OIG reviews state day care regulators

OIG reviews state day care regulators

A recent OIG audit of the state's day care regulation unit found that when processing permit renewals, all tested applications met federal and state requirements. The same was not true of all follow-up inspections for issues found at child care facilities.

The audit focused on determining whether the Texas Health and Human Services Commission's Child Care Regulation unit complied with selected rules involving permit renewals and facility inspections between September 2019 and August 2021. Child Care Regulation oversees facilities that provide center-based care to children younger than 13 for less than 24 hours.

During the audit period, 10,653 permit renewal applications were processed. Auditors randomly selected 90 sample applications and found that all met the tested requirements, including:

• Reviewing the operations’ history for frequent or repeated violations.
• Verifying there were no outstanding deficiencies at the time of permit renewal.
• Completing required facility inspections prior to permit renewal.
• Ensuring supervisors approved assessment of deficiencies when necessary.

While reviewing the Child Care Regulation's facility inspections, auditors found that follow-up reviews were not always completed in a timely manner. Inspectors must reinspect the deficiency within a timeframe based on the potential risk to children when they find issues at a facility. Of the 180 reviewed deficiencies, 14 did not receive a follow-up within the designated timeframe, all of which were identified as the highest risk to children's safety.

Within the 180 sampled deficiencies that had been resolved, 11 did not contain a narrative explaining the actions taken to come into compliance. Facilities deficiencies and resolutions are available for public review. Failing to provide narratives provides an incomplete account of the facility's compliance with regulations.

To resolve the issues, auditors provided Child Care Regulation with two recommendations that would, if followed, bring them into compliance. Specifically, the unit should:

• Improve the inspection oversight process to ensure inspectors follow up on high-weighted deficiencies within 15 days from the compliance date set by the inspector.
• Train inspectors to write follow-up narratives in the Child Care Licensing Automation Support System (CLASS) that describe how the operations corrected the deficiencies.