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Scant Training With No Tests

State's minimal rules are easy to circumvent

By Curtis L. Taylor, Investigations Team
Originally published in Newsday, 1999
DAY EIGHT

New York State doesn't let just anyone style hair or polish fingernails for a living.

Those wanting a license to care for your scalp or cuticles must undergo weeks or months of classroom instruction, pass competency tests and sometimes demonstrate their skills before a panel of professionals.

But when it comes to people who care for your children, state regulators are much less demanding.

A Newsday investigation found significant loopholes and lax oversight in the state system that is supposed to guarantee minimum competency standards for day-care providers. The newspaper found that the state system has minimal requirements for training, and that even those provisions can be easily circumvented by applicants or existing providers who don't honestly fill out paperwork or actually attend required courses. There's also no competency testing.

It's even easier if you're already doing day care. For renewal, these providers "are not required to submit documentation of attendance at training sessions with the renewal application," according to regulations.

"We are in the Dark Ages when it comes to training," said Alice Brown, longtime director of the Child Activity Center at Adelphi University, noting that poorly trained providers can cause irreparable harm to children.

"There should be more regulations, and providers should be required to show proof of training before they are allowed to take care of children," Brown said.

Dina d'Oyen, the family child-care trainer at United Neighborhood Houses in Manhattan, agrees. She taught the required 15-hour training course for two years before switching to her current position. She stopped because she said she could not "in good conscience" be part of a system that was letting providers go into business with so little training.

"It was a joke," said d'Oyen, who is now teaching a 65-hour course for providers linked to United Neighborhood Houses. "I wouldn't send my children to anyone [trained during those sessions]. I didn't think it was adequate enough for me to feel safe in sending my own children—and I was teaching it." D'Oyen said she only had time to briefly cover the required topics and that it bothered her that the course did not require cardiopulmonary resuscitation training.

"I would rather have these people spend 15 hours on infant and toddler CPR and child abuse prevention, so at least they could save lives," she said.

There are 24,267 licensed providers in the state's three levels of day care, including centers and the family or group day cares operated out of providers' homes. And, generally speaking, it's easy to get permission from the state, without verification of skills or competence, to care for children.

While the requirements vary slightly for each category, providers are required to complete 15 hours of training during the first year of registration, according to state regulations. An additional 15 hours is required during each two-year licensing period.

For group family providers who care for 12 to 14 children in their homes with an assistant, the law does not specify any number of hours for training. The hours are specified for family day-care providers, who care for fewer children, and for workers and operators of day-care centers, who care for more.

This quirk in state social services law is but one of the anomalies involving the training required of those who care for children, Newsday found.

State officials acknowledge gaps in the training requirements for day-care providers and have pledged changes. In fact, Gov. George Pataki announced legislation last week to tighten one of the loopholes in the training system and stiffen requirements for providers.

Newsday's review of current state requirements for day-care workers found: The state has only minimal training standards. Unlike other state-regulated occupations, day-care providers can begin caring for children and get their training later. The state requires hundreds of hours of training and passing a test before getting a license to cut hair, manicure nails, remove hair with hot wax or sell real estate.

There is no set curriculum for providers to take.

The state approves the content of the 2 1/2-hour orientation course and the general topic areas for the 15-hour training requirement. But there is no standard curriculum that requires providers to take a set of mandatory courses.

As a result, a provider can complete training courses but not cover something as basic as emergency first-aid or treatment.

Day-care providers are allowed to care for children without adequate training skills. After completing the orientation, providers are allowed to start in the business of day care while they complete their training. Pataki's proposal would end that practice.

State policy says that providers seeking renewal are to be taken at their word when they say they have taken the necessary training. Until recently, providers satisfied continued-training requirements merely by marking a box on their license renewal forms. No proof was necessary. In fact, a 1998 Bureau of Early Childhood Services policy statement says that providers should be accepted at their word "unless there is reason to question its veracity" and adds that providers are not required either to submit documentation of their training or keep it on hand for immediate inspection by a bureau representative.

Day-care providers never are tested on what they have learned. As proof of their training, the providers typically receive certificates after attending sessions. "All the certificate says is you attended, it doesn't say you listened," said Connie Galin, education coordinator for the Child Care Council in Suffolk County, which offers some of the sessions. "It doesn't say you learned anything." In fact, a reporter who attended a training session walked away with the same blank certificate given to providers. In addition, attendees were required to sign in but not show proof of identification.

