Infant’s death in day care leads to abuse findings, court challenge

Iowa's Department of Health and Human Services is responsible for investigating allegatons of child abuse. (Main image by Catherine Falls Commercial and Getty Images; logo courtesy the State of Iowa)

An eastern Iowa day care provider is challenging the state’s findings that she committed abuse that led to the death of an infant.

Amanda Cooke of Manchester, who has been a state-registered child care provider since April 2020, has filed a petition in Polk County District Court seeking judicial review of a decision made by the Iowa Department of Health and Human Services after investigating the death of a child she cared for in her home.

State records indicate that at 6 a.m. on Oct. 9, 2023, the mother of a 5-month-old girl dropped her daughter off at Cooke’s Delaware County home. According to the subsequent findings of state investigators, Cooke took the child to the basement of her home and placed her in a Pack ‘n Play portable crib for a nap. Cooke checked on the child at around 7 a.m. or 7:15 a.m., and later told investigators the child fussed a bit but continued to sleep.

When checking on the child again, at around 8:30 a.m., Cooke rubbed the child’s back and got no response and then noticed the child’s face was pressed against a blanket in the crib. Cooke initiated CPR, then had her husband call 911. The child was taken to a hospital, but died the next day.

An autopsy indicated she died of cardiopulmonary arrest due to combined effects of positional asphyxia and smothering caused by the blanket in the crib. The medical examiner classified the death as an accident.

According to state investigators, Cooke told police she had left the child’s blanket draped over the side of the crib, half in and half out of the crib.

The case resulted in three separate decisions by the DHHS, which first concluded that Cooke’s conduct constituted abuse in that she denied the child critical care and failed to provide proper supervision.

Separately, DHHS also revoked Cooke’s child-care provider registration with the state, and  terminated her child care assistance provider agreement with the state.

Cooke’s basement had not been approved for child care, the state alleged, adding that Cooke later told investigators she had moved the crib to the basement after her husband was involved in an accident and needed additional space on the main floor to use his wheelchair.

Judge: No abuse, but Cooke ignored training

Cooke appealed the state’s decisions, which resulted in a hearing before Administrative Law Judge Laura Lockard.

After hearing testimony in the dispute, Lockard issued a proposed decision, subject to the approval of the DHHS director, ruling in Cooke’s favor on the issue of child abuse. Lockard stated that “while there was a tragic outcome in this case, there is no evidence that Cooke’s conduct in putting (the child) down with a blanket in her sleeping area constitutes child abuse. It is difficult to imagine such a finding being made if the adult in question was the child’s parent. Cooke must be judged by the same objective standard that any other caregiver would be; her training as a day care provider does not figure into the child abuse determination.”

Having reversed the finding of child abuse, Lockard next turned to the state’s revocation of Cooke’s child care provider registration. On that score, Lockard ruled that “while there is no question that Cooke is remorseful about (the child’s) death,” Cooke had ignored her training and allowed the infant to have a blanket in her sleeping area while napping in the basement where she couldn’t be observed.

“If the blanket was in the Pack ‘n Play, it was because Cooke placed the blanket in the Pack ‘n Play or on the Pack ‘n Play in such a manner that (the child) could pull it down onto the mattress,” Lockard ruled. “Under these circumstances, revocation of Cooke’s child development home registration was warranted.”

On the last remaining issue, the termination of Cooke’s child care assistance provider agreement with the state, Lockard noted that DHHS could take that action if it found a hazard to the safety and well-being of a child and the provider could not, or refused to, correct the hazard. There was no evidence to suggest that sort of violation, Lockard ruled.

In her ruling, Lockard acknowledged the conflicting nature of the state’s standards for terminating a day care provider’s registration and revoking the provider’s agreement to operate.

“While it seems discrepant that Cooke’s child care provider registration would be revoked but her provider agreement would not be terminated, the regulatory requirements for the two actions are different,” Lockard observed.

Lockard’s proposed ruling then went to DHHS Director Kelly Garcia, who on April 22 rejected it and issued a final order “deleting the entirety” of Lockard’s ruling and affirming her department’s findings of child abuse, as well as her department’s decisions to terminate Cooke’s registration and revoke her child care provider agreement with the state.

In a recently filed court petition, Cooke is seeking judicial review of the state’s decision that she committed child abuse through the denial of critical care. The state has yet to file a response to the petition.

According to Lockard’s findings in the case, the state’s child care compliance worker, Kathy Huinker, stated at the hearing that safe-sleep regulations are “notoriously difficult” to enforce because day care providers who know the inspector is coming for an announced visit can make sure that they are in compliance that day.

Even for unannounced visits, Huinker testified, providers can ensure that infants are in safe-sleep positions before letting the inspector inside the building.

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