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STATE OF MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES DEPARTMENT OF CHILD WELFARE LICENSING

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RICK SNYDER GOVERNOR

STATE OF MICHIGAN

DEPARTMENT OF HEALTH AND HUMAN SERVICES

DEPARTMENT OF CHILD WELFARE LICENSING

NICK LYON DIRECTOR

August 17, 2015 Yvwania Richardson

Alternatives for Children & Families, Inc. PO Box 190238 Burton, MI 48519 RE: License #: Investigation #: CB250200945 2015C0221023

Alternatives for Children & Families, Inc.

Dear Ms. Richardson:

Attached is the Special Investigation Report for the above referenced facility. Due to the severity of the violations, disciplinary action against your license is recommended. You will be notified in writing of the department’s action and your options for resolution of this matter.

Please review the enclosed documentation for accuracy and contact me with any questions. In the event that I am not available and you need to speak to someone immediately, please contact the local office at (248) 975-5053.

Please note that violations of any licensing rules are also violations of the MSA and your contract.

Sincerely,

Alicia Wiggins, Licensing Consultant

MDHHS\Division of Child Welfare Licensing 4th Floor, Suite 4B

51111 Woodward Avenue Pontiac, MI 48342

(248) 917-1048 enclosure

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MICHIGAN DEPARTMENT OF HEALTH AND HUMAN SERVICES DEPARTMENT OF CHILD WELFARE LICENSING

SPECIAL INVESTIGATION REPORT

I. IDENTIFYING INFORMATION

License #: CB250200945

Investigation #: 2015C0221023

Complaint Receipt Date: 07/08/2015

Investigation Initiation Date: 07/08/2015

Report Due Date: 09/06/2015

Licensee Name: Alternatives For Children & Families, Inc.

Licensee Address: 2065 South Center Road

Burton, MI 48519

Licensee Telephone #: (810) 250-3820

Administrator: Yvwania Richardson, Administrator

Licensee Designee: (810) 250-3820

Name of Facility: Alternatives for Children & Families, Inc.

Facility Address: 2065 S. Center Rd

Burton, MI 48519

Facility Telephone #: (810) 250-3820

Original Issuance Date: 03/01/1993

License Status: REGULAR

Effective Date: 01/27/2015

Expiration Date: 01/26/2017

Capacity: Unknown

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II. ALLEGATION(S)

Violation Established?

Alternatives for Children & Families placed Foster Child A in a foster home that has had several infractions, many for lack of supervision. They left an additional foster child in the home after Foster Child A went missing.

Yes

The following information has not been entered in MiSACWIS and/or has not been provided to Oakland Co. MDHHS:

Foster Child A 1. Dental exam

2. Placement Exception Request (PER) for Foster Parent A as there were more than 6 children in the foster home.

3. Initial Service Plan (ISP) and Updated Service Plan (USP) 4. Updated school records

5. No face to face visits entered in MiSACWIS since April 2015 Foster Child B

1. Medical and dental exam

2. Family Team Meeting (FTM) for change of placement 3. ISP and USP

4. Relative licensing waiver

5. Change of placement documents 6. Updated school records

7. No face to face visits entered in MiSACWIS since April 2015 Foster Child C

1. Updated school records 2. Medical and dental exam 3. FTM for change of placement 4. Relative licensing waiver

5. Change of placement documents

6. No face to face visits entered in MiSACWIS since April 2015 Foster Child D

1. Medical and dental exam 2. Relative home study

3. Relative licensure referral or relative licensing waiver

4. Change of placement documents. MDHHS and GAL were not notified of Foster Child D’s change of placement.

5. Social work contacts beginning on 03/18/2015 6. FTM for change of placement

Yes

MDHHS and GAL were not notified of Foster Child A’s AWOLP according to MDHHS’ AWOLP policy.

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III. METHODOLOGY

07/08/2015 Special Investigation Intake 2015C0221023

07/08/2015 Special Investigation Initiated - Telephone

Spoke with Oakland Co. MDHHS Supervisor, Justin Wrobel, Oakland Co. MDHHS Foster Care Worker, Ebony Jeffries and Oakland Co. MDHHS Foster Care Worker, Alisia Johnson. 07/10/2015 Inspection Completed On-site

Reviewed Foster Parent A's case file. 07/14/2015 Contact - Face to Face

Interviewed Alternatives for Children & Families' Director of Clinical and Casework Services, Geneva Harvey. Reviewed Foster Parent A, Foster Child A, Foster Child B, Foster Child C and Foster Child D’s case files and documentation on MiSACWIS. 07/20/2015 Contact - Face to Face

Interviewed Kristen Nolen-Winfield, Alternatives for Children & Families' Foster Care Worker, Laura Vyvyan, Alternatives for Children & Families' Licensing Worker, Brad Dixon, Director of Adoption & Placement Services, and Geneva Harvey, Director of Clinical and Caseworker Services. Reviewed documentation on MiSACWIS.

07/23/2015 Contact - Telephone call made

Interviewed Foster Parent B, Foster Parent C, Foster Parent D, Foster Parent E and Foster Parent F.

07/29/2015 Contact - Telephone call received Interviewed Foster Parent G. 08/05/2015 Contact - Face to Face

Reviewed licensing files for Foster Home A, Foster Home B, Foster Home C, Foster Home D, Foster Home E and Foster Home F.

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ALLEGATION #1

:

Alternatives for Children & Families placed Foster Child A in a foster home that has had several infractions, many for lack of supervision. They left an additional foster child in the home after Foster Child A went missing.

INVESTIGATION:

A review of the Interim Inspections and Renewal Inspections beginning in 2012 for Alternatives for Children & Families revealed the following citations:

January 2012 Interim Inspection

• R 400.12212 Personnel Records (3) (a)

• R 400.12311 Placement Agreement (3) and (4) • R 400.12313 Reevaluation (6)

• R 400.12314 License Recommendation (3)(b)(iii)

• R 400.12315 Borrowed Home (1)(b), (c), (d), (f) and (g) • R 400.12316 Special Evaluation (2)(a), (b), (c), (4) and (5) • R 400.12403 Policy and Procedures (2) (p)

• R 400.12404 Placement (5) • R 400.12409 Education Policy

• R 400.12413 Medical and Dental Care Policy (1)(c)(ii) and (f)(i) • R 400.12418 Service Plans: Initial and Updated (2) and (3) • R 400.12419 Visitation (2)

• R 400.12606 Agency Recommendation (3) • R 400.12707 Orientation (a),(b),(c),(d) and (e) January 2013 Renewal Inspection

• R 400.12306 Application Request (2)(a),(b),(c),(d),(e),(f),(g) and (i) • R 400.12313 Reevaluation (2) (b)

• R 400.12314 License Recommendation (3)(b)(iii)

• R 400.12404 Placement (5), (6)(a)(iii-vi), (6)(b), (6)(c), (6)(d) and (6)(g) • R 400.12405 Change of Placement (d)

• R 400.12409 Education Policy

• R 400.12413 Medical and Dental Care Policy (1)(c)(ii)

• R 400.12418 Service Plans: Initial and Updated (1)(a)(b), (6)(a) and (6)(g) • R 400.12605 Adoptive Evaluation (3)(i),(v), (viii),(ix),(x) and (xv)

• R 400.12606 Agency Recommendation (3) • MSA VI E Caseload Standards

• MSA VII A Assessments and Service Plans

• MSA VII B Supervisory Overnight of Assessments and Service Plans • MSA VII G Caseworker Contact and Visits

• MSA VII G Worker-Parent Visits

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• DHHS Policy FOM 722-6 Unannounced Home Visit

• DHHS Policy FOM 722-8 Foster Care –Initial Service Plan (Supervisory Approval)

• DHHS Policy FOM 722-8C Foster Care –Parent Agency Treatment Plan & Service Agreement