Providers who do satisfy the state training requirements still can find themselves lacking critical skills. Lifesaving emergency procedures, for example, are not covered in training given to providers.

Even day-care centers with extensive problems, including health and safety violations, can thumb their noses at regulators who suggest their employees need more training. One Suffolk County day care was among a handful on the Island to be singled out by the state for remedial training, but politely refused it.

New York lags behind other states in its training requirements. Massachusetts requires that every family day-care provider be certified in first aid and CPR.

Vermont requires that the provider be able to read; pass a preapplication inspection to ensure the potential provider is qualified before registering, and to complete six hours of interactive training yearly. In New York State, most of the training courses are run by nonprofit organizations that are not required to tell the state who has received the training or the subjects being taught. The state does, however, approve the curriculum for the initial orientation.

These shortcomings in the system pose a threat to thousands of New York children.

Andreia Loures knew something was wrong with an infant girl she started caring for in March. The baby always seemed to be experiencing discomfort: crying, sweating and spitting up milk.

Although she had completed the mandatory state training, none of those courses included instruction in advanced infant care.

Loures relied on what she learned reading books and magazines on infant/toddler care, and her own experience as a mother of two, in caring for the infant.

But on April 27, her self-taught instruction in infant care would prove not enough.

Loures placed the infant in a crib for a nap because the baby was "upset." "I put her in the crib, so she could rest," Loures said. "I folded a blanket and left it under her. I usually don't put them there like that. I normally lay her on the back with her eyes up. But the other mothers said to put her on her stomach with the blanket for a little while, and it seemed to help her." After making lunch for the other children in her care, Loures went to check on the baby, who still was sleeping.

"I went to check her body and it was cold," Loures said. "But her head was warm. She looked pale and she wasn't breathing. Blood and milk came out of her mouth when I started to pump her heart." Loures dialed 911 and the baby was rushed to the Southside Hospital in Bay Shore, where she was pronounced dead at 4:07 p.m. The cause of death was later determined to be sudden infant death syndrome (SIDS). State authorities determined that Loures was not responsible for what happened to the girl.

Loures said that while no amount of state training would have saved the baby's life, she believes the infant/toddler courses should be mandatory. She also believes the CPR course she took and used on the baby should be mandatory.

But the state ignores practical training advice that might help day-care workers provide a safer environment for children. Since 1992, the prestigious American Academy of Pediatrics has recommended that healthy infants sleep on their sides or backs. Studies have shown that babies who slept on their stomachs risked a higher incidence of SIDS. Since AAP made this announcement, the SIDS rate in the United States has dropped significantly. While the state does publicize a sticker campaign emphasizing the importance of sleeping positions for infants, the education effort is not reflected in the regulations.

"The problem is the subjects are always the same. This is my third year and the classes are the same, like child abuse and maltreatment," Loures said. "I didn't take any course that teaches you how to care for an infant. Any of this type of training can only help. It should be required." "There's no teeth behind any of this seeming authority," said Fran Karliner, corporate and information services coordinator for the Child Care Council of Nassau. "You have a new provider who has heard what the regulations are, that there are (15 hours of additional training required and), that you'd better do this because you want to be renewed.

"We encourage them to network with other providers and within a year they become savvy: 'You don't have to worry, just say that you have the training and that'll be enough.' "They become aware that there are no teeth to these regulations. It's not because the state doesn't want to have them. There's just not enough money in the budget to support the kind of staff you would need to send people out and really make sure that the rules are being abided by."

Suzanne Zafonte Sennett, director of the state's Bureau of Early Childhood Services, acknowledged that there were serious flaws in tracking whether providers had completed their training, partly because the state doesn't ask for proof until a provider is inspected. And her department's target is to inspect only 20 percent of the facilities each year.

With the typical license or registration valid for two years, this means a provider can go through three renewal periods before any verification effort is made. "I think that is inappropriate; it's a piece that we're changing," Sennett said. In fact, Pataki's legislation would raise the goal to 50 percent of facilities each year.

Sennett said that a new form, about to be implemented, will require providers to detail the training they have received instead of merely indicating that they have fulfilled the training requirement. "I think that once we start really being able to document and really start to track where it is that people are going for training, I think that we potentially have recommendations for new training that we may want…or other incentives to put into the system." Just as important, providers and day-care officials say, is the type of training and the form in which it is offered. In particular, some were critical of the reliance on closed-circuit television and telephone hookups. They are cost-effective but not as conducive to learning as teachers in the classroom with students, the providers and officials say.

