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State regulators have shut down two Twin Cities child-care providers that failed to follow safe-sleep practices in cases where infants died this year, according to records made public this week.

In one case, the state also faulted a Carver County licensing inspector who discovered the provider was not following safe-sleep practices just days before the infant's death, yet failed to issue sanctions that might have corrected the problem.

"There should have been a correction order issued in this instance," said Chuck Johnson, chief financial and operating officer for the state Department of Human Services (DHS). "Our folks did talk with the county about that and they did agree one should have been issued.''

Taken together, the two cases fit a pattern highlighted in a Star Tribune investigation that has examined a spike in child-care deaths statewide over the past five years. During that period, more than 50 children have died while in the care of licensed child-care providers, the vast majority at small in-home providers.

In a significant number of cases, providers failed to follow safe-sleep practices or operated over their capacity.

So far this year, six infants in Minnesota have died while in licensed care.

The Feb. 27 death of an 8-month-old boy at the home of Kimberly Ries in Chanhassen was ruled a sudden unexplained infant death, according to DHS records.

Just four days before the incident, Carver County licensor Angela Lunow had visited the home for a re-licensing inspection and discovered a blanket and a soft toy in a crib, which presented a suffocation risk. She talked to the provider about the unsafe practice, but did not issue a correction order.

On the day of his death, the infant had a blanket in his crib. The investigation determined that it did not contribute to the boy's death, but regulators cited the repeated unsafe-sleep practices as well as a capacity violation as reason for taking Ries' license.

Reached Friday, Ries said she wishes Lunow had issued a correction order before the death because it would have carried more weight than the verbal warning.

"I'm at fault -- I allowed him to have it," Ries said. "I'm thankful it didn't play a part in his death. But it's an issue. I had my license revoked."

In a separate action, regulators revoked the license of a Scott County in-home provider whose decisions were connected directly to the death of a 3-month-old boy in her care. Provider Karen Johnson failed to follow safe-sleep practices when she swaddled the infant and propped up his head and shoulder with a pillow inside a crib to help comfort the boy, who had acid reflux.

During a 30-minute period on the morning of Feb. 7, the child moved off the pillow. When Johnson checked on him, he was face down in the mattress and had stopped breathing, state records show. The cause of death was probable positional asphyxia attributed to the baby's unsafe sleep position. Johnson has not returned calls seeking comment. Both providers have the right to appeal the state's decisions.

Tougher enforcement

Since the pattern of deaths came to light, DHS has responded by ordering a review of deaths going back five years and toughening enforcement carried out by county regulators, who inspect in-home care facilities.

On May 31, DHS asked counties to start fining providers $200 for each unsafe-sleep violation -- a tougher enforcement action than a correction order.

"We'd like to step up the manner of enforcement with the child-care community around sleep violations," said DHS' Chuck Johnson. He said the agency needs to make clear that following enforcement protocols, like documenting violations, is also important.

Inspectors should always issue formal sanctions if they spot safety risks in licensed homes, said Katy Chase, executive director of the Minnesota Licensed Family Child Care Association. Whether there was a safety concern in Ries' case is open to interpretation, though. While there is broad agreement that stuffed toys and quilts present safety risks in cribs, county agencies differ over whether light blankets present risks.

Chase said her organization has been lobbying for more consistency in child-care enforcement by counties, or for transferring the role of inspections to the state. "We have a huge concern with inconsistency from county to county of licensing interpretation."

Ries, 48, said the death has been devastating professionally, but the personal toll has been greater. She had been in the day-care business more than two decades, but now wishes she had taken more training on ever-changing licensing requirements and standards.

"The rules are there for a reason,'' she said.

Brad Schrade • 612-673-4777