IV. I. Suspected Child Abuse/Neglect in a Facility or Institution

Effective 12/18/02

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PURPOSE

1.Parents

In general, parents, guardians, or custodians are the persons who are responsible for the welfare of their child.  In a variety of instances, persons other than parents may provide certain parenting activities in a variety of institutional settings, such as day care centers, hospitals, schools, foster homes, and residential facilities.

 

When selecting or utilizing a facility, parents are, in effect, expecting the facility to partially or fully provide for the well-being of the child.  The facility is then assuming some responsibility for the child.  Parents, guardians, or custodians may often not be fully aware of the details of daily routine and care, so that the child may be quite dependent on the facility to provide for his needs in a safe atmosphere.

 

2.Licensing Authorities

In recognizing the vulnerability of children receiving child care, the State of Maine mandates licensing of various facilities to ensure that certain standards are met.  However, current legislation and licensing requirements are not always sufficient to protect the child, when related to the vulnerability of the child.  In general, the more difficult for the parent to protect his child and the more vulnerable the child, the more child protective intervention, if required, there will be.

 

3.Facilities

The Department has close working relationships with a wide variety of child care facilities, including purchasing child care services for child protective and substitute care clients.  Child care facilities in Maine provide valuable professional services.  Both the Department and providers recognize that children who have been abused, neglected and/or exploited in the past are vulnerable; there is a tendency for children to apply previously learned behavior in a new setting in order to gain some sense of self control in both situations.

 

The Department and providers also recognize that there are people inclined toward power over or sexual exploitation of children who tend to seek situations where there are children.  The Department expects that facilities have developed practices and procedures to minimize these risks.  The Department seeks to work jointly with facilities to enhance their abilities to provide safe care for children.

 

4.Mutual Goals

Facilities, parents, licensing authorities, and the Institutional Abuse Unit, and Child Protective Services are mutually concerned and working together for the well-being and safe care of children.

 

LEGAL BASE

Under Title 22 MRSA §4002, "person responsible for the child" is defined as "a person with responsibility for a childs health or welfare, whether in the childs home or another home or a facility which, as part of its function, provides for care of the child.  It includes the childs custodian."  The responsible persons could include the administrators and caretakers in a facility.  The Department of Human Services has responsibility to provide services and safety to a child reported to be abused/neglected, regardless of the setting.

 

PRACTICE STANDARDS

1.Working Agreements

The Department encourages the development of working agreements between Department regional offices and providers to enhance professional working relationships toward the mutual goal of safe care.  Working agreements should address:

a.Referrals to the facility by the Department:
1)Contracted slots
2)Slots funded by other resources
b.Reports by the facility of suspected abuse or neglect within the childs family or elsewhere.
c.Reports of suspected abuse or neglect occurring within the facility reported by:
1)Administrators or staff of the facility
2)Persons outside the facility
d.Joint workshops.

 

2.Receipt of Reports
a.Reports of suspected child abuse or neglect in a facility will be processed in the same manner as other reports/referrals, including receipt of reports, screening and assessment.
b.A copy of the report form will be sent to the central office program specialist who will give a copy to the central office licensing authority.

 

3.Licensing Issue Only
a.When a report is not specifically related to suspected child abuse or neglect, but may be related to licensing/certification/treatment standards, the reporter will be given information on how to reach the appropriate licensing authority.  The intake worker will forward written information to the Institutional Abuse Supervisor and then it will move on to the licensing authority.
b.The usual licensing authority by type of facility:

(1)        Family Foster Homes

Department of Human Services,

Bureau of Child and Family Services

Foster Home Licensing

(2)        Relative Foster Home

 

(3)        Child Placing Agencies        

 

(4)        Specialized Childrens Homes

Department of Human Services

Community Services Center

Licensing Unit

(5)        Day Care Homes

 

(6)        Day Care Centers

 

(7)        Nursery Schools        

 

(8)        Home Baby-sitting Service Providers

 

(9)        Group Homes, Emergency Shelters

 

(10)        Residential Treatment Centers

 

(11)        Correction Facilities

Department of Corrections

Commissioner; also Office of Advocacy

Department of Corrections

 

 

 

 

(12)        Mental Health Residential Care

Department of Mental Health

Licensing Program; also Office of Advocacy,

Department of Mental Health and Mental Retardation

 

