Rick Scott Governor State of Florida Department of Children and Families Rebecca Kapusta Interim Secretary Office of Inspector General Enhancing Public Trust in Government Investigative Report 2017-0070 December 17, 2018 Keith R. Parks Inspector General Amie H. Young, J.D. Chief of Investigations “Provide leadership in the promotion of accountability and integrity of State Government.” Mission: Work in Partnership with Local Communities to Protect the Vulnerable, Promote Strong and Economically Self-Sufficient Families, and Advance Personal and Family Recovery and Resiliency DEPARTMENT OF CHILDREN AND FAMILIES OFFICE OF INSPECTOR GENERAL Rebecca Kapusta Interim Secretary Investigative Report Case Number: 2017-0070 Keith R. Parks Inspector General INTRODUCTION TE D On October 3, 2017, the Department of Children and Families (Department) Southeast Region Family Safety Operations Manager (OM) Robert Shea reported to the Office of Inspector General (OIG) that former Child Protective Investigator Supervisor (CPIS) Beverlie Hyacinthe1 allegedly falsified supervisory consultations and reviews in Florida Safe Families Network (FSFN) Investigation #2017-265938, resulting in a child being abused after the initial investigation was completed. AC Ms. Hyacinthe documented in FSFN Investigation #2017-265938 that she conducted an initial supervisory consultation in person with former Circuit 15 Child Protective Investigator (CPI) Nadege Jolicoeur2 on September 11, 2017 at 5:00 p.m. Ms. Hyacinthe documented in the Supervisory Hyperlink that she agreed with the “safety decision”; however, the Present Danger Assessment (PDA) was not completed by Ms. Jolicoeur until September 12, 2017. According to Ms. Jolicoeur, Ms. Hyacinthe’s documentation was inaccurate. Mr. Shea further reported that after the discovery of the alleged falsification in FSFN Investigation #2017-265938, a review of 32 open cases in Ms. Hyacinthe’s unit was completed and there appeared to be “numerous concerning false statements in the initial consults.” According to the FSFN Audit Screens,3 Ms. Hyacinthe viewed the PDAs either after the initial consultation or not at all in 10 additional cases.4 ED ALLEGATION AND FINDING R Allegation and Finding Circuit 15 Child Protective Investigator Supervisor (CPIS) Beverlie Hyacinthe falsified supervisory consultations and reviews in FSFN Investigations #2017-259504, #2017259509, #2017-259523, #2017-259582, #2017-265938, #2017-270133, #2017-270163, #2017-270992, #2017-271486, #2017-271546, and #2017-571587. Potential violation of Rule 60L-36.005 (1)(3)(e) and (f), F.A.C.; Rule 65C-29.003(3)(c)4., F.A.C.; Section 1-8.c.(5) and (6)(b), CFOP 60-55; Section 6-2.a. and b.(1) and Section 3-4.a. and e., CFOP 170-5; § 838.022(1)(a), F.S.; and § 839.13(2)(a) and (c), F.S. Finding: SUPPORTED. 1 Effective December 12, 2017, Ms. Hyacinthe was no longer employed by the Department. Effective May 13, 2018, Ms. Jolicoeur was no longer employed by the Department. 3 The FSFN Audit Screen automatically captures a user that has logged-in, including the screen viewed, date, and time, as well as the name of the user. 4 Subsequently identified by Mr. Shea as FSFN Investigations #2017-259504, #2017-259509, #2017-259523, #2017259582, #2017-270133, #2017-270163, #2017-270992, #2017-271486, #2017-271546, and #2017-571587. 2 1 Office of Inspector General Investigative Report #2017-0070 COMPLAINANT TESTIMONY Mr. Shea was contacted (unknown date) by Southeast Region Training Manager Marc Simmons, who informed him that Ms. Jolicoeur reached out to him regarding FSFN Investigation #2017-265938, a case assigned to Ms. Jolicoeur by Ms. Hyacinthe on September 11, 2017, that had been investigated and closed. TE D Mr. Simmons believed Ms. Hyacinthe did not give Ms. Jolicoeur sufficient instruction, provisions were not made to provide for the safety of the children, and the initial case was not fully investigated. Another abuse report was called into the Florida Abuse Hotline (Hotline) on September 19, 2017 (FSFN Investigation #2017-273420) and