Health Department Failed to Ensure Childcare Providers Tested Water for Lead: City Comptroller Audit

Health Department Failed to Ensure Childcare Providers Tested Water for Lead: City Comptroller Audit

PHOTO: Auditors uncovered that officials ordered staff to enter false information into the DOHMH tracking database to indicate that a lead test was completed at centers, even when it had not been, according to Comptroller Stringer. Courtesy of Wikihow

By Forum Staff

Department of Health and Mental Hygiene officials failed to ensure that childcare providers tested the water in their daycare centers for lead, and ordered staff to enter false information into the agency’s tracking database to indicate that a lead test was completed at some facilities, even when it had not been, according to an audit released last Friday by City Comptroller Scott Stringer.

The Bureau of Child Care, a division of DOHMH, is responsible for overseeing and monitoring approximately 2,300 Group Child/Day Care providers in all five boroughs. A group daycare center is defined as providing childcare to three or more children under age 6 for five or more hours per week, and more than 30 days in a 12-month period.

In 2008, Stringer noted, the City Health Code was amended to require water lead tests at all daycare centers, but did not specify when those test should be conducted or how often. After the testing requirement was imposed, in an effort to enhance safety, in 2011 DOHMH’s computerized database – CCATS – was modified to only allow permits to be issued with proof of a lead test and an appropriate remediation plan in the event the test had unsatisfactory results.

The audit reviewed permits issued to daycare centers from Aug. 29, 2012, through Aug. 29, 2014, and examined a sample of 119 providers to see if DOHMH maintained adequate controls to ensure that the daycare centers only got permits after meeting established requirements. Auditors did not perform any lead tests, nor did they look for evidence of sick children, but rather focused on the agency’s oversight and operations of the permitting process, Stringer noted.

The audit’s findings include:

DOHMH failed to fully enforce water lead test requirements, even though more than 10 percent of daycare centers that had completed lead tests showed positive results    

  • Out of 119 sampled daycare centers, all of which received permits, auditors found evidence of a water lead test at only 49 (or 41 percent).
  • Of those 49 daycare centers that submitted tests, five were found to have unacceptable levels of lead. Three subsequently submitted a Corrective Action Plan and later received acceptable water lead tests, one remediated the condition and submitted an acceptable test and in the final instance, DOHMH determined that even though there was a positive lead test, it was within acceptable ranges.
  • For the 70 centers that did not have proof of tests, auditors found that the City did not have any water lead test results on file, in either electronic or hardcopy form, nor could the agency provide any evidence that its staff had received such reports.

DOHMH instructed staff to falsely record that water lead tests were performed where they had not been, allowing daycare centers to receive permits

  • Bureau of Child Care management directed staff in writing to record that the agency had received lead reports that showed acceptable results from the 70 centers—even where no such reports had been provided. In an email from agency management, employees were directed to enter the statement for each of the 70 centers: “Water Lead Test Negative in CCATS in order to issue permits.”
  • By falsely recording that lead tests were complete, the agency was able bypass its own system requirements to issue permits for daycare centers. However, in doing so, they failed to ensure that lead water testing would ever be done at any of the centers.

Pressed to explain why centers were allowed to open without evidence of lead tests, DOHMH offered unsatisfactory answers

  • DOHMH said the requirement for testing had the unintended result of blocking renewal permits, which prompted them to create the “workaround” of instructing their staff to enter incorrect information into CCATS.
  • The agency said many of the providers for whom they took this action were under contract with the Administration for Children’s Services or the New York City Housing Authority, and those agencies were responsible for lead tests. However, DOHMH provided no evidence to support this claim and the auditors’ review of the 70 facilities with no evidence of lead tests found that 52 were neither ACS-affiliated nor in a NYCHA building.
  • Finally, Stringer said, the agency said it had ended the practice of entering false information about lead tests in 2012. But the auditor’s sample, for permits from 2012 through 2014, found the practice had not changed.

There was no evidence that the 70 daycare centers ever showed that they had completed lead tests and the agency indicated it would only require lead testing if a child showed up with a high level of lead in his or her blood 

  • Of the 70 centers where no evidence of a test result was found during Fiscal Years 2013-2014, 67 had applied for renewal permits and three for new permits. But in 2015, while the audit was underway, Stringer noted, there was no evidence that test results had ever been received from any of them.
  • According to agency officials, the only time that a day care provider would be required to be re-tested for lead would be in the case that a child tested for elevated levels of lead in his or her blood.

Stringer’s audit issued several recommendations, including that DOHMH:

  • Ensure that no daycare center is issued a permit, new or renewal, without submitting a water lead test with acceptable results.
  • Follow up on the 70 daycare centers listed in the audit and ensure that they conduct lead tests as soon as possible.
  • Review its records immediately to see if there are additional centers, beyond the 70 listed in the audit, that indicate a negative lead test was received where it had not been, and ensure that a lead test is performed as soon as possible.

“The health of our children is non-negotiable,” Stringer said. “The fact that the Department of Health directed its employees to enter false information in an official database is a blatant violation of public trust. It should not take an audit to ensure that a City agency is doing its job to protect our kids.”

In response to the audit, DOHMH informed Stringer’s office that it had reviewed all 70 child care centers identified as missing the results of a water lead test, and have since found that the 61 sites that are still operating are compliant with water lead test protocol and the remaining nine had closed. In addition, DOHMH announced that it had reviewed its entire database to finally ensure that lead tests had been conducted at all sites and found that 95 percent of the 2,300 daycare center sites did not have elevated lead levels and the remaining five percent had begun remediation.

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