 

 

 

(13)        Substance Abuse Treatment Centers

Department of Human Services

 

Office of Alcohol and Drug Abuse Prevention

(14)        Public and Private Day and Residential Schools

Department of Education,

Guidance and Curriculum Consultant

(15)Hospitals

(including mental health institutes)

Department of Human Services,

Bureau of Medical Services

Division of Licensure and Certification

(16)Skilled Nursing Facilities

 

(17)Intermediate Care Facilities

(including Pineland and Levinson)

 

(18)Adult Boarding Homes

 

(19)Adult Foster Homes

 

(20)Camps, day or residential

Department of Human Services,

Health Engineering & District Attorney if appropriate

 

4.Intake Study/Investigation by Child Protective Services
a.The basic standards of policy on child protection will apply, including the time frame for intake study (one month).  See Intake Study, Section IV.D.
b.The intake study will proceed as outlined in this manual, with modifications to include the licensing authority, facility administrators and other people using the facility.
c.In residential or day care centers, program administrators will be considered "parent substitutes."  Aides, house or cottage parents will be considered "caretakers," hired by the parent substitutes.
d.Central office coordination:
(1)The central office Institutional Abuse Supervisor will be promptly notified and will be responsible for coordination with any other central office units or programs within this Department or with other departments.
(2)The extent of central office involvement will be determined by several factors including the extent and complexity of the investigation.

 

e.The licensing authority will be promptly contacted so that it can determined what immediate steps it may need to take, and will be encouraged to participate in the study.

The Departments Bureau of Child and Family Services is responsible for licensing of foster family homes.  Day care, group and residential facilities are licensed by the Community Services Center.  The Bureau has determined that licensing staff will take an active role regarding possible violations of licensing standards when a child protective investigation occurs in a facility licensed or registered by the Bureau.

 

f.Coordination for possible civil or criminal action

Depending on the nature and content of the report, the worker in conjunction with his supervisor (and in conjunction with the licensing authority, if any, participating in the study), will determine whether to immediately contact an Assistant Attorney General for advice regarding possible civil or criminal action, which could include referral to the Attorney Generals Criminal Division or to the district attorney.

 

g.Children placed by Department

If any of the children in the facility were placed by the Department of Human Services, the Regional Program Manager for Child and Family Services or his designee will determine:

(1)The extent Substitute Care staff will be involved because of their knowledge of facility staff and/or their responsibilities for children placed, especially if the child is in foster or residential care.
(2)Whether assistance in performing the study will be requested from central office or another regional office or another agency (if manpower or objectivity is a consideration).

 

h.Interviewing the child

A determination will be made whether the child(ren) will be interviewed at the facility, at home, or elsewhere.  The determination will be based on the contents of the report and threat of serious harm, including probable suppression of information.

 

i.The initial contact with the facility
(1)To start the study/investigation, prompt contact will be with the persons identified by the facility as responsible for coordination with the Department and the facilitys management of instances of suspected abuse/neglect/exploitation.
(2)If there is documented reason to believe that the identified person(s) may be a perpetrator or have an objectivity conflict, another person connected with the facility will be contacted, such as the director or a board member.

 

j.Extent of study investigation

The worker and supervisor (and any participating licensing authority) will consider:

(1)The vulnerability of the child(ren):
(a)The child(ren), such as age of the child, childs special problems or needs, if any, (including any past abuse, neglect, or exploitation), and extent to which the facility meets the childs overall needs during the course of the day.
(b)The management practices of the facility, such as extent of written practices and procedures for operation of the facility and extent of role of board or other oversight body.
(c)The regularity of contact/access by outside entities such as licensing authority, parents, and placement agencies.
(d)The ease with which the persons with primary legal responsibility for the child can protect the child, including extent the parent or child has knowledge of applicable redress/appeal procedures of the facility and extent these procedures can or have been utilized.
(2)Whether the study will include the entire facility and its program, or only certain cottages or parts of the program.
(3)The extent to which other agencies or persons need to be immediately notified and/or involved (e.g., agencies or parents placing children in the facility, and/or the facilitys board, law enforcement.)

