Daycare Nightmares

In response to growing demand, the number of daycare facilities in Missouri is increasing each year. So are the problems.

The parents of other kids at these facilities, let alone the public, don't learn about these problems easily, because daycare providers are not required to inform parents of the results of state inspections -- only to post their state licenses in their facilities. Violations can only be found by looking through thick files at the Bureau of Child Care's office at 220 S. Jefferson Ave. Although those files are public, only three to five parents a week, on average, examine them in St. Louis -- suggesting that most are either unaware of the files or do not have the time.

The Child Day Care Association in St. Louis can give parents a list of providers in their ZIP code and a list of questions to ask and things to look for when they visit a facility. For the most part, however, it is up to parents to play private detective dtermine the quality of a facility -- by calling other parents, spending long periods of time observing staff or poring over files to learn whether a facility has a history of problems with the state.

For Internet-savvy parents, there is one other place to go for help. Employees of licensed facilities must undergo a criminal-background check, and the state recently made it easier to research the criminal backgrounds of unlicensed child-care workers through its Caregiver Background Screening Service, which will screen an individual's name through both criminal checks and through the state's child-abuse-and-neglect registry. Parents can log onto an Internet site (gov.state.mo.us/background/). Before 1999, the state did not require such checks of its registered vendors -- individuals who receive state subsidies to provide child care.

Corinne Patton, coordinator of the public-awareness campaign for the Missouri Child Care Resource and Referral Network: "There is a lot going on in child care right now; we are getting more attention than ever before. Some of that close scrutiny is going to point out what is not OK."
Corinne Patton, coordinator of the public-awareness campaign for the Missouri Child Care Resource and Referral Network: "There is a lot going on in child care right now; we are getting more attention than ever before. Some of that close scrutiny is going to point out what is not OK."
Corinne Patton, coordinator of the public-awareness campaign for the Missouri Child Care Resource and Referral Network: "There is a lot going on in child care right now; we are getting more attention than ever before. Some of that close scrutiny is going to point out what is not OK."
Jennifer Silverberg
Corinne Patton, coordinator of the public-awareness campaign for the Missouri Child Care Resource and Referral Network: "There is a lot going on in child care right now; we are getting more attention than ever before. Some of that close scrutiny is going to point out what is not OK."

The state is also creating a computerized database of licensing records to make it easier for parents to check a facility's record on the Internet. But that database is likely two years away, and the information, particularly that involving substantiated complaints, may not be very detailed. Unsubstantiated complaints, particularly a series of them alleging a similar problem, can often be more telling than a single substantiated complaint, says Pauline Koch, executive director of the National Association of Regulatory Administrators, who previously worked for the state of Delaware in the area of child-care regulation. In Missouri, however, unsubstantiated complaints are not open to the public.

The system of child care in the military, which has improved significantly in the past decade, requires that a parent accompany an inspector on visits, helping enlist parents in ensuring a facility's compliance with the rules. Some states require centers to post any violations on the door. Missouri does not.

That idea has been proposed and is being pursued, say state child-care officials. But with the state's complicated rule-making process, even that is at least a couple of years away.

Weak regulations and inadequate oversight of child-care providers can prove a recipe for disaster. Just look south to Tennessee. That state was widely viewed as one of the weakest in the nation in terms of supervision and quality, with children-to-staff ratios higher than those of most states -- at one staff member per six infants, for instance, compared with a 1-4 ratio in Missouri. Its caseloads for inspectors were far lower than those in Missouri, however, at one to 20, and Tennessee inspectors visited child-care providers at least three times a year, in addition to license-renewal visits.

Tennessee attracted national attention this year as its regulatory system underwent a major overhaul -- but only after two Memphis children died in daycare vans on a single day last summer. Darnecia Slater, 22 months, was forgotten in a child-care van on a hot day and discovered seven hours later. Her core body temperature had soared to 108 degrees. Across town at another center, 2-year-old Brandon Mann was left in a van for more than five hours. He, too, died of hyperthermia.

In the aftermath of the deaths, the state's Department of Human Services adopted a zero-tolerance policy for centers that broke the rules and endangered the lives of children in their care. "Those were the extremes of the extreme," says Lisa Gallon, a Tennessee DHS spokeswoman. "We were having a lot of children being left on vans because they didn't thoroughly check the vans. After those two deaths happened in July, our commissioner got our child-care folks together and said, 'We need to do something to get the attention of providers.'"

The deaths spurred new legislation, giving the agency power to immediately shut down a center if children's life, health or welfare was in jeopardy, or to fine centers as much as $1,000 per day for major violations. The state is also creating a "report card" system to inform parents about the quality of care at individual centers. The number of licensing visits was doubled from three to six annually, and caseloads shrank to 10 or 15 per inspector. In the past year, 15 centers were shut down by the state. Tennessee's progress is being closely watched by child advocates across the country, including Missouri.

In June alone, Tennessee's DHS suspended the licenses of three facilities and closed them immediately. One was a Nashville center that left a 4-year-old behind at a skating rink, the latest in a series of violations at that facility. Another was a center at which a 34-month-old child was assaulted by a teenager who slipped inside unnoticed. And a third was closed after a 3-year-old wandered away from the center.

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