Nashville day cares earn top marks despite safety violations

Despite multiple, serious violations at child care centers in Kentucky and Indiana stretching back for more than a decade, a for-profit child care operator expanded its business to Middle Tennessee, where the Department of Human Services licensed it to open a dozen more facilities.

Never Grow Up Inc., which operates 12 child care centers here in Middle Tennessee under The Academy and Holly Tree brands, continued to violate health and safety rules.

In one case, an unsupervised 5-year-old child suffered a shock to the hand and burns after inserting a bobby pin into an electrical outlet. In another, a 4-year-old boy was forgotten in a classroom while caregivers took other children out to play. Violation records posted online by DHS also describe an incident at another Never Grow Up facility where discipline administered by caregivers was said to have been “frightening and potentially injurious” and to have “caused bodily pain."

In spite of these and other violations, DHS gave all but one of the Never Grow Up facilities with violations in Davidson, Williamson and Sumner counties a two- or three-star rating. Three stars is the highest quality rating the state confers on child care centers.

For many parents seeking quality child care centers, the star rating is the key factor in deciding whether a center will be a safe, nurturing environment for their child.

But an investigation by The Tennessean found numerous violations at agencies like Never Grow Up that have earned the state’s highest quality ratings. The newspaper’s investigation into records of all agencies in Davidson and Williamson counties over a four-year period that had been assessed a civil penalty, suspended or put on probation for violations revealed a disconnect between perceived quality of care and what child care inspectors at DHS actually found.

The information about child care centers' histories of violations is not easy to obtain.

Parents who want to dig further into an agency’s history can find a brief list of recent violations online. Although other states routinely post their full inspection records, Tennessee parents must contact the individual inspector who visited an agency to obtain a copy of DHS' inspection records. To learn whether a facility has health violations, parents must contact their local health department.

And records maintained by DHS do not tell parents whether a facility’s owner had a history of violations in another state — or elsewhere in Tennessee if the owner has changed names or locations.

When The Tennessean requested records for more than three dozen facilities operating in Middle Tennessee, officials with DHS took six months to provide the records.

In total, Never Grow Up operates nearly 30 child care centers. In Kentucky and Indiana inspectors have documented cases of insect and rodent infestations, infants put to sleep with potentially suffocating blankets and bibs, and multiple instances of unsupervised children, including a 4-year-old girl who was left forgotten on a cot under a basement stairway for up to 30 minutes before she woke up “shaking and crying.”

In comments to The Tennessean about these kinds of violations, owner and operator of Never Grow Up, Dwight Derringer, said, "I think that, as with everything, when we find an issue we report, we go forward, we terminate, we retrain and we address."

Three of Never Grow Up's Middle Tennessee child care centers have had no DHS-documented violations since July 2013. But for parents who consider two- or three-star child care centers the gold standard, findings at the other centers raise questions about the reliability of a rating system that rewards facilities that have been cited for serious violations of child care management practices. The cases also call into question DHS' due diligence in investigating the background of companies and individuals who may have a questionable track record.

Star quality

Tennessee launched the Star-Quality Child Care Program 15 years ago as part of a broader effort to improve child care and to give parents more information about the quality of care their children receive. It is a voluntary system. Child care centers that decide to participate can earn a rating of one to three stars. No star at all still means a facility meets minimum licensing standards, while three stars means it meets the state's highest standards.

"Compliance history" — an agency's record of maintaining standards and breaking the rules — is only one of the factors DHS considers when assigning a star rating. The compliance history assesses serious violations and civil penalties assessed over only one previous licensing year. That makes it hard for parents to understand the full scope of an agency's track record when it comes to safety and welfare.

Instead, the ratings skew more toward evaluating the qualifications of the center's staff and leadership than toward its day-to-day operations. The ratings also rely heavily on a prescheduled three- to four-hour observation visit by a DHS worker.

Until July of last year, records of violations weren't available online. Since then, DHS has begun posting a summary of violations dating back to July 2013 — lists that display “transportation” or “supervision” violations but provide only limited details of incidents. Violations can encompass anything from missing paperwork to more serious occurrences of endangering the welfare of children.