"A lot of the people who enter the profession have no background in it," said Laura Ludlum, associate director of the Rainbow Chimes day-care center in Huntington. "They are not aware of what a huge task it is. Then we put them in front of a video, and we say, 'Here, learn how to do it.' That doesn't make sense. I understand it is a cost-reduction feature. You can reach more people that way, but is it effective? No." "Getting people into the discussion with things that are relevant to them.

Helping them learn through their own experiences…that is far superior to the video training," said Galin, the Suffolk Child Care Council's education coordinator.

Sennett said the state is looking at ways "to move training from a workshop driven sort of world…toward more of a professional development kind of an approach." "What the research shows is that real quality improvement comes when people invest in real skill development," Sennett said. "We have developed a scholarship program that allows providers to seek training in programs that will either lead to credentials in early childhood or a degree within the college system."

Janet Walerstein, executive director for the Child Care Council of Suffolk, said, "The ideal would be to have all levels of experience with distance learning, onsite training, mentoring in the providers' homes, a modeling support system through various problems…no one model is the best." Brown, of Adelphi University, said recent studies show that positive early interaction and a warm environment contribute to a child's brain development during the first two years and set the pattern for learning and behavior in later life.

"Warm, responsive care is not merely pleasant and reassuring, but plays an especially vital role in the early years," a report released last year by the Families and Work Institute noted. "Negative experiences, or the absence of appropriate stimulation, can have an especially powerful impact on children's development." State officials had concerns about negative experiences at the Wyandanch Day Care Center, but couldn't force additional training on employees there.

Documents show state officials had concerns about several situations at the center, including issues involving fire safety and staffing.

The center's director, Louise Hamlett, declined repeated requests for an interview. In letters sent to the state she has defended the programs at the center, where she has worked since 1982. In fact, several of the letters she sent the state in response to its inquiries end with the phrase, "Yours for Quality Care." She used the same civility in declining the state's offers of help in terms of staff training.

In December, 1997, Aurora Farrington, a regional day-care manager for the state on Long Island, sent a memorandum to her staff noting that the Wyandanch Day Care Center was one of six centers on Long Island to be included in something called the 1998 Day Care Directors Management Project.

Under that project, operated by the New York State Child Care Coordinating Council, the center's staff would receive free training in the area of supervising children. Hamlett refused the offer.

"As a result of our continued diligence in training, the center is not experiencing any difficulties in the area of supervision," Hamlett wrote the council. "Accordingly, we respectfully decline your invitation. Hopefully, this will in turn create an opportunity for another center to participate in our stead." The state did nothing once Hamlett declined the training.

Some day-care advocates are pushing for tougher requirements that include competency testing, pre-application inspections and raising the minimum level of hours required for licensing.

The governor's proposal—which covered many of the same issues raised by Newsday during this series of stories—would double required training hours from 15 to 30. It also would end the practice of allowing day-care applicants to start caring for children before completing a training program. Many states already have standards covering these issues-and others that go even further.

But child-care providers and industry experts say the administration's proposal is a step in the right direction.

"I think 30 hours is excellent," said Gloria Wallick, executive director of the Child Care Council of Nassau. "It is an important step for the training and development of people who are qualified to work as providers in the development of children." Wallick, however, cautioned that the governor was not specific in who would pay for the additional training, and whether the new requirements would be implemented across the board for all providers, particularly group family child care. The law must be changed to formalize the training requirements for group family day-care providers, who care for 12 to 14 children in their homes with an assistant, she said.

Lydia Okrant, a project specialist with the Child Care Council of Suffolk, said there was "no magic number" in terms of how much training should be required, but that any additional requirements would only strengthen the system.

Still, Sennett cautioned that making day-care training standards too tough might actually hurt the public by driving some potential providers away from the field.

"I think there is some value to creating opportunities for all providers to come to this profession in different ways to be able to build on where they are, but not to presume that you need to have a degree in early childhood in order to be able to provide a good nurturing environment," Sennett said. "I think we have to be responsive to communities. Responsive to what families feel comfortable with, and it's a hard balance."

Where to Find Answers, Help

Here are some addresses and telephone numbers that might prove helpful if you have questions about day care or problems with a day-care facility.

To report violations or file complaints against a day-care provider:

For help in choosing a day-care provider:

Copyright © 2002, Newsday, Inc.

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