 

5.Threat of Serious Harm and Notification to Parents

Whenever serious harm or threat of serious harm to a child in the facility exists, including probable suppression of information.

a.Contact Central Office Program Specialist who will confer with the Assistant Attorney General.
b.The parents, guardians, or placing agency will be contacted and informed of the level of harm and advised to take steps to protect their child; suggestions for alternative care may be made.

If they decide not to heed this advice, that family will be opened as a protective family, in accordance with the usual child protective procedures.  (A family may be opened as a protective family if there is harm or substantial risk of harm in the facility or elsewhere.)

Prompt notification of the Departments determination and action taken will be given to the administrator identified by the facility to receive such notification which may be oral, and promptly followed by written notification which has been approved or prepared by the Central Office Program Specialist, with advice from the Assistant Attorney General.

 

6.Determinations Will be Made Promptly
a.Whether the report/referral is substantiated or unsubstantiated and the reasons for the determination.
(1)Substantiated reports will require a corrective action plan (see 9 below), or other action (e.g., by a licensing authority).
(2)The licensing authority will be notified immediately when a determination has been made that at least one instance of abuse or neglect has been substantiated.

Evidence (e.g., affidavits and/or written reports) will be promptly submitted to the licensing authority, if requested.

(3)Unsubstantiated reports of abuse or neglect may be:
(a)Licensing violations, which are the responsibility of a licensing authority.
(b)Inappropriate child management techniques (which may also be licensing violations) or insufficient program management methods.  (Program improvement plans will be suggested (see 9 below).
(c)Not substantiated because of insufficient evidence.  When this occurs, the reasons for this determination will be given.  It will be made clear that the report cannot be substantiated, but there is a possibility that abuse or neglect occurred.
b.If substantiated, the level of risk of harm to all children in the facility.
c.Steps necessary, if any, to protect the child(ren), which may include notification to parents/guardians and law enforcement.
d.Persons who will be continuing contacts with the facility, including purposes of the contacts.

 

7.Corrective Action or Program Improvement Plans
a.It is preferable that such plans be developed jointly by the facility, the licensing authority and child protective services.
b.These may take place at any juncture, and should include both immediate and longer range plans for:
(1)The facility (e.g., replacing a particular staff person, revising hiring and/or supervisory practices, changing a procedure, or other necessary administrative or program modifications).
(2)The child(ren) who were harmed (e.g., counseling, medical treatment, change in program).
(3)Assistance from the Department.
c.The plan may initially be oral, and then promptly followed by a written plan (see 8 above and 10 and 12 below).

 

8.Staff Reassignment or Suspension
a.In some instances a staff member may be reassigned or suspended by the facility during the study, on recommendation of the Department or on the facilitys independent decision.
b.An interim or final report will be made to facility regarding that staff person within 10 days from the reassignment or suspension when the action was taken on recommendation of the Department, and will contain sufficient details for the facility to determine its further action.

 

9.Conclusion of Case Study; Conference
a.The Regional Program Manager or his designee will discuss the results of the study with the Institutional Abuse Supervisor in order to determine the Departments next steps.
b.The licensing authority will be invited to participate in this discussion.
c.The Assistant Attorney General will be notified and may participate.

 

10.A written report will be completed within 2 weeks of the determination.
a.The report will contain:
(1)Whether abuse or neglect was substantiated, maintaining confidentiality of the child(ren) in accordance with 22 MRSA §4008.
(2)Any corrective action plans to deal with the abuse/neglect or otherwise improve the program to prevent abuse/neglect.
b.See attached guidelines for writing reports on investigation and making recommendations.
c.This report or a summary may be incorporated in a statement to the provider by the licensing authority as part of a licensing action.
d.A summary report approved or prepared by the Institutional Abuse Supervisor with consultation from Assistant Attorney General will be disseminated to:
(1)Regional Program Manager
(2)Child Protective Program Specialist
(3)Other Regional Program Managers whose regions are using or are likely to use the facility
(4)Licensing authority, if any
(5)Other agencies having children placed in the facility
(6)Other persons who need to know this information in order to carry out their responsibilities, such as Assistant Attorney General, law enforcement
(7)The facility.