• DHHS Policy FOM 722-9 Foster Care-Updated Service Plan (Supervisory Approval)

• DHHS Policy FOM 722-9 USP Updated

• DHHS Policy ADM 210 Required Adoption Focus Activities • DHHS Policy ADM 300 Child Adoption Assessments

• DHHS Policy ADM 330 Quarterly Adoption Progress Reports

• DHHS Policy ADM 710 State Ward Tracking System and Registration on the Michigan Adoption Resource Exchange

• DHHS Policy ADM 950 Post Placement, Adoption Supervision and Finalization Procedures

• DHHS Policy ADM 980 Closing Documentation February 2014 Interim Inspection

• R 400.12214 Compliance with 1975 PA 238 • R 400.12315 Borrowed home (1) (c),(f) and (g)

• R 400.12418 Service plans; initial and updated (2) and (3) • R 400.12419 Visitation (2)

• MSA VII.G.2 Caseworker Contacts and Visits

• DHHS Policy FOM 722-6 Unannounced Home Visit

• DHHS Policy FOM 722-6H Caseworker Contact with Child in Out-of-Home Placement: First Two Months after Initial Placement or a Placement Move • DHHS Policy FOM 722-8 ISP Supervisory Approval

• DHHS Policy FOM 722-8C PATP Signatures Development, Participation and Negotiation of PATP –Signatures

• DHHS Policy FOM 722-9 USP Supervisory Approval December 2014 Renewal Inspection

• R 400.12310 Initial evaluation (2)

• R 400.12316 Special evaluation (6)(a) and (b) • R 400.12317 Foster home record (2)(d) (iii)

• R 400.12418 Service plans; initial and updated (1)(a) and (b) • MSA VII A 5 Assessments and Service Plans

• MSA VII B Supervisory Oversight of Assessments and Service Plans • MSA VII D 1b Family Team Meetings

• MSA VIII B 3 Medical Files

• DHHS Policy FOM 722-3 Quarterly Assessments • DHHS Policy FOM 722-6 Unannounced Home Visit

• DHHS Policy FOM 722-6H Caseworker Contact with Child in Out-of-Home Placement: First Two Months after Initial Placement or a Placement Move • DHHS Policy FOM 722-8 ISP Supervisory Approval

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• DHHS Policy FOM 722-9 USP Supervisory Approval • DHS Policy FOM 801 Health Requirements

A review of the Special Investigations (SI) beginning in 2012 for Alternatives for Children & Families revealed the following citations:

• SI#2013C0420016 was received on 12/21/2012. The allegations were as

follows: (1) the agency failed to complete a timely DHS- 69 showing Child A and Child B’s out of state address change, USP covering the quarterly period

05/19/2012-08/16/2012, or to submit the next USP due 11/2012; as well as, failed to submit court reports for court hearing 07/13/2012 and 08/10/2012, (2) the agency failed to request courtesy out-of-state supervision or a wellness child check for Child A and Child B whose Guardianship was not ordered for until 09/26/2012, (3) it was also noted that the complaint included an allegation pertaining to overpayments to the agency, after the children’s relative’s home was closed, yet that issue was not investigated as it was not rule related , and reportedly repayment issues were being addressed. The agency received citations for the following:

o R 400.12207 Staff responsibilities (3) (a). The agency did not complete a court report for the children’s 07/13/2012 or 08/10/2012, court hearing; and review of the court order for each hearing indicated the agency gave a verbal report suggesting the court did not require/request a written court report. However, the worker/agency did not appropriately indicate this information to DHHS; and therein was/were not responsive in her duties to work directly with DHHS.

o R 400.12418 Service plans, Initial and Updated (1) (b). The 05/19/2012- 08/16/2012 USP stated 08/16/2012 as the completion date; however, the agency worker, supervisor and director all indicated the USP signed by the worker and supervisor on10/18/2012 was not completed on time. o DHHS Policy FOM 913-4 Placement Resources: Child Placing Agency

Reporting Requirements. A DHS-69 documenting Child A and Child B’s replacement to Arkansas was not completed and the foster care worker could not recall when exactly DHHS was made aware of the placement change. The change was indicated in the 05/19/2012- 08/16/2012 USP, which was documented being submitted to DHHS on 10/18/2012.

Additionally, the agency did not complete a November 2012 USP and one was due for the period 08/17/2012- 11/14/2012, in that the last USP’s 08/16/2012 end date, and the 11/08/2012 date the agency submitted the DHS-69 Action Summary closing the case was greater than 30 calendar days. This stated USP remained outstanding. Furthermore, the agency’s case closing DHS-69 Action Summary was completed 11/05/2012 per the worker’s signature date and submitted to DHHS 11/08/2012, more than three business days of the children’s guardianship which was granted at the 09/07/2012 court hearing.

o DHHS Policy FOM-722 Foster Care- Courtesy Supervision. A request to DHHS for courtesy supervision of Child A and Child B’s placement in

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Arkansas, pending their guardianship by their great grandmother, was not made.

o MSA VII D Family Team Meeting. A family team meeting was not held related to Child A and Child B’s relocation out- of- state, and the case termination.

• SI#2013C0420024 was received on 03/07/2013. The allegations were as follows: (1) the agency placed Child A in Illinois without prior Interstate approval. The agency failed to seek courtesy supervision, and had no face to face contact or supervision for the child from 12/23/2012 through 01/29/2013. (2) During the course of the investigation, it was discovered the agency failed to complete an action summary (DHS-69) related to Child A’s replacement, as the agency believed case transfer to DHHS was within the required timeframe. The agency failed to conduct a

FTM prior to or after the child’s replacement. The agency received citations for the following:

o R 400.12403 Policy and procedures (1). The agency admitted it allowed the grandparent to take the child for placement in Illinois, prior to Interstate Compact’s approval of the home/placement.

o DHHS Policy FOM 722-14. A request to DHHS for courtesy supervision of Child A’ s placement with the maternal grandparents, in Illinois, for the period December 23, 2012 to January 29, 2013 was not made.

o DHHS Policy FOM 913-4 Placement Resources: Child Placing Agency Reporting Requirements. The agency did not provide advance notice to

DHHS of Child A’s replacement to Illinois. The DHS-69 documenting Child A’s replacement to Illinois was completed 01/02/2013, more than three business days after the child’s 12/23/2012 placement with the grandparents.

o MSA VII D Family Team Meeting. A FTM was not held related to Child A’s relocation out- of-state/replacement.

• SI#2013C0420048 was received on 08/26/2013. The allegations were as follows: (1) On 8/25/2013, Child A (2 ½) choked on a peanut butter sandwich and died. (2) During the course of the investigation, it was discovered the agency’s special evaluation report related to Child A’s death, and three other special evaluation reports (dated

02/12/2013, 02/26/2013 and 09/02/2013) contained information related to Children Protective Services’ (CPS) involvement. The special evaluation report related to Child A’s death mentioned CPS several times and named the CPS worker. Two other special evaluation reports reviewed during the investigation also mentioned CPS on more than one occasion. (3) During the course of the investigation, it was discovered the agency did not request an exception for Child A’s foster parents to have more than a total of six children placed in the foster home, as mandated by DHHS policy. The agency received citations for the following:

o 722.120 Investigation and examination of conditions, books, records, and reports; visits regarding health or fire protection; records; report; forms; confidentiality; disclosure of information; availability of confidential records. [M.S.A. 25.358(20)] The agency’s special evaluation related to Child A’s

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death and two other special evaluations completed on Child A’s foster parents in 2013 did not safeguard CPS’s involvement.

o DHHS Policy FOM 722-3 Foster Care- Placement/Replacement. An exception request (DHS- 399) for the foster family to have more than a total of six

children in the home was not requested or approved.

• SI#2013C0420054 was received on 09/25/2013. The allegations were as follows: (1) The agency failed to invite the Lawyer- Guardian Ad Litem (LGAL) to Youth A’s FTM held 05/28/2013 or to hold a FTM after Youth A went AWOLP in July and August 2013. (2)The agency failed to provide notice of Youth A’s AWOLPs to the LGAL or to file for an AWOLP hearing with the court. (3) The agency failed to pursue Youth A’s goal of independent living by obtaining him a supervised independent living stipend as ordered by the court on 06/11/2013. (4) The agency failed to seek the Michigan Children

Institute’s (MCI) assistance in approval of an alternative placement of Youth A, an MCI ward, with his biological mother. (5) The agency closed Youth A’s case prior to

providing Youth A his clothing allowance. (6) Youth A has had four different workers since May 2013. (7) During the source of the investigation, it was discovered Youth A’s 12/28/2012-02/22/2013 USP did not contain the youth’s or foster parent’s signature; and that a subsequent USP was late. The agency received citations for the following:

o MSA VII D Family Team Meeting. Written nor advance notification of the May 28, 2013 FTM, nor indicated scheduled August 12, 2013 and August 15, 2013 FTMs was not provided to the LGAL nor did the FTM convene in absence of the family, as dictated in the MSA requirement.

o DHHS Policy FOM 722-3 Foster Care Placement and Replacement. The agency contacted DHHS related to the AWOLP and provided the child’s known location. Written notification to the court for an AWOLP hearing was not advised.

However, after receiving notification of the youth’s AWOLP in July and again in August, the agency did not provide notification of the AWOLPs to the LGAL or court within 24 hours as indicated by the policy.

o DHHS Policy FOM 722-8 C Foster Care- Parent Agency Treatment Plan & Service Agreement. The 12/28/2012- 02/22/2013 service plan did not contain the foster parent’s signature.

o MSA VII A Assessments and Service Plans. The 12/28/2012-02/22/2013 service plan did not contain the youth’s signature.

o DHHS Policy FOM 722-6 Foster Care- Updated Service Plan. The supervisor signed the 05/24/2013-08/21/2013 USP seven days late.

• SI#2014C0420039 was received on 07/10/2014. The allegations were as follows: (1) The agency failed to maintain various case file documentation as required by policy, inclusive of a signed copy of a September 12, 2012 court report, Foster Care

Review Board (FCRB) Report regarding the agency’s recommendation for Child A’s replacement from his foster home; social work contacts of the agency’s contacts with the paternal uncle, and social work contacts of Child A’s visits with the paternal uncle; and a copy of the paternal uncle’s guardianship petition and the court’s denial order pertaining to it. (2) The agency failed to complete a relative home study on Child A’s

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paternal uncle prior to, recommending the uncle for placement of Child A, allowing Child A unsupervised visits with the paternal uncle. (3) During the course of the investigation it was discovered, the agency did not complete FTMs as required by MSA and policy. Additionally, the agency did not conduct criminal history and central registry clearances on Child A’s paternal uncle’s wife prior to allowing visitations between Child A and the paternal uncle and his wife. The agency received citations for the following:

o DHHS Policy FOM 722-05 Foster Case- Case Record. The agency failed to obtain or maintain a copy of service activity reporting: namely, a December 2013 FCRB hearing document and guardianship petitioning and denial documentation related the child’s paternal uncle’s pursuit of guardianship of the child. The agency admitted, it did not request or obtain a copy of the FCRB document until months after the said event; and after DHHS brought the matter to their

attention. The agency was not sure when the guardianship paper work was received; though it was provided via DHHS just prior to or after this complaint. o DHHS Policy FOM 722-06H Caseworker Contacts. The agency failed to

adequately document its or Child A’s ongoing contacts with the paternal uncle, or the paternal uncle’s wife. The agency reported its worker conducted a home visit with the paternal uncle and his wife on 10/29/2013 to assess the paternal uncle’s home; and that the relative had a visit with Child A in Child A’s foster home 10/31/2013; and thereafter visited Child A in the community; and that Child A had at least two overnight visits with the paternal uncle in December 2013. Also that the paternal uncle continued visitations with Child A until July 2014. The 10/29/2013, 10/31/2013 or other specific dates of visits or contacts with the paternal uncle, or between the paternal uncle and Child A were not documented, on some type of visit sheet, or within the social work contacts of the service plans.

o MSA VIII D 6(c) Foster & Adoption Recruitment, Retention & Support. The agency scheduled placement of Child A with a paternal uncle and the uncle’s wife for 12/13/2013, but it failed to complete a home study, or document that the uncle’s home was safe and was an appropriate placement for Child A prior to allowing Child A unsupervised visits with the paternal uncle. A home study on this uncle and his wife was not documented until 07/01/2014.

o MSA VII D Family Team Meeting. A FTM was not documented to have occurred when the agency decided to pursue the paternal uncle as a permanent

placement plan for Child A; or during the case service plan periods notably 07/20/2013- 10/08/2013; 10/09/2013- 01/06/2014, and 01/07/2014- 04/04/2014. o DHHS Policy FOM 722-06 Criminal Record Check-Law Enforcement Information

Network( LEIN). The agency failed to obtain or request a criminal history clearance on Child A’s paternal uncle’s wife, prior to allowing contact between that person and Child A. The agency did not obtain a criminal history clearance on the paternal uncle’s wife until 07/07/2014, though contacts between the child and the paternal uncle reportedly commenced in October or November 2013; and subsequently included unsupervised overnight visits in December 2013, which would have included the paternal uncle’s wife.

o R 400.12207 Staff responsibilities (3) (a). The agency staff failed to obtain or apprise DHHS of the need for a central registry clearance on Child A’s paternal

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uncle’s wife, prior to allowing that person contact and unsupervised visits with the child; or to keep DHHS apprised of the dates and outcome of the visits with that person and Child A’s paternal uncle.

Foster Parent A’s case file was reviewed on 07/14/2015. Since 2012, the agency completed six special evaluations on Foster Parent A. Foster Parent A was found to be in non-compliance of licensing rules and provided with a corrective action plan (CAP) for four of the special evaluations.

• On 05/08/2012, the agency opened a special evaluation. The allegations were as follows: (1) A 17 year old foster child was arrested for alleged sexual contact with another youth in the home. (2) Foster Parent A takes a foster child to his biological mother’s home for parenting time. Foster Parent A was found to be in non-compliance with R 400.9501 (2) (a) due to Foster Parent A being a mandated reporter and not calling the allegations into Genesee Co. CPS. Foster Parent A was found to be in non- compliance with R400.9202 (e) due to Foster Parent A’s mother, who was the substitute caregiver and the adult in the home responsible for supervision of the children,

indicating that she did not leave her bedroom to check on the children while they were in another area of the house. The CAP consisted of Foster Parent A agreeing to contact CPS immediately any time physical or sexual abuse is suspected or known to have occurred in the foster home, provide direct supervision to all youth in the foster home and attend training titled “Rights, Roles and Responsibilities of foster parents.”

• On 08/25/2013, the agency opened a special evaluation. The allegation was that Foster Parent A backhanded a foster child in the face and hurt his nose. No marks or bruises were observed. The foster child stated Foster Parent A backhanded him

because his brother hit him and he hit his brother back. Foster Parent A was found to be in non-compliance with R 400. 9201 (i) and R 400.9404 (1) and (3). The foster child and his brother reported that Foster Parent A has used physical discipline on the foster child. The foster child repeated the same exact story to his foster care worker and the foster care worker’s supervisor, who both felt that he was telling the truth. The CAP consisted of Foster Parent A agreeing to provide appropriate discipline according to the agency’s policy, which states that physical discipline cannot be used on any youth residing in the foster home and attending training on behavioral management.

• On 08/21/2014, the agency opened a special evaluation. The allegation was that a foster child disclosed to Foster Parent A that two foster children in the home kissed. It was alleged that the female foster child performed oral sex on the male foster child. Foster Parent A was found to be in non-compliance with R 400.9501 (2) (a) due to Foster Parent A being a mandated reporter and not calling the allegations into Genesee Co. CPS. Foster Parent A was found to be in non-compliance with R 400.9202 (e) due to Foster Parent A’s mother, who was the adult in the home who was responsible for supervision, was sitting on the front porch while the children were playing in the back yard. Foster Parent A was in the house cooking dinner. The CAP consisted of Foster Parent A agreeing to contact CPS immediately any time physical or sexual abuse is suspected or known to have occurred in the foster home, provide direct supervision to

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all youth in the foster home and attend training titled “Rights, Roles and Responsibilities of foster parents.”

• On 12/19/2014, the agency opened a special evaluation. The allegation was that Foster Parent A did not administer a foster child’s prescription medication as ordered. The prescribed medication was in the foster child’s possession and not locked in a safe place. Foster Parent A was found to be in non-compliance with R 400.9411 (3) due to Foster Parent A admitting that she gave the foster child her medication to give to the new foster parent when going on a weekend visitation with the new foster parent. Foster Parent A was found to be in non-compliance with R 400.9411 (4) due to Foster Parent A not giving the foster child her prescribed Risperdal for over a week as the medication was missing and Foster Parent A did not report this to the case manager. The agency developed a CAP for Foster Parent A consisting of Foster Parent A agreeing to keep all prescribed and over the counter medication in a locked safe place, not allowing children to keep medication in their possession and dispensing medication prescribed by a physician to the foster child. This CAP was not signed by Foster Parent A.

Foster Parent A’s training log was reviewed. There was no documentation that provided evidence that Foster Parent A had received training pertaining to caring for

children who have autism. Foster Parent A signed the agency’s Foster Parent

Information Checklist form for Foster Child A on 02/27/2015. The form documented that Foster Child A was non-verbal and he had autism.

On 07/20/2015, Laura Vyvyan, Alternatives for Children & Families' Licensing Worker, was interviewed on-site. Ms. Vyvyan reported that she began her employment with Alternatives for Children & Families on 03/18/2015. She reported that the only special evaluation that she has been assigned to is the current one regarding Foster Child A’s disappearance at the park. Ms. Vyvyan reported that she has not completed the special evaluation regarding Foster Child A. She stated that when Foster Child A was placed with Foster Parent A there were not more than 6 children in the home. However, Ms. Vyvyan stated that in March 2015 Kristen Nolen-Winfield, Alternatives for Children & Families' Foster Care Worker, completed a home visit with Foster Parent A and observed that another child was living in the home. Ms. Nolen-Winfield then informed Ms. Vyvyan that there was another child living in the home, which Foster Parent A had received power of attorney for so that she could care for him. She stated that she had received the power of attorney documentation from Foster Parent A approximately 6 weeks ago. Ms. Vyvyan stated that she did not open a special evaluation regarding Foster Parent A not disclosing the household member change because she was waiting for Foster Parent A to provide the documentation showing that she has power of

attorney of the child. Ms. Vyvyan reported that a PER was not requested once there were more than 6 children in Foster Parent A’s home. Ms. Vyvyan indicated that to her knowledge Foster Parent A has not had any training pertaining to caring for children who have autism.

On 07/20/2015, Brad Dixon, Director of Adoption & Placement Services, was interviewed on-site. Mr. Dixon reported that Foster Parent A did not have training

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pertaining to caring for children who have autism. He reported that he reviewed Foster Parent A’s case file including the special evaluations that have been completed on her. He indicated that after reviewing the special evaluations Foster Parent A’s license probably should have been changed to a provisional license. Mr. Dixon stated that he could not explain why Foster Parent A continued to have a regular license after the special evaluations were completed. He reported that when a foster parent is placed on a provisional license the agency usually does not place children in the home because the agency does not receive payment for the foster child. Mr. Dixon stated that when a foster home is placed on a provisional license the issues in the foster home have to be severe, which would cause the children to be removed from the home. He reported that the issues being addressed in the special evaluations for Foster Parent A were not that severe to remove the children from the foster home. Mr. Dixon reported that he was made aware that Foster Parent A had power of attorney of Child D via the document that was signed on 03/03/2015. He reported that a special evaluation was not opened on Foster Parent A for not informing the agency of the change of her household

members. Mr. Dixon stated that Foster Parent A did not sign the CAP for the

12/19/2014 special evaluation. He stated that the licensing worker who completed the special evaluation reported that she mailed the CAP to Foster Parent A, but never received the signed copy back.

As a result of the significant licensing rule violations with Foster Parent A stemming from the investigation of Allegation#1, further foster home licensing files were reviewed. On 08/05/2015, six of fifty-nine foster home licensing files were randomly selected and reviewed. The following information was found in the foster home licensing files: Foster Home A

• A biological parent complained that she smelled liquor on the breath of the babysitter of the children while at the hospital on 08/26/2014. An incident report was written on 09/03/2014 by the agency when they were made aware. A letter was sent to the foster parent on 09/15/2014 summarizing a meeting with the foster parent, (a date was not given for the meeting), acknowledging that the foster parent was aware of the allegation that the babysitter smelled like alcohol and that it had happened before. She gave the babysitter a drug/alcohol screen which came back negative. The foster mother decided not to use the babysitter again. The letter stated that the foster mother would be off work for 4-6 weeks and the children would be enrolled in a local daycare center.

Foster Home B

• The agency received a complaint on 04/14/2015. The investigation close date is 05/28/2015 and the report signature date is 06/01/2015. The CAP was signed by the foster parent on 06/01/2015. Foster Home B was found to be in non-

compliance with the following rules:

o R 400.9201 (j) (k) Foster home applicant/licensee qualifications. In the agency’s investigation, the foster mother initially lied about a retail fraud charge. She reported she thought it was not on her record because she did not do it, yet she was serving community service for it.

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o R400.9301 (1) Maintenance. The agency’s report cited broken glass on the front lawn.

o R400.9304 (1) (a) and (2) Smoke detectors; carbon monoxide detectors. The agency’s report stated there was no carbon monoxide detector and no batteries for the smoke detectors.

o R400.9306 (3) (b) and (d) Bedrooms. A foster child, who had been in the home for a year, had no bedding for the entire time he was in the home. o R400.9310 (2) Smoking. The foster parent cleaned away ashes during

the interview with the workers and asked her if they smelled smoke. o R400.9413 (3) and (4) Substitute care. Upon arrival for the investigation,

the worker found the children alone with the foster parent’s 13 year old relative providing substitute care.

o Rule 400.9414 (4) (f) Unusual incident notification. The foster mother failed to report the retail fraud and license suspensions.

o R400.9415 (2) Hazardous materials. The foster mother did not have medication stored securely.

Foster Home C

• The relocation study for Foster Home C says that they have no pets. The previous renewal reevaluation says that they have 2 dogs, a fish and 2 geckos. The relocation reevaluation does not mention the changes in the number of pets. • In the narrative paragraphs of the income section of the reevaluation reports, it

says that the foster father in Foster Home C is employed at BRD construction and has a net income of $2800.00 per month. However, the lists of income and expenses all say that he is receiving this amount as unemployment. The 2012 renewal reevaluation says he is receiving unemployment.

• The 2014 renewal reevaluation report did not have an assessment of training needs of foster parents. They have children placed in their home. All of the training these foster parents have had since licensure has been taken on-line, has been from books and videos. The report says there is a mandatory 2 hour training that all foster parents must take every 2 years on rights, role, and responsibilities of foster parents. It was not documented that they had the training.

• The 2013 interim report has no assessment of training needs. The report just says they received 10 hours of training and need 6 more hours. The report says there is a mandatory 2 hour training that all foster parents must take every 2 years on rights, role, and responsibilities of foster parents. It was not

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• The 2012 reevaluation report has no assessment of training hours. The report says there is a mandatory 2 hour training that all foster parents must take every 2 years on rights, role, and responsibilities of foster parents. It was not

documented that they had the training.

• The 2015 relocation study, 2014 renewal report, 2013 interim report all say they are licensed for children 5-14 years. The 2012 renewal report says they are licensed for children 2-10 years. The 2012 BCAL-3706 form says they are licensed for children 2-10 years.

Foster Home D

• The 2012 reevaluation report says the foster parents each competed 6 hours of training. Four hours each was for watching the movie “Blindside.” The training records in the file list no training received for 2012 at all. There is no supporting documentation that indicates that any training was received for 2012, including what is mentioned in the report.

• The 2013 reevaluation and 2014 renewal reevaluation had no assessment of training needs for the foster parents. It only says how many hours they got, how many they need, and that they have to attend the mandatory training on rights, role, and responsibilities of foster parents.

Foster Home E

• The 2012, 2013 and 2014 reevaluation reports state that the foster parent needs to complete the mandatory training on rights, role, and responsibilities of foster parents.

• Substitute caregiver did not receive a criminal history clearance and a central registry clearance.

Foster Home F

• The May 2012 renewal reevaluation indicated that on the day of the home visit for the renewal the foster parent informed the licensing worker that her daughter moved back into the home on 01/12/2012. A special evaluation was not opened for the non-compliance of the licensing rule for not notifying the agency of the change in household members.

• Substitute caregiver did not receive a criminal history clearance and a central registry clearance.

• The training log for the foster parent documented the following trainings: o Antoine Fisher movie on 05/17/2011

o I am Sam movie on 05/17/2011 o Losing Isaiah on 05/17/2011

o Antoine Fisher movie on 05/02/2012 o I am Sam movie on 05/02/2012 o Losing Isaiah on 05/02/2012

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APPLICABLE RULE

R 400.12206 Staff qualifications.

(1) An agency shall require a staff member who has ongoing contact with children or parents to be a person who is of good character and emotionally stable and who has the ability, experience, education, and training to perform the duties assigned.

ANALYSIS: Five special evaluations were reviewed and all demonstrate a

pattern of Brad Dixon, Alternatives for Children & Families’ Director of Adoption & Placement Services, approving special evaluations which have inappropriate licensing

recommendations based on the findings and continuing to recommend regular licenses for foster parents when significant violations have been cited and safety issues are present. On 05/08/2012, the agency opened a special evaluation in which Foster Parent A was found to be in non-compliance with R 400.9501 (2) (a) due to not reporting alleged sexual abuse allegations into Genesee Co. CPS. She was found to be in non- compliance with R400.9202 (e) due to lack of supervision by Foster Parent A’s mother, who was the substitute caregiver and the adult in the home responsible for supervision of the children. Foster Parent A was given a CAP and it was recommended that a regular license be continued. On 08/25/2013, the agency opened a special evaluation in which Foster Parent A was found to be in non-compliance with R 400. 9201 (i) and R 400.9404 (1) and (3) due to using physical discipline on a foster child. Foster Parent A was given a CAP and it was recommended that a regular license be continued. On 08/21/2014, the agency

opened a special evaluation in which Foster Parent A was found to be in non-compliance with R 400.9501 (2) (a) due to Foster Parent A not reporting sexual abuse allegations into Genesee Co. CPS. She was found to be in non-compliance with R 400.9202 (e) due to lack of supervision by Foster Parent A’s mother, who was the adult in the home who was responsible for supervision. Foster Parent A was given a CAP and it was

recommended that a regular license be continued. On

12/19/2014, the agency opened a special evaluation in which Foster Parent A was found to be in non-compliance with R 400.9411 (3) due to Foster Parent A admitting that she gave a foster child her medication to give to the new foster parent when going on a weekend visitation with the new foster parent. Foster Parent A was found to be in non-compliance with R 400.9411 (4) due to not administering the foster child’s prescribed

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Risperdal for over a week as the medication was missing and Foster Parent A did not report this to the case manager. Foster Parent A was given a CAP and a regular license was

recommended.

The agency completed a special evaluation on Foster Home B on 05/28/2015. Foster Home B was found to be in non-

compliance with the following rules:

• R 400.9201 (j) (k) Foster home applicant/licensee qualifications due to lying about a retail fraud charge. • R400.9301 (1) Maintenance due to the foster parent

having broken glass on the front lawn.

• R400.9304 (1) (a) and (2) Smoke detectors; carbon monoxide detectors due to the foster home not having a carbon monoxide detector and having no batteries for the smoke detectors.

• R400.9306 (3) (b) and (d) Bedrooms due to a foster child, who had been in the home for a year, having no bedding for the entire time he was in the home.

• R400.9310 (2) Smoking due to the foster parent cleaning away ashes during the interview with the workers and asking them if they smelled smoke.

• R400.9413 (3) and (4) Substitute care. Upon arrival for the investigation, the worker found the children alone with the foster parent’s 13 year old relative providing

substitute care.

• Rule 400.9414 (4) (f) Unusual incident notification due to the foster mother failing to report the retail fraud and driver’s license suspension.

• R400.9415 (2) Hazardous materials due to the foster parent not having medication stored securely.

Foster Home B was provided with a CAP which was signed on 06/01/2015 and it was recommended that her regular license status continue.

Each special evaluation had significant licensing rule violations. However, the foster parents continued to have regular licenses when in fact a recommendation should have been made to either issue a provisional license or revocation of their foster home license. The licensing recommendations that were made demonstrated that there was no assessment of the foster parents’ decision making skills when it comes to safely caring for foster children.

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APPLICABLE RULE

R 400.12303 Policy and procedures.

(1) An agency shall have and follow written policies and procedures for assessing and certifying foster homes for

licensure. An agency may not have a policy related to certifying homes that violates Section 102 of the Elliott-Larsen Civil Rights Act, 1976 PA 453, MCL 37.2102.

(2) Policies and procedures shall cover all of the following areas and be on forms provided, and in a manner prescribed, by the department:

(h) Foster parent/agency agreement. (j) ) Behavior management.

(k) Religion.

(l) ) Communication. (m) Personal possessions. (n) Allowance and money. (o) Clothing. (p) Substitute care. (q) ) Supervision. (r) ) Hazardous materials. (s) Unusual incidents. (t) Emergency policy.

ANALYSIS: At the 08/05/2015 on-site visit, the Chief Administrator was

asked to provide the agency’s updated policy and procedures manual due to there being new licensing rules which were effective on 01/05/2015. The Chief Administrator indicated that she was currently in the process of updating the agency’s policies and procedures to reflect the changes of the new rules.

CONCLUSION: VIOLATION ESTABLISHED

APPLICABLE RULE

R 400.12312 Foster parent training.

(5) An agency shall document all training received by each foster parent.

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ANALYSIS: The reevaluation report for Foster Home D states that the foster parents received four hours each for watching the movie

“Blindside.” The movie is not four hours long. The training records in the file list no training received for 2012 at all. There is no supporting documentation that indicates that any training was received for 2012, including what is mentioned in the report.

CONCLUSION: VIOLATION ESTABLISHED

APPLICABLE RULE

R 400.12316 Foster parent training.

(3) The training specified in subrule (2)(a), and (b), of this rule shall address all of the following areas:

(a) Characteristics and needs of children who may be placed into the home.

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ANALYSIS: Foster Child A was placed in Foster Parent A’s home on

02/23/2015. Foster Parent A’s training log did not document that Foster Parent A had received training pertaining to caring for children who have autism. Both the licensing worker and

licensing supervisor acknowledged that Foster Parent A had not received training on autism. Per the rule, Foster Parent A should have been provided training that related to Foster Child A’s needs. At the very least, Foster Parent A should have been trained on how to handle issues dealing with Foster Child A’s communication skills, physical safety and self-care.

Foster Home E’s training completed in 2012 was the same training they completed in 2011. The foster parent watched the same movie in 2012 that they watched in 2011. The trainings that foster parents complete should not include a repeat of a movie they watched. There should be a variety of training that addresses all of the following areas:

(a) Characteristics and needs of children who may be placed into the home.

(b) Safe sleep practices for infants. (c) Effective parenting.

(d) Behavior management, including de-escalation techniques. (e) Importance of the foster child’s family.

(f) ) Concurrent planning. (g) ) Role of the agency.

(h) Emergency procedures, first aid, and fire safety. (i) ) Preparation of the foster child for permanence and independence.

(j) The role of the court and lawyer guardian ad litem in permanency planning.

CONCLUSION: VIOLATION ESTABLISHED

APPLICABLE RULE

R 400.12319 Substitute care policy.

An agency’s substitute care policy shall, at a minimum, contain provisions for all of the following:

(a) Qualifications for substitute caregivers, consistent with the requirements of 1973 PA 116 and child care licensing rules.

ANALYSIS: There were no criminal history clearances and central registry

clearances for the substitute caregivers for Foster Home E and Foster Home F.

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APPLICABLE RULE

R 400.12324 Reevaluation.

(2) The annual reevaluation shall include a determination and assessment of all of the following:

(a) All changes to the factual information contained in the initial evaluation and subsequent renewal evaluations.

ANALYSIS: It appears that the reports for Foster Home C are not being

updated to reflect accurate information. The relocation study for Foster Home C says that they have no pets. The previous renewal reevaluation says that they have 2 dogs, a fish and 2 geckos. The relocation reevaluation does not mention the changes in the number of pets. There was inconsistent reporting of the foster parent’s income. In the narrative

paragraphs of the income section of the reevaluation reports, it says that the foster father in Foster Home C is employed at BRD construction and has a net income of $2800.00 per month. However, the lists of income and expenses all say that he is receiving this amount as unemployment. The 2012 renewal reevaluation says he is receiving unemployment.

CONCLUSION: VIOLATION ESTABLISHED

APPLICABLE RULE

R 400.12324 Reevaluation.

(2) The annual reevaluation shall include a determination and assessment of all of the following:

(c) Training needs of the family.

ANALYSIS: The agency has not addressed the fact that for three years they

have required Foster Home C to complete 2 hours of training on rights, role, and responsibilities of foster parents and Foster Home C has not completed the training.

The agency has not addressed the fact that for two years they have required Foster Home D to complete 2 hours of training on rights, role and responsibilities of foster parents and Foster Home D has not completed the training.

The agency has not addressed the fact that for three years they have required Foster Home E to complete 2 hours of training on rights, role and responsibilities of foster parents and Foster Home E has not completed the training.

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CONCLUSION: VIOLATION ESTABLISHED

APPLICABLE RULE

R 400.12325 License recommendation.

(1) An agency shall recommend to the department the

appropriate licensing action consistent with facts contained in the foster home evaluation and any special evaluations.

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ANALYSIS: Since 2012, the agency completed six special evaluations on Foster Parent A. Foster Parent A was found to be in non- compliance of licensing rules and provided with CAPs for four of the special evaluations. The 05/08/2012 special evaluation was concerning allegations of inappropriate sexual contact among children that were in the home due to Foster Parent A’s substitute caregiver’s lack of supervision of the children. In addition, Foster Parent A failed to report the allegations to CPS. The 08/25/2013 special evaluation was concerning Foster Parent A using physical discipline violating the agency’s discipline policy. The 08/21/2014 special evaluation was concerning allegations of inappropriate sexual contact among the children in the home due to Foster Parent A’s lack of supervision as well as Foster Parent A’s substitute caregiver’s lack of supervision. Again, Foster Parent A failed to report the allegations to CPS.

The third special evaluation should have prompted the agency to recommend that disciplinary action be issued to Foster Parent A. The three special evaluations demonstrated Foster Parent A’s substantial noncompliance of foster home licensing rules which could have jeopardized the health, safety, and care of the children placed in her home.

The fourth special evaluation, which occurred on12/19/2014, further shows Foster Parent A’s continuous lack of judgment and inappropriate decision making skills when caring for children placed in her home.

A special evaluation for Foster Home B was completed on 06/01/2015. The agency failed to use the findings of this

investigation to make the correct recommendation, which should have been disciplinary action of her foster home license.

Children were put at risk while placed with Foster Home B. They were left with a 13 year old caregiver. The foster mother was shop lifting with the foster children and the stolen item was hidden under a diaper bag. Her driver’s license was suspended, yet she was still driving. A foster child went without proper linens for a year. The foster parent demonstrated both willful and substantial non-compliance of foster home licensing rules which could have jeopardized the health, safety, and care of the children placed in her home.

For Foster Home C, the age range on the BCAL-3706 form was not changed until October 2014 to state that the foster home was licensed to accept children between the ages of 2-14 years

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old.

CONCLUSION: VIOLATION ESTABLISHED

APPLICABLE RULE

R 400.12325 License recommendation.

(3) Except for an original license, an agency shall recommend to the department the issuance of a regular license or the

continuation of an active license only when all rules are in compliance or both of the following conditions exist:

(b) A written corrective action plan has been developed. The plan shall be in compliance with all of the following

requirements:

(iii) Be signed and dated by the foster parent and the agency.

ANALYSIS: A CAP was developed as a result of the 12/19/2014 special

evaluation for Foster Parent A. The CAP was not signed by Foster Parent A. The agency’s Director of Adoption and

Placement stated that the licensing worker, who completed the special evaluation, reported that she mailed the CAP to Foster Parent A, but never received the signed copy back.

CONCLUSION: VIOLATION ESTABLISHED

APPLICABLE RULE

R 400.12327 Special evaluation.

(1) An agency shall do all of the following when anyone in the agency receives information that relates to possible

noncompliance with any foster home rule:

(a) Submit a special investigation record to the department’s licensing authority within 5 working days in the manner

prescribed by the department.

(b) Initiate a special evaluation of the foster home as soon as is indicated, based on the information received, but not later than 7 calendar days after receipt of the information.

(c) Conduct a thorough investigation including all necessary collateral contacts.

(d) Notify all social service workers who have children placed in the home that a special evaluation has been initiated.

(2) An agency shall inform foster parents of all of the following before they are questioned or interviewed regarding a special evaluation:

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(a) That a special evaluation has been initiated. (b) A clear description of the allegations.

(c) That the foster parents may involve a person of their choice in any interviews with them involving the special evaluation if the involvement does not impede the timely completion of the

evaluation.

(3) An agency shall complete a special evaluation within 45 calendar days after receipt of the information. If additional time is required, then the agency shall inform the foster parent, in writing, of the basis for the extension and the expected length of the extension. The total time for the completion of the

investigation shall not exceed 90 calendar days without written approval from the chief administrator or his or her designee.

(4) ) Before completion of the written report required by subrule (6) of this rule, an agency shall provide the foster parent with a verbal summary of the preliminary findings at the conclusion of the evaluation.

(5) Within 15 days of the conclusion of the evaluation, an agency shall complete a written report that includes all of the following information:

(a) The date the information was received.

(b) Identification of the information source, unless anonymous or confidential, as specified in the child protection law, 1975 PA 238, MCL 722.621 to 722.638.

(c) The allegations.

(d) Dates and places of contacts, names of persons interviewed, and names of the interviewers. If children are interviewed, their last names shall not be included in the report.

(e) Findings of fact, based upon the evaluation.

(f) ) Conclusions regarding licensing rules compliance or noncompliance based on the findings of fact.

(g) ) Any change in the agency’s decision regarding the number, gender, age, race, ethnic background, and specific characteristics of children who may be placed that is based upon the documentation contained in the summary and conclusions of the report.

(h) Recommendations regarding licensing action and any required corrective action.

(6) An agency shall do all of the following:

(a) Provide the foster parent with a copy of the report

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completion.

(b) Inform the foster parent, in writing, that he or she has a right to have his or her written response included as an

attachment to the report required by subrule (5) of this rule. (c) Provide a copy of the report to any social services worker that has children placed in the home.

(7) If any violations are cited and there is a signed corrective action plan, all social service workers who have children placed in the home shall be notified there is a corrective action plan and what is required of the foster parent in that plan.

ANALYSIS: In March 2015, the agency’s licensing worker was made aware

that Foster Parent A had received power of attorney of a child and that the child was living in the home. Foster Parent A was in violation of foster home licensing rule 400.9502 Reporting foster home changes (c) due to her not informing the agency of the change of household composition. The agency failed to open a special evaluation to address this non-compliance of the foster home licensing rule.

A special evaluation should have been completed for Foster Home A in September 2014 regarding the allegations that were made. There is no known information about the other time or times the babysitter was drinking. A special evaluation would have addressed answered questions such as were the children in danger while she was babysitting and was she driving the children while intoxicated. The foster father is a cross country truck driver and the foster mother works outside of the home as a nurse. The home is licensed for six. The foster mother needs a reliable substitute care giver. The agency’s failure to look further into this placed the children at risk.

The May 2012 renewal reevaluation for Foster Home E indicated that on the day of the home visit for the renewal the foster parent informed the licensing worker that her daughter moved back into the home on 01/12/2012. A special evaluation was not opened for the non-compliance of the licensing rule for not notifying the agency of the change in household members.

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ALLEGATION#2

:

The following information has not been entered in MiSACWIS and/or has not been provided to Oakland Co. MDHHS:

Foster Child A 1. Dental exam

2. Placement Exception Request (PER) for Foster Parent A as there were more than 6 children in the foster home.

3. Initial Service Plan (ISP) and Updated Service Plan (USP) 4. Updated school records

5. No face to face visits entered in MiSACWIS since April 2015

Foster Child B

1. Medical and dental exam

2. Family Team Meeting (FTM) for change of placement 3. ISP and USP

4. Relative licensing waiver

5. Change of placement documents 6. Updated school records

7. No face to face visits entered in MiSACWIS since April 2015 Foster Child C

1. Updated school records 2. Medical and dental exam 3. FTM for change of placement 4. Relative licensing waiver

5. Change of placement documents

6. No face to face visits entered in MiSACWIS since April 2015 7. ISP and USP

Foster Child D

1. Medical and dental exam 2. Relative home study

3. Relative licensure referral or relative licensing waiver

4. Change of placement documents. MDHHS and GAL were not notified of Foster Child D’s change of placement.

5. Social work contacts beginning on 03/18/2015 6. FTM for change of placement

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INVESTIGATION:

A review of Foster Child A’s agency case file and his case on MiSACWIS showed the following:

• Foster Child A’s body was found on 07/10/2015 in Lake Callis in Davisburg, Michigan.

• There was not a dental exam in the case file or in MiSACWIS.

• A PER was not completed for Foster Parent A when there were more than 6 children in the home.

• The ISP for reporting period 02/23/2015 to 03/24/2015 was completed on 07/10/2015. It should be noted that an email from Kristen Nolen-Winfield, Alternatives for Children & Families' Foster Care Worker, to Alisia Johnson, Oakland Co. DHHS PAFC Monitoring Worker, dated 05/13/2015 indicated that the helpdesk ticket had been resolved, which allowed Ms. Nolen-Winfield to complete the ISP.

• The USP for report period 03/25/2015 to 06/22/2015 was in progress status in MiSACWIS.

• The case file contained Foster Child A’s IEPC dated 03/05/2015 from the school he attended while placed in Foster Parent A’s home. MiSACWIS did not contain any updated educational records.

• A face to face visit with Foster Child A took place on 04/10/2015 and it was entered in MiSACWIS on 07/06/2015. A face to face visit with Foster Child A took place on 05/20/2015 and it was entered in MiSACWIS on 07/20/2015. A face to face visit with Foster Child A took place on 06/10/2015 and it was entered in MiSACWIS on 07/20/2015.

A review of Foster Child B’s agency case file and his case on MiSACWIS showed the following:

• Foster Child B was placed with relatives on 04/28/2015.

• There were no medical or dental exam forms in the case file or in MiSACWIS. • There were no educational records in the case file or in MiSACWIS.

• A FTM for Foster Child B’s change of placement to his relative’s home is documented in MiSACWIS having been completed on 04/23/2015. Ms. Nolen- Winfield and Foster Child B’s mother participated in the FTM. A DHS-1105, Family Team Meeting Report, was not in the file nor was it uploaded in MiSACWIS.

• The ISP for reporting period 02/23/2015 to 03/24/2015 was completed on 07/10/2015. It should be noted that an email from Kristen Nolen-Winfield, Alternatives for Children & Families' Foster Care Worker, to Alisia Johnson, Oakland Co. DHHS PAFC Monitoring Worker, dated 05/13/2015 indicated that the helpdesk ticket had been resolved, which allowed Ms. Nolen-Winfield to complete the ISP.

• The USP for report period 03/25/2015 to 06/22/2015 was in progress status in MiSACWIS.

• A relative home study for Foster Child B’s relative placement was not in the file nor was it uploaded in MiSACWIS.

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• The relative licensing waiver was signed by the relative and supervisor

on03/17/2015. The PAFC Director signed the waiver on 03/20/2015. The waiver was not approved by the Child Welfare County Director.

• The relative caregiver did not sign the DHS-972, Foster Home Licensing Requirements for Relative Caregivers.

• The DHS-30, Foster Parent Notice and the DHS-31, Foster Care Placement Decision Notice were completed on 06/30/2015. These forms were not uploaded in MiSACWIS.

• A DHS-69 Foster Care/Juvenile Justice Action Summary to document the change of placement to Foster Child B’s relative home was not in the case file nor was it uploaded in MiSACWIS.

• A face to face visit with Foster Child B took place on 04/28/2015 and it was entered in MiSACWIS on 07/06/2015. A face to face visit with Foster Child B took place on 05/20/2015 and was entered in MiSACWIS on 07/06/2015. A face to face visit with Foster Child B in June was not entered in MiSACWIS.

A review of Foster Child C’s agency case file and his case on MiSACWIS showed the following:

• Foster Child C was placed with relatives on 04/28/2015.

• There were no educational records in the case file or in MiSACWIS.

• There were no medical or dental exam forms in the case file or in MiSACWIS. • A FTM for Foster Child C’s change of placement to his relative’s home is

documented in MiSACWIS having been completed on 04/23/2015. Ms. Nolen- Winfield and Foster Child C’s mother participated in the FTM. A DHS-1105, Family Team Meeting Report, was not in the file nor was it uploaded in MiSACWIS.

• A relative home study for Foster Child C’s relative placement was not in the file nor was it uploaded in MiSACWIS.

• The relative caregiver did not sign the DHS-972, Foster Home Licensing Requirements for Relative Caregivers.

• The relative licensing waiver form was signed by the relative and supervisor on 03/17/2015. The PAFC Director signed the waiver on 03/20/2015. The waiver was not approved by the Child Welfare County Director.

• The DHS-30, Foster Parent Notice and the DHS-31, Foster Care Placement Decision Notice were completed on 06/30/2015. These forms were not uploaded in MiSACWIS.

• A DHS-69 Foster Care/Juvenile Justice Action Summary to document the change of placement to Foster Child C’s relative home was not in the case file nor was it uploaded in MiSACWIS.

• The ISP for reporting period 02/23/2015 to 03/24/2015 was completed on 07/10/2015. It should be noted that an email from Kristen Nolen-Winfield, Alternatives for Children & Families' Foster Care Worker, to Alisia Johnson, Oakland Co. DHHS PAFC Monitoring Worker, dated 05/13/2015 indicated that the helpdesk ticket had been resolved, which allowed Ms. Nolen-Winfield to complete the ISP.