the children were subsequently sheltered. After FSFN Investigation #2017-265938 was assigned, Ms. Jolicoeur contacted Ms. Hyacinthe for a Pre-Commencement Consultation (PRCM). Ms. Jolicoeur attempted to speak with Ms. Hyacinthe; however, Ms. Hyacinthe informed her that her work cellular telephone was about to lose its charge and she did not have a way of re-charging it.5 As a result, Ms. Jolicoeur never completed the consultation or received instructions from Ms. Hyacinthe on how to proceed with the case. AC Circuit 15 has a Coordinated Continuing Operations Plan (COOP) in place for emergencies and, according to that protocol, Ms. Hyacinthe was to notify Circuit 15 Program Administrator (PA) Sarah Thompson that she was unable to maintain contact with her oncall staff. Once Ms. Thompson was notified, she (Ms. Thompson) would have instituted an alternative case assignment process. ED As a result of the information received from Mr. Simmons, Mr. Shea performed a Quality Assurance Review (QAR) on cases assigned to Ms. Hyacinthe on September 27, 2017, and discovered several cases with various discrepancies. Ms. Hyacinthe documented in FSFN that she completed PRCMs on multiple cases and approved the PDA; however, there were several cases with no PDA completed at the time of the PRCM. Additionally, the FSFN Audit Screen reflected that Ms. Hyacinthe did not view the PDA, or that she viewed it after she documented approval in the FSFN Supervisory Hyperlink. R On October 2, 2017, Mr. Shea and Ms. Thompson met with Ms. Hyacinthe, at which time Ms. Hyacinthe stated the documentation in FSFN Investigation #2017-265938 was completed in error. Mr. Shea provided Ms. Hyacinthe with a written list of the cases he had identified in the QAR with the concerns he had for each one, and asked her to review it and provide a detailed explanation for each of the concerns. Mr. Shea did not receive the list back from Ms. Hyacinthe. 5 On September 11, 2017, offices were closed due to Hurricane Irma and employees were teleworking. Hurricane Irma made landfall in Florida on September 10, 2017. 2 Office of Inspector General lnvestiqative Report #2017-0070 The following table identifies the documentation discrepancies identified: FSFN Date and Time Date Date and Time Date and Time Investigation Intake Received PDA Completed PRCM Documented PDA Viewed (2017) (2017) (2017) (2017) 2017459504 September 4 Sf?tf??er?.7 2017459509 September? 8333329574 8? $31.7 2017459523 September? 8:33:33? 8? 3.31.7 2017459582 8? 2p}? 531.2 September 2 8? 3:5" 531.3 8? it? 6" 531.7 2017-265938 563g"::1 1 September 12 58338153? PDA not reviewed 2017-270163 883:5": 31 5 September 18 5:19 2017270992 86;??231 7 September 21 88223315317 831321177 Series?? 2017-271546 se?fgn: :18 September 18 8823;312:318 $53,335.24 2017-57158? 33:32:18 September 19 363*85" 2 :18 WITNESS TESTIMONY The following individuals were interviewed: Circuit 15 PA Sarah Thompson 0 Former Circuit 15 CPI Nadege Jolicoeur 0 Circuit 15 CPI Megan Banks 0 Circuit 15 CPI Jessica Miller 0 Circuit 15 Senior Child Protective Investigator (SCPI) Debbie Carter Ms. Thompson has been a PA for approximately three years and her responsibilities include supervising and providing consultation to CPISs and their four units in Circuit 15. She informally meets with CPIS staff to discuss ongoing issues or problems; however, due to the informality of the meetings, she does not maintain documentation. According to Ms. Thompson, Mr. Shea has formal all-staff meetings with sign-in sheets, meeting agendas, and recorded notes; however, Ms. Hyacinthe missed most of those meetings. Ms. Thompson would try to review the items missed with Ms. Hyacinthe, but was not able to provide the information consistently. Ms. Thompson stated that Ms. Hyacinthe was hired as an SCPI in Circuit 15 on November 8, 2016 and promoted to CPIS on December 2, 2016. Ms. Hyacinthe previously applied for a Office of Inspector General Investigative Report #2017-0070 CPIS position in Circuit 15 (unknown date), but Ms. Thompson did not