March 2019

 

Licensing staff may consider enforcement actions when an operation meets any of the criteria outlined in 7110 Circumstances That May Call for Enforcement Action.

When determining what type of enforcement action to take consider the following:

Governing Body and Staffing

Level of Involvement of the governing body has in the operation

Ability to identify operation needs

Knowledge behind intent of standards

Knowledge of operation policy and procedures

Other history as a permit holder, governing body, or a controlling person

Compliance History

Scope and severity of deficiencies

Patterns of deficiencies

Repetition of deficiencies

Investigation history

Responsiveness to deficiencies

Previous enforcement actions

Nature of Risk

Isolated serious incident that may have resulted in injury or death or has resulted in injury or death

Systemic issues at the operation that negatively impact the health and safety of children in care

Other/Extenuating Factors

Operation capacity

Type of permit

Type of services provided

Number of children impacted by enforcement action

Impact to the community

Involvement from the other governmental agencies

Here are some questions (by area) to consider when assessing risk:

Governing Body and Staffing

  1. Are the director, administrator, and the operation's professional staff qualified to hold their respective positions at the operation?
  2. Does the director or administrator maintain an adequate presence at the operation?
  3. Are the director, or administrator, and the operation's staff and caregivers aware of and knowledgeable about the minimum standard rules?
  4. Does the person in charge have the authority to make changes or corrections? Is the person in charge knowledgeable about the minimum standard rules?
  5. Are staff mindful of environmental factors (location, physical facilities, proximity to sex offenders, and so on) that may present a hazard to children in care?
  6. What is the level of experience of the staff?
  7. Is adequate staff training and orientation provided?
  8. What is the frequency of staff turnover?
  9. Are approved risk evaluations in effect? If so, how many approved risk evaluations are in effect and for what type of background check findings? Are there any patterns in the type of charges or abuse or neglect allegations upon which the risk evaluations were conducted? Are conditions of the approved risk evaluations met?

Compliance History and Nature of Risk

  1. Are waivers or variances in effect and, if so, how many? Are conditions of the waivers or variances met?
  2. Have there been significant changes in the operation's compliance history? If so, do changes in performance correlate with any specific factors at the operation (for example, a new director, change in season, staff shortage)?
  3. Are fire and health inspections kept current and are repairs to the physical building and outdoor equipment made promptly?
  4. Are deficiencies that have been recently cited related to high-risk standards (such as infant care, quality of supervision, child/caregiver ratio, and emergency behavior intervention)?
  5. Have deficiencies been addressed appropriately and in a timely manner? Are there repeated deficiencies?
  6. Do the staff or caregivers appear to recognize how continued deficiencies will affect the children?
  7. Is the operation responsive to technical assistance?
  8. Has the operation historically initiated corrections on its own, or waited for additional regulatory action to be implemented before correcting deficiencies?
  9. How many warning letters has Licensing sent to the operation during the past 24 months?
  10. Has the operation previously completed and implemented Form 7277, Child Care Licensing Plan of Action?
  11. Have monetary penalties been assessed against the operation?
  12. Is the operation on, or has it ever been on, evaluation or probation?
  13. Were previous Licensing actions successful at reducing risk?
  14. How many reports of potential problems (investigations) has Licensing received about the operation? Did Licensing ultimately cite the operation for deficiencies? What percentage of the reports received were self-reports? How many reports should have been self-reported but were not?
  15. Is there a trend in the type of allegations or serious incidents reported?
  16. What are the ages of the children involved in any deficiencies or questionable situations?
  17. Did any of the reports result in substantiated determinations of abuse or neglect?

Other/Extenuating Factors

  1. What age range does the operation serve?
  2. What are the hours of operation?
  3. What services does the operation provide?
  4. Were children in care during the last inspection?