstruct its website so parents can sort through three years’ worth of violations from each facility by searching specific providers.
“If a person sees this, maybe they’ll think to ask if something seems off,” she said. “If I can help one person, it’s worth it.”
Picking isn’t easy
Each registered facility can be found at SCChildcare.org, run by DSS.
“Two things you never skimp on, tires and child care,” said Matheus, the DSS spokeswoman. “It does make a difference when you do have all the information and can compare centers.”
DSS Director Amber Gilum said the website is one of the ways the agency shows its commitment to monitoring the quality of child care facilities.
“Our economy is improving, and more South Carolinians are going to work. As a result, more of our children are being cared for outside the home,” she said. “At DSS, we want to give parents options and choices to help them make that most difficult and important decision of finding someone to take care of their children while they are working.”
After her daughter’s death, Martin started the Kellie Rynn Foundation to help provide 75 percent of tuition costs for families who wouldn’t otherwise be able to afford quality child care.
“For some child care, it’s $1,200 a month per child. This is why this is so important. Families can’t afford these centers,” she said.
Kellie Rynn was an independent, bright, fun-loving baby, Martin said. She would wake up laughing and smiling, and Martin’s 21-month-old son, Finley, shares a lot of her characteristics.
Martin said her son and the memory of her daughter keep her working for the future of children like them.
“I know we’re going to see her again. That’s what gets me through this,” she said. “I don’t want anybody to forget her.”