THE RECENT DEBATE in the Arizona Legislature about cutting state oversight of child care centers seems hauntingly ironic to me now.
Just over a year ago, my 11-month-old daughter was burned on 10 percent of her body when she tugged an electrical cord at her child care center and a crock pot of scalding water toppled onto her chest, chin and arm.
A day after the accident, an inspector with the Arizona Department of Health's Child Care Licensure Office called to ask how severe were the injuries to my little girl. She told me the crock pot had been removed, that it never should have been there in the first place.
"Bottles will never be warmed in a crock pot again," she said.
At the time her words hardly sank in. My focus was on getting our baby and the rest of my family through the next two weeks of daily burn therapy. During those agonizing treatments, her wounds--one the size of a dessert plate--were scrubbed until they bled, to reduce the severity of scarring. Our baby writhed and struggled to escape while my husband and I helped nurses hold her down, muffling our own sobs and trying to offer comforting words over her screams.
Eventually she passed out of the danger period for infection, and her burns were reclassified as "deep second-degree"; had they been third-degree she would've required skin grafts. My family then began what was to be a long period of healing that still continues.
I DIDN'T REALIZE until last month what solace I had taken from the state inspector's words on the phone that day. I believed at least some good would come of my daughter's suffering, that stricter safety restrictions would be in place and never would such an accident befall another child.
That consolation was shattered one night in May as I watched the evening news in horror. Three babies at a northwest Tucson child care center were injured in an accident identical to my daughter's: A curious toddler yanked a cord attached to a crock pot full of scalding water.
Two children, 14-month-old twins, received second-degree burns on their legs. A third baby, 10 months old, suffered more severe injuries and was still hospitalized a week after the accident, but the family requested the hospital not release any information about the child.
If the experiences of these three babies, and mine, are to be remembered, I hope it's in convincing others that we must revitalize the system we have for scrutinizing safety in child care centers.
We carefully monitor and license everyone from those who care for the poultry we eat to the barbers who could leave our scalps with a chemical burn. We should care as much about our children.
"The least we can do for kids is what we do for hairdressers, and already we are doing less than that," said Penelope Jacks, a Tucson child advocate with the Children's Action Alliance.
Our state is lurching along with the efforts of the anti-regulation zealots, and several Arizona legislators have embraced the notion that we must further deregulate the pitifully unregulated child care business.
During the past legislative session, the already stretched-thin system of child care monitoring was nearly dismantled. In the end, the Office of Child Care Licensure was relieved to escape with two-thirds of its previous budget.
Every day, 127,000 children are cared for in 1,400 child care centers and 200 group homes in Arizona. We employ only 23 inspectors to ensure our children are safe in those centers. For Tucson and Southern Arizona, where ratios have been the highest, inspectors have been responsible for monitoring more than 80 centers each.
Those numbers are about to get much worse because 700 child care centers in public schools, previously exempt from inspections, are being added to the rolls of the Office of Child Care Licensure.
In the Tucson office, each of the three inspectors will now be responsible for monitoring 140 child care centers a year--nearly three centers a week, with no possibility for repeat visits or follow-up measures.
The Child Welfare League of America recommends a ratio of one inspector per 40 centers, and the National Association for the Education of Young Children suggests 1:50, with a maximum not to exceed 1:75.
A state auditor general's report in the late 1980s condemned Arizona's inspector-to-center ratios, saying that expecting one specialist to monitor 110 or 120 centers was an unreasonable burden and such numbers would be completely ineffective.
Nevertheless, Arizona lawmakers in March deeply slashed an already meager $1.6 million budget for the Office of Child Care Licensure.
Rep. Bob Burns, R-Glendale, argued for greater cuts, saying inspections every three years would be enough. Burns and his wife have run child care centers in Glendale for 25 years; one of those centers reportedly was found in violation of state codes in 13 of 17 visits from 1989 to 1995.
Rep. Mark Killian, R-Mesa, said parents should be responsible for monitoring child care, not the state.
FORTUNATELY BURNS AND Killian do not speak for a majority of child care workers or center directors. Several interviewed recently said they welcome more supervision and view inspections as a necessary source of support and guidance.
After arduous debate in the Legislature, some of the discussion centering around whether the care of children deserves at least as much oversight as the care of cattle, $500,000 was cut from the Office of Child Care Licensure and a provision to add money to cover review of the 700 additional child care centers was dumped, according to Sen. Ruth Solomon, D-Tucson.