 

11.Follow-up responsibilities will be determined, including:
a.Obtaining/disseminating periodic reports.
b.Subsequent interviews/contacts with facility employees and/or children.
c.Notification to agencies and parents having children in the facility, regarding findings and any corrective action plans (e.g., a joint letter from the facility, Child Protective Services and the licensing authority, approved or prepared by the Central Office Program Specialist).
d.Tracking of individual or aggregate investigations will be done by designated Program Specialists in Central Office.

 

12.Suspected Abuse/Neglect/Exploitation Elsewhere
a.If there is reason to suspect that a child in the facility needs protective services in his own home, a referral/report will be made to the field office where that family resides.
b.Particular family cases, if any, will be opened in accordance with the usual child protective procedures.

 

PROCEDURES

1.Case will be opened on the information system under the name in which the license is issued, if any, if not, the name of the facility or owner with the case number being:
a.The IRS number assigned to the corporation, or
b.The Social Security Number of the owner/operator, or
c.If neither of the above exists, an A number.

 

CROSS REFERENCE:                Child and Family Services Manual, Section IV, Intake Study,

                         Relationship to Law Enforcement, Section XI, Subsection Y

 

 

 

Worker(s)                                

Supervisor                                

Office                                        

Referral Date                        

Date of Report                        

 

Case Name:                Facility

                 Address

                 Phone

                 Director/Owner

 

Case Number:

 

 

I.        Referral - restatement of incident(s)/problem

A.Referent (who)
B.Problem, including child(ren) and alleged perpetrator(s); severity, duration (what)
C.Dates of incident(s) and referral (when)
D.Where incident(s) occurred (where)
E.How the incident(s) occurred and how referent learned of problem (how)
F.Circumstances leading up to the incident(s) what precipitated referral (why)

 

II.        Previous Agency Involvement

To include prior involvement with the facility as well as with particularly perpetrator if applicable.

 

III.        Investigation

A.Statement(s) of child(ren).  Details in their words and in the sequence described by them. Not paraphrased by worker.  Include date(s) of interview(s).
B.Statement of alleged perpetrator(s).  Details as in A. above. Date(s) of interview(s).
C.Statement of witnesses:

1.        Other children and/or staff

2.        Other relevant collateral sources

D.Description of the facility, related to the incident(s)

What where the surroundings like

Condition of the facility

How children appeared to act in the facility

E.Medical statement or reports

Attach medical statements or reports if applicable

F.Additional information

Attach police reports and/or other pertinent reports if applicable.

 

IV.        Findings

 Include:

 Description of the child(ren)s condition

Whether or not abuse was substantiated and basis for determination

 Degree of harm for child(ren)

 

V.        Remedial Action Taken, if any

A.By the facility
B.By investigator(s) and/or licensing authority
C.By parents
D.Follow up with children

 

VI.        District Attorney

State whether incident was reported to the District Attorney and date of the referral.  Attach a copy of the referral to the District Attorney.

 

VII.        Recommendations

List recommendations that the worker believes would remedy the situation and prevent future abusive situations.

 

IX.        Make Recommendations

 When appropriate, there are two types of recommendations that can be made.

A.Corrective actions that worker believes would remedy the situation and prevent future abusive situations.  These recommendations must relate directly to the specific, observable incidents of harm to the child(ren) in the facility that was investigated.  Examples include:

 

1.Dismissal, suspension of employee.  Reason must be given.
2.Transfer or counseling of employee.
3.Staff training in a specific area of child care.
4.Develop policy (specific) on handling of certain matters (medical care, etc.)

 

B.Program improvements that are not directly related to specific instances of harm but are relevant to the prevention of abuse, neglect, or exploitation of children.  Examples include:
1.Quality of program:  educational, recreational, etc.
2.Staff recruitment and hiring practices.
3.Staff training program.
4.Intake criteria for children.
5.Physical plant.

 

Not all investigations need to have recommendations included in the report.  Often, the action needed to remedy the situation has already occurred prior to the submission of the final report and the investigator need only state this.

 

On the other hand, a critical, objective examination of an incident or a segment of a program is both beneficial to the improvement of the program and the quality of care given to the children.  Recommendations should be given when warranted, regardless of the results of the investigation.

 

(Credits:  This report format was adapted from the format developed by Gregory Smiles, New Jersey Child Protective Services, under a federal grant from the National Center on Child Abuse and Neglect.)

 

See Addendum C at end of Section IV.