While DHS officials took months to provide The Tennessean with records of 38 facilities operating in Davidson and Williamson counties that have civil penalties levied against them, the full inspection reports for dozens of Never Grow Up child care centers in Indiana and Kentucky are readily available online.

Growing demand

Even with documented major violations and civil penalties across multiple agencies, companies like Never Grow Up could expand quickly in Middle Tennessee because rapidly changing demographics and population growth have increased the demand for day cares. In fact, the strong Nashville market brought Never Grow Up here, Derringer said. The company plans to open a new location, The Academy of Forrest Crossing, in Franklin in early 2016, according to Derringer.

Tennessee is a very proactive child care state, Derringer said. Tennessee program evaluators have "no issue writing citations and civil penalties," which, he said, are "going to happen from time to time."

"We certainly do not wish for them to happen ever. Our goal is zero — 100 percent compliance, 100 percent of the time." But, he added, "no airliner plans on crashing either."

Before licensing child care providers, DHS conducts a variety of inspections, including environmental, runs background checks on employees and verifies compliance with rules and regulations. The history of serious violations, civil penalties or probation at a facility is considered before issuing a license to another facility owned by the same individual or company, but all decisions are handled on a "case-by-case basis," according to DHS spokeswoman Stephanie Jarnagin.

DHS examines an agency's track record in another state only "if we are aware," Jarnagin said.

Once a facility is licensed, DHS uses a report card and star system to help others assess a center's caliber of care.

To monitor for rules compliance, DHS' licensing staff conducts at least four unannounced visits to all licensed agencies during the licensing year. The majority of agencies associated with Never Grow Up receive four to five unannounced visits each year — based on the two- to three-star rating at each center, Jarnagin said.

Violations were cited when observed and the agency was provided an opportunity to correct them. Unannounced follow-up visits were conducted to ensure the violations were corrected. DHS is "always looking," Jarnagin said, for ways to improve the quality and safety of its licensed child care facilities.

“In contrast to having no information, I think the star quality rating and improvement system is a huge step up,” said Margaret Burchinal, a senior scientist at the Frank Porter Graham Child Development Institute at the University of North Carolina, where she focuses on child care research. “But, in terms of knowing exactly what is the best thing to put in the system, that’s a work in progress.”

Burchinal believes the child care research and oversight community must develop systems that aren’t so complicated and that clearly provide parents information about health and safety at centers. But getting these various systems to talk to one another “is a really big task.”

One thing is for certain regardless of the system: “Safety is always the bottom line,” she said. “If safety is not being ensured, it should not be considered a good quality program.”

Long waits

When searching for a good quality program for her son, Kelsey Loschke stressed like she never had before.

The 27-year-old Antioch mom did her research. She talked to co-workers about what options they used, and she narrowed down options based on location and cost. But then she discovered a disconcerting reality about the Nashville child care landscape — nearly all the highest quality centers have wait lists for months, and some are more than a year.

"When all of those paths ended in sadness, we picked up a parent magazine and I spent hours upon hours calling place after place after place," she said. Loschke didn't even have the luxury of narrowing down her choices using the star quality system; at that point she just needed someone to watch her soon-to-be-born son, so she started scheduling visits.

At one place in East Nashville, she said the smoke break area for child care workers shared a wall with the infant room. "You could smell smoke in the room," she said.

But even when she was desperate, Loschke wasn't ready to accept that standard of care. "As parents, we just feel such a strong responsibility to the safety and health of our babies," she said.

What she needed was oversight that would hold agencies to that same standard — and hold them accountable if they did not.

Earlier violations

In The Tennessean's investigation, the facilities with the most egregious violations were often repeat offenders — including three facilities owned by Never Grow Up Inc.

One of those, Holly Tree Christian Preschool of Priest Lake, has been issued multiple civil penalties for violations since 2011 and was once placed on a 60-day probation, but it now holds the highest quality rating the state can confer on a licensed child care facility — three stars.

In the past four years, agency staff logged four major supervision violations, including two in 2013 when caregivers let an 11-month-old wander alone out of the classroom and left another child unsupervised for at least 30 minutes when he fell asleep while caregivers took some kids to the bus stop and transported others to school. These two major supervision violations in 2013 resulted in a $500 fine.

Despite violations, this child care center continued to operate and receive bonuses and subsidies given to agencies caring for low-income children. DHS paid the agency $301,987.30 in subsidies and bonuses between 2011 and 2015 tied to its star rating.

"People being human are going to make errors," Derringer, the company owner, said. "We are more than crazy when we start doing (child head) count sheets and require (caregivers) to count from room to room, yet errors still occur. I can’t explain it. … I wish I could give you some great reason, but I can’t.

Another local Never Grow Up facility, The Academy of Harpeth Village — which is currently rated as a two-star facility in Nashville — obtained its first operating license on May 1, 2013. That same month DHS received an anonymous complaint that the agency misplaced two children and that the parents were not contacted about the incident.

One child was left outside on the playground unsupervised. Another walked alone into the center through a propped-open door on the playground. The door then shut and locked, leaving the caregiver outside the building and unable to follow the child.

A DHS investigation determined that the allegations were valid and that there was a lapse of supervision. The center had not logged a report for either incident. It did fire the caregiver involved in both instances. For the violations, DHS fined The Academy of Harpeth Village $450.

Three other Never Grow Up agencies — The Academy of McKay's Mill, The Academy of Powell Place in Maryland Farms and The Academy of Maryland Farms — are without violations. The Powell Place location is the company's newest. It opened in January. Because it hasn't been through an entire licensing year, it is not yet eligible for the star system.

During 2013-14, 23 Davidson County agencies lost a star rating because of civil penalties. An additional 11 Davidson County agencies were closed because of license denial or revocation.

Patterns extend to other states

Never Grow Up was established in 1998 when Derringer purchased six day cares in Louisville, Ky. Derringer, who said he had "zero" child care experience before that time, wanted his own company and began to look for day care businesses he thought had long-term potential. He has since expanded his Kentucky brand, Southside Christian Child Care, to include 17 Kentucky- and Indiana-based child care centers.

Based on a review of documentation by Kentucky’s Cabinet for Health and Family Services and Indiana’s Family and Social Services Administration, Never Grow Up failed to assure compliance with regulatory requirements, with a majority of those centers accumulating licensing violations.

Among the most significant of an extensive list:

Hygiene and health violations that included a rodent infestation at the Louisville Southside Christian Child Care #1, which led to the revocation of the center's food license in 2013. Each of the company's facilities in Louisville has been cited for other health and hygiene violations that included standing water in a boys' bathroom, dirty floors, changing tables and walls, and protruding wires in a playground fence. At one facility, caregivers were placing infants on a bare, wooden table without padding to change diapers.

Numerous failures in conducting background checks that included a caregiver who had committed child abuse being allowed to work with children at Southside Christian Child Care's #3 Louisville facility in May, while in a separate incident at another Southside Christian facility in March, a caregiver who had committed child neglect worked alone with children.

Caregivers at one site using "loud, threatening, aggressive, and demeaning language in front of, and to, the children in care." The inspectors concluded: "Based on interviews with staff, some children appear afraid of the staff members."

At the same site, an agency driver was at fault in a crash that sent a van with two children on board careening into a trash bin and then a yard. The agency had no driving record for the driver on file, inspectors found.

'Not a perfect science'

Derringer said no state regulatory agency has ever forced him to close one of his centers. He employs about 500 people to run and oversee his centers, which serve about 2,000 families.

In Tennessee, he has a chief operating officer who handles oversight of the local centers, making sure they have documentation to meet licensing standards. Each of the 12 sites has a director and assistant director who oversee the hiring of the teachers. "They are responsible," Derringer said. "We don’t make individual hiring or firing decisions at every center." Company executives do hold monthly staff meetings with directors and attend quarterly training with the staff: "We trust and verify just like everything else," Derringer said.

Derringer said they have cameras in all their classrooms, and they do criminal background and registry checks before hiring caregivers.

"Child care is not a perfect science, but it should be planned and go well," he said. "It should not be chaos."

It’s not perfect every day, he said, because of the number of employees: "And some people, out of 500 employees, are sometimes not going to do the right thing."

Reach Jessica Bliss at 615-259-8253 and on Twitter @jlbliss. Reach Anita Wadhwani at 615-259-8092 and on Twitter @anitawadhwani.

Live chat with the reporters of this story between 11 a.m. and 12 p.m. Monday at Tennessean.com.