That budget reduction was a compromise; an earlier proposal was to take $900,000 from the office. The legislators' action to at least restore some of the funds came only after public outcry following an Easter package of stories in the Arizona Republic detailing how a deficient system for monitoring safety in Arizona child care centers might have contributed to nine deaths and many injuries to young children.
Arizona is one of the 13 worst states in the nation for the quality, safety and availability of child care, according to the Child Care Action Campaign. One criterion used to determine a state's ranking was the commitment of state leaders toward ensuring quality care.
Considering the cuts, accidents like the one that burned my daughter and the three babies "will occur many, many more times," Solomon said.
JACKS, OF THE Children's Action Alliance, said, "We are completely of the mind that the state has responsibility. There is no way that parents can take on (the safety monitoring in child care centers). They don't know the standards, and they can't enforce what they see."
Just as one wouldn't expect a customer at a local steak house to go to the kitchen to check the date on the milk or the temperature of the rinse water, one cannot expect parents to become experts combing their child care centers.
Certainly parents must be involved in safety at centers, but not solely responsible for the oversight of children's welfare.
Interestingly, some child advocates suggest that newspapers publish the inspection reports of child care centers, just as restaurant health inspections are detailed regularly in many papers.
The state licenses that hang on the walls of all child care centers, ironically, may lull parents into a false sense of security and complacency.
"When you take your child to a place with a sign that says this center was inspected and licensed by the state, you expect some basic safety standards," Solomon says.
"I don't think we can provide bottom-line safety with what we have now, especially after the cuts we've just seen. Parents need not only be angry but alarmed," Solomon says.
Officials at the Office of Child Care Licensure agree there is a crisis. When a staff and a budget are stretched as thin as theirs, safety will be compromised, says Marlene Morgan, the office's program manager.
I can only guess that those deficiencies contributed to my daughter's injuries. The crock pot that fell on her had gone undetected during three previous state inspections.
Apparently the inspector who later told me a crock pot should never have been in my daughter's center was just interpreting words in state rules that have been too open to interpretation, Morgan said.
As a result of the recent accident with the three babies, Morgan said her office is considering the prohibition of crock pots and microwaves in infant care. She said they might consider, however, allowing appliances if certain architectural requirements are met.
Must it take serious injury to three babies to stiffen state rules? One baby was not enough?
The recent accident, though, coincides with rules reviews, Morgan said. Public hearings will be held around the state on the proposed changes.
"The political climate is very deregulatory. If we're working within that climate, and we are working in a very anti-regulatory atmosphere, it's difficult for us to come up with more rules," Morgan said.
"There comes a time when we as an organization have to take a very firm stand," she said.
Even if new rules are enacted, Morgan admitted, enforcing them could prove futile. Given the budget for next year and new demands on inspectors, the office will be able to do little more than operate in a "reactive mode," she said.
Any new rules do not negate the responsibility of a child care center to have effective, adequate supervision and safety. But if state standards, rules and adequate checks can prevent accidents like these burns, we must not accept retrenchment from our legislators.
We should enhance--not strip--the regulatory powers of those who watch over the people who watch our babies.
Susan M. Knight, mother of two children, is an adjunct professor in the University of Arizona journalism department.
What Parents Can DoWAITING FOR STATE agencies or the Legislature to enact rules and laws that adequately protect our children in child care centers may not be the best strategy. You can take a more active role in the safety of young children if you:
Drop in unannounced at your child care center regularly. Always write a note to the teacher and director about any concerns, and request a response to ensure follow-through.
Make it possible for your employees or co-workers to take a couple of hours off without penalty to visit their children's child care center at least several times a year.
Urge the creation of a safety committee at your school or child care center. Membership should include parents, teachers, the director, a board member and/or someone with outside expertise, such as a paramedic. Comb the school thoroughly on a quarterly or bi-annual basis, looking for potential risks and ways to improve safety. Eventually, these committees may be required by the state licensure office.
Obtain safety checklists from agencies and organizations that are monitors or resources for child care workers. Two local sources are the state Department of Health's Office of Child Care Licensure (1-800-615-8555) and the Tucson Association for Child Care's Resource and Referral Service (520-325-5778 or 1-800-308-9000).
Review the easily accessible public records that include complaints and accident reports on your child care center. A folder on each school in Tucson and Southern Arizona is kept at the state government building at 400 W. Congress St., Suite 100. The records take "a half a minute to pull," according to one assistant there, and are available from 8 a.m. to 5 p.m. Monday through Friday.
--Susan M. Knight
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