The people in the front lines of the state's child-welfare system - the caseworkers - who are tasked with ensuring the protection and safety of children are not trained well enough, not paid well enough, are overwhelmed with caseloads and are not given access to the resources they need to do their job properly.

Those are among the key findings outlined in a report Thursday by Pennsylvania Auditor General Eugene DePasquale on the state of Pennsylvania's embattled child-welfare system, which last year saw 46 children die and 79 others critically abused and neglected.

The report - entitled "State of the Child" - finds systemic and critical deficiencies across the state's Children Youth Services, the agency that oversees child-welfare and protection,

"What I found...is appalling," DePasquale said. "I'm talking about wholesale system breakdowns that actually prevent CYS caseworkers from protecting our children from abuse and neglect."

The 80-page report comes in the wake of a spike of child deaths and increased caseworker caseloads, which last year prompted an audit of county level child welfare offices. The year-long examination of the system played out against the backdrop of changes to child protective services laws in the wake of child sex abuse scandals involving Jerry Sandusky and the Roman Catholic Church.

The report recommends that the state's child-welfare system should be under the constant review of an independent ombudsman tasked with reviewing complaints and making recommendations for improvement of the system.

In outlining the special assessment of the strengths and challenges of the state's child-welfare system, DePasquale noted that caseworkers take the brunt of the blame when a child dies, even as the findings of the report show an "extremely problematic system with deficiencies that put children's lives at risk."

County children and youth services across the state face similar challenges, including: difficulty in hiring qualified caseworkers and training them; caseworkers who, in addition to being critically underpaid, are unequipped and lack proper training to deal with the scope of caseloads, including the challenges of dealing with increasing caseloads that involve heroin abuse.

"Children are being horribly abused and neglected in Pennsylvania every day," DePasquale said. "In recent months, we've heard of toddlers being kept in cages, newborns left home alone and starving school-age children locked in filthy rooms. There are heartbreaking stories every week."

Among the many findings, the report highlights the chronically high turnover rate among caseworkers, which in some cases, like that of York County at 90 percent, make it impossible for the agency to fulfill its mission.

"How do you have any continuity of care for these vulnerable kids and families," DePasquale said. "The answer is you don't - and the kids suffer because of it."

He noted that in almost all cases caseworkers are so overwhelmed by the volume of paperwork required of them that "their primary mission of protecting children has been lost in the frantic rush just to survive each day."

Children's advocates applauded DePasquale's recommendation to appoint an ombudsman to oversee the child-welfare system.

"While federal and state laws provide the framework for how child welfare services are to be delivered, by and large, critical decisions affecting a child's safety and connection to a stable family can be quite random varying dramatically from caseworker to caseworker and county-to county," said Cathleen Palm, Founder of the Center for Children's Justice. "Pennsylvania's child welfare structure too rarely lends itself to transparency or accountability undercutting the identification of systemic issues that impact, not just one child, but also the collective community of children."

Pennsylvania's child welfare system includes 67 county-level agencies, four regional offices and the state level Office of Children, Youth and Families, which falls under the Pennsylvania Department of Human Services. In 2016, approximately $1.8 billion in local, state and federal funds were spent on child welfare services with state dollars representing $1 billion of that overall spending.

"What really disturbs me is that nearly half of the children who died were in families that were already known to CYS," DePasquale said.

DePasquale noted that DHS must appeal to the General Assembly for more money to fund its programs. Public pressure, the report notes, is paramount in assisting the state and county officials in revamping the system.

The report notes a slew of recommendations, including:

updating all job descriptions

Create administrative efficiencies to provide paperwork relief to caseworkers

Evaluate the merit of using the State Civil Service Commission to hire caseworkers and supervisors

Improve training for caseworkers, including training them to interview hostile people and defusing hostile situations

The evaluation of caseworker salaries; increasing salaries based on experience and educational attainment

In a statement to the media, Palm said that for the proposed ombudsman to be effective, the individual must operate with independence and be given meaningful enforcement powers as well as impartiality in conducting inquiries and investigations.