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• A face to face visit with Foster Child C took place on 04/28/2015 and was entered in MiSACWIS on 07/06/2015. A face to face visit with Foster Child C took place on 05/20/2015 and it was entered in MiSACWIS on 07/06/2015. A face to face visit with Foster Child C took place on 06/10/2015 and it was entered in MiSACWIS on 07/06/2015.

A review of Foster Child D’s agency case file and his case on MiSACWIS showed the following:

• A medical exam was completed for Foster Child D; however, there is no date on the medical exam to verify when it was completed. The medical exam form is not uploaded in MiSACWIS.

• A dental exam was not completed for Foster Child D.

• Foster Child D was placed with his relative on 06/12/2015. The home visit to the relative’s home was completed on 05/13/2015 by Ms. Vyvyan. The relative home study for Foster Child D’s current relative placement was signed on 06/01/2015 by Ms. Vyvyan and was not signed by a supervisor. Brad Dixon, Director of Adoption & Placement Services, was typed where the supervisor’s signature should have been signed. The relative home study was entered in MiSACWIS on 06/16/2015.

• The DHS-30, Foster Parent Notice and the DHS-31, Foster Care Placement Decision Notice were completed on 06/12/2015. These forms were not uploaded in MiSACWIS. Social work contacts did not document that MDHHS was notified about the change of placement occurring before Foster Child D was placed with his relative.

• A court report dated 06/09/2015 indicated that a home study for Foster Child D’s relative was completed and that the plan was for Foster Child D to be placed with this relative on 06/12/2015 after the school year.

• A DHS-69 Foster Care/Juvenile Justice Action Summary to document the change of placement to Foster Child D’s relative home was not in the case file nor was it uploaded in MiSACWIS.

• A face to face visit with Foster Child D took place on 04/10/2015 and was entered in MiSACWIS on 06/24/2015. A face to face visit with Foster Child D took place on 05/20/2015 and it was entered in MiSACWIS on 06/24/2015. A face to face visit with Foster Child D took place on 06/12/2015 and it was entered in MiSACWIS on 06/24/2015.

• A FTM for Foster Child D’s change of placement to his relative’s home is documented in MiSACWIS having been completed on 06/12/2015. Ms. Nolen- Winfield and Foster Child D’s mother participated in the FTM. A DHS-1105, Family Team Meeting Report, was not in the file nor was it uploaded in MiSACWIS.

• The ISP was completed in MiSACWIS on 04/30/2015. The ISP has not been uploaded in MiSACWIS.

• The USP was due 06/22/2015 and it was completed 06/24/2015. The USP was uploaded in MiSACWIS on 07/07/2015.

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On 07/14/2015, Geneva Harvey, Alternatives for Children & Families' Director of Clinical and Casework Services, was interviewed on-site. Ms. Harvey reported that the ISP for Foster Child A and his siblings was completed late due to there being an issue with MiSACWIS. She reported that Foster Child A did not receive a dental exam because the dentist said that he was not equipped with appropriate staff to be able to deal with his behaviors during the dental exam. Ms. Harvey reported that there was no

documentation of the dentist making this statement. She reported that Foster B was taken to his medical appointment by Foster Parent F; however, there is no

documentation that the medical exam was completed. Ms. Harvey reported that the relative home study for Foster B and Foster C’s placement was uploaded in MiSACWIS. Ms. Harvey reported that at the time of Foster B and Foster C’s placement with

relatives, the relative stated that she did not want to be licensed. She reported that to her knowledge the relative signed a relative licensing waiver.

On 07/20/2015, Kristen Nolen-Winfield, Alternatives for Children & Families' Foster Care Worker, was interviewed on-site. Ms. Nolen-Winfield reported that she has been the assigned worker for Foster Child A, Foster Child B, Foster Child C and Foster Child D since they were placed with Alternatives for Children & Families in February 2015. She reported that her face to face visits with the children have been entered in MiSACWIS. Ms. Nolen-Winfield reported that when Foster Child A was placed in Foster Parent A’s home there were four adopted children in the home in addition to Foster Child A and Foster Child B. Once Foster Child B was placed with his relative, another child whom Foster Parent A had power of attorney of moved into the home. Ms. Nolen-Winfield reported that while Foster Child A was placed in Foster Parent A’s home there were no safety or supervision issues. She stated that Foster Parent A learned Foster Child A’s behaviors quickly. Foster Child A was having issues with sleeping at night and Foster Parent A expressed her concerns with the psychiatrist, Dr. Ellen Johnson. Dr. Johnson prescribed him medication and he was sleeping better. Ms. Nolen-Winfield stated that Foster Child A did not have a dental exam and she could not provide an answer as to why he did not have a dental exam completed. She reported that the ISP was

completed late due to a MiSACWIS issue. The USP was completed during the week of July 13th; however, her supervisor returned it to her with corrections. Ms. Nolen- Winfield reported that information regarding educational updates was entered in social work contacts. She reported that she did not receive report cards for the foster children. She stated that she believed that Foster Child B had a medical and dental exam. Ms. Nolen-Winfield reported that a FTM for Foster Child B and Foster Child C’s change of placement occurred, however, she cannot locate the FTM paperwork. She stated that DHHS was not notified about the change of placement for Foster Child B and Foster Child C. Ms. Nolen-Winfield reported that at the 06/09/2015 court hearing she reported to the court about the plan to move Foster Child D with his relative. Ms. Nolen-Winfield stated that the LGAL was present at the hearing; however, she is unsure if the Oakland Co. DHHS Foster Care Monitor was present at the court hearing. She stated that she does not recall if the Oakland Co. DHHS Foster Care Monitor was notified about Foster Child D’s change of placement. She stated that she does not know if there is a

procedure on how DHHS is supposed to be notified regarding change of placements. She reported that the relative home study for Foster Child B and Foster Child C’s

(32)

current placement has been uploaded in MiSACWIS. She reported that the change of placement forms were completed for Foster Child B and Foster Child C. Ms. Nolen- Winfield stated that Foster Child B and Foster Child C’s current relative placement did not sign a relative licensing waiver and they were not referred for licensure.

On 07/20/2015, Brad Dixon, Director of Adoption & Placement Services, was

interviewed on-site. Mr. Dixon reviewed the placements for Foster Parent A with this Licensing Consultant, which are as follows:

Foster Child E was placed in the home from 01/06/2015 to 05/14/2015. Foster Child A was placed in the home from 02/23/2015 to 07/04/2015. Foster Child B was placed in the home from 02/23/2015 to 04/28/2015. Foster Child F was placed in the home from 05/28/2015 to 07/06/2015.

Foster Parent A’s three adopted children lived in the home as well as the child whom she had power of attorney of beginning in 03/03/2015. Mr. Dixon agreed that there was a period of time where there were more than six children in Foster Parent A’s home and a PER should have been requested.

APPLICABLE RULE

R 400.12413 Medical and dental care policy.

(1) An agency's medical and dental care policy shall, at a minimum, include all of the following:

(c) A physical examination for each child as follows, unless a greater frequency is medically indicated:

(i) ) For a child under 2 years of age, a physical

examination shall have been completed within 3 months before being placed in foster care or a new physical examination shall be completed within 30 calendar days after being placed in foster care.

(ii) For a child 2 years of age or older, a physical

examination shall have been completed within 12 months before placement or a new physical examination shall be completed within 30 calendar days after placement.

(iii) ysical examination every 14 months.

(f) The provision of a dental examination and any treatment required for each child who is 4 years of age and older,

including both of the following:

(i) ) A dental examination within 12 months before

placement or a new dental examination shall be completed not more than 90 calendar days after placement.

(ii) A dental reexamination shall be obtained at least every 18 months, unless a greater frequency is indicated.

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