"Screaming and Crying Occurred in that Classroom Daily"

Meanwhile, agency employs under-qualified staff...

"The reviewer heard loud screaming and crying at different times during the interview.  The reviewer asked the Center Manager if she wanted to check on the classroom, but the Center Manager said that screaming and crying occurred in that classroom daily."

This is a quote from the report on a July 2018 unannounced monitoring review of the Cape Cod Child Development Head Start Program.  The Q&A happened in the interview of the Acting Center Manager at Cape Cod Child Development's Head Start program's Hyannis Preschool.

More from observations at the Hyannis 1 classroom at the Hyannis Pre-School:

Observations of teacher-child interactions at the Hyannis I classroom at the Hyannis Preschool confirmed that teaching practices were not nurturing and responsive and interactions did not foster trust and emotional security, provide supportive feedback for learning, and support a all children's engagement in learning experiences and activities. During on outdoor play observation. the reviewer observed a child. who the lead teacher had previously identified as a child with significant behavioral challenges, hit a child on the face and head with a 6-inch by 6-inch hard plastic object. Three teachers witnessed the child crying loudly, rubbing his face where be had been hit, and saying "he hit.'' However, none of the three staff responded to the incident and instead directed the group of children to line up to return to the classroom. The reviewer asked the lead teacher to intervene and provide assistance to the hurt child and engage the child with challenging behaviors about the impact of his actions. The lead teacher responded by asking the child twice to apologize to the crying child instead of responding to the physical and emotional needs of the injured child. No staff checked the child's face for a bruise or cut. The one-to-one aide did not provide guidance to the child with challenging behaviors so that he could engage in the process of learning that hurting another person was not acceptable.

Lest one believe this type of behavior is limited to the Hyannis Pre-School, the Head Start investigators remarked:

Teachers and Center Managers at six of seven sites visited stated, children and staff were bitten and hit weekly by children whose behaviors were "out of control.'' Five Center Managers stated that some classrooms at their centers were unmanageable because children' s externalizing behavioral issues put the safety of the child. his or her peers, and the teacher at risk.

Four teachers stated they were unable to adequately implement the curriculum because their attention was focused on. as stated by one teacher, "managing the chaos." One teacher stated. "l feel bad that l cannot give attention to the children who are ready to read and write. One child is very bright but I just cannot give her what she needs."

Data from Behavior Incident Reports compiled by the grantee's Behavior Specialist included the following information: ln March 2018, 4 centers had a total of 14 incidents of children hurting children; 3 incidents of children hurting staff, and 4 incidents of children biting. In April 2018. 3 centers reported a total of 13 incidents of children hurting children and 5 incidents of biting; however, not all centers submitted incident reports. For example, one teacher stated she did not consistently submit incident reports regarding children hitting staff because she would "be filling paperwork out all day.''

The substitute lead teacher in the Hyannis 3 classroom at the Hyannis Preschool, employed 23 years, described how the lead teacher was on medical leave due to a child--with challenging behaviors who had an Individualized Education Program ( IEP)--injuring the teacher's foot. The teacher described the fall 2017 incident as the child either pushed the lead teacher or the lead teacher tripped as she was trying to de-escalate the child's challenging behavior. Following the incident, the lead teacher returned to work. but the pain of the injury continued requiring foot surgery and extended leave for recovery. A review of the child's IEP found behavior strategies the therapists recommended; however, there was no evidence in the lesson plan that individualization or mental health support for the child was provided. Additionally, a review of the lesson plan indicated no intentional planning for any of the children in the classroom. or other curriculum activities to promote pro-social development and to support children to develop self-regulation skills.

The report also criticizes Cape Cod Child Development's Head Start program for hiring unqualified staff:

The majority of Center Managers stated that many of the teacher aides, substitutes. and staff hired to provide one-to-one support for children with challenging behaviors did not have the required skills and were not provided adequate professional development to respond to the social and emotional needs of some of the children. Two teachers at the Centerville site stated long-term vacant teacher aide positions were most often filled by unskilled substitutes. The reviewer observed this during an observation of a one-to-one teacher aide assigned to a specific child in the Hyannis I classroom at the Hyannis Preschool. The teacher aide did not utilize any strategies to guide the child when be bit another child or when be would not cooperate with the lead teacher.

Unqualified Staff

Indeed, the qualification of Head Start management and classroom staff is a recurring theme in the report.  The Head Start reviewers' report states the following:

The grantee did not ensure center-based teachers had at least an associate's or bachelor's degree in child development or early childhood education: assistant teacher's, at a minimum had a Child Development Associate (CDA); ensure health procedures were performed by a licensed or certified health professional: or use staff or consultants to support nutrition services who were registered dieticians or nutritionists with appropriate qualifications.

A review of a chart showing the credentials of all teaching staff found 16 teachers/lead teachers did not possess the minimum credential. Four of the 16 were enrolled in an educational program but had not yet achieved the required credential. Also. a review of the staff credentials chart showed eight assistant teachers/floaters did not possess a minimum of a CDA credential. Of the eight. only one was currently enrolled in an educational program to acquire a credential.

The program did not have access to a licensed or certified health professional to perform procedures and to review a system which monitors and facilitates the implementation of a follow-up plan to meet any treatment needs associated with a health, oral health. social and emotional. or developmental problem of a child. In an interview. the Health Manager stated she could not sign off on children's individual health plans and the Human Resources Director acknowledged there was a vacancy for a nurse position and at the time of the monitoring review the position had not yet been posted.

The program did not use staff or consultants who were registered dieticians or nutritionists with appropriate qualifications to suppon nutrition services. The Health Coordinator. who was responsible for nutrition services, did not meet the qualifications to suppon nutrition services.
The grantee did not ensure center-based teachers had at least an associate's or bachelor's degree in child development or early childhood education; assistant teacher's, at a minimum, had a CDA; ensure health procedures were performed by a licensed or certified health professional; and use staff or consultants to support nutrition services who were registered dieticians or nutritionists with appropriate qualifications: therefore. it was not in compliance with the regulation.

Head Start gave Cape Cod Child Development 120 days to correct this situation with staff credentials.

Elsewhere in the report the credentialing issue is visited again:

There was evidence that other staff did not have the appropriate credentials for the positions they held. For example. the Behavioral Specialist shared and record review showed that she possessed a Bachelor of Arts in Early Childhood Education. but did not have evidence of formal training in behavioral science or experience in addressing mental health needs as required by her position. Also, a review of the Health Manager's personnel file indicated no experience with nutrition or overseeing a nutrition program. or any evidence that she was a licensed or certified health professional able to perform health procedures as required by the nurse role she had assumed. Finally. a review of teacher credential documentation showed that 22 of 67 teachers and/or assistant teachers did not meet the minimum qualification for a Head Slart teacher--a Child Development Associate Credential.

As budgetary constraints escalated during 2017-2018, positions remained un-filled and the duties of vacant positions were often combined with occupied positions.  Reviewers found this led to a high level of work stress and perhaps increased staff departures.

According to interviews with current management staff, the former Chief Executive Officer (CEO) [Anne Colwell] and current Human Resources (HR) Director decided to place a hold on hiring beginning in the winter of 2018 for some staff positions and had eliminated some positions, and these decisions were driven by the financial difficulties the agency was facing. These decisions were also confirmed through a review of Board and other meeting minutes. According to the HR Director, current vacancies included 15 teachers. 2 transportation aides. 1 family advocate. and a nurse position; however, this information did not give the full picture of staffing vacancies, including pending resignations. According to one current manager. layoffs were planned for the Disabilities Manager. Family Services Manager. and Facilities Manager; however, the layoffs were put on hold. According to the Early Education and Development Director and the former Head Start Director, they had communicated to the CEO and the HR Director the need to fill teacher, family worker. and coaching vacancies; however, their requests were denied.

Managers reported when a management or other position was vacated. the grantee would at times reassign the duties of that position to another manager rather than post and rehire for the position. For example, Center Managers and staff reported the Nutritionist resigned in April 2018 and her duties were reassigned to the Health Manager who did not have the appropriate qualifications or training to support nutrition services- as described below. The Health Manager further reported the nurse resigned in May 2018 and had not been replaced at the time of the review. Consequently. during the months of June to August 2018 the program did not employ or contract with an experienced or trained health professional to respond to teachers' requests for guidance on medical concerns. and the Health Manager was unable and/or unqualified to perform such duties. Typically, without some knowledge/experience in what all of the various requirements were. a health manager would rely on someone else with medical/mental health/nutrition expertise to ensure that all Head Start Program Performance Standards were met; however, that did not occur here due to the staffing issues. For instance, a teacher reported when she asked the Health Manager to provide guidance on how to handle a child's rash the Health Manager stated that she was "not qualified" to do so and therefore her visit to the center to observe the child was not necessary. A Center Manager also reported the Health Manager had failed all 15 children in the Onset 3 classroom on their vision and hearing screenings but follow-up testing confirmed only two children had failed. Additionally. during an interview, the Health Manager stated she was not qualified to review and approve children's Individual Health Plans (THPs) and as a result. the children's IHPs were not up-to-date for enrolled children.

Three managers further reported the Disabilities Manager had also served as a home visitor-carrying a full caseload-and as the Qualty Assurance Specialist. and was not able to provide timely observations and follow-up services for children with disabilities or children with suspected disabilities. The Disabilities Manager submitted her resignation effective July 27. 2018. The Head Start Director reported the agency had no plan to hire a oew Disabilities Manager and no plan was in place for another professional within the organization to manage and oversee services to children with disabilities. The Head Start Director also submitted her resignation in June 2018, effective August 30, 2018. but the program had no succession plan or recruitment plan for her replacement.

The grantee had also not employed a Chief Financial Officer (CFO) since January 2018. Prior to the departure of the most recent CFO in January 2018, there had been turnover in the CFO position in Spring 2017 and in August 2018. At the time of the review. a fiscal consultant was serving as an interim CFO for 10 hours per week to serve the entire agency. It is worth restating here that the Head Start grant for the budget period ending December 31, 2017 was spent down ahead of schedule by November 30, 2017. leaving the grantee without a month of funds to operate the Head Start program. The grantee continued to operate Head Start services in December 2017; however, it was unclear what funds were used to provide those services.

More to Come

There's plenty more to come as future articles in this series examine some of the other findings in the ACF report.

Head Start is an absolutely essential service for many Cape Cod families.  Some 377 local children attend Head Start programs provided by Cape Cod Child Development.

While many of the items cited in the federal Head Start report appear as intricate finance or policy items, they are moving parts in a machine to deliver services to the agency's Head Start clients.  When the machine malfunctions, we end up with cases like the classroom scenarios cited at the top of this story.

If you'd like to jump ahead, you can download the entire federal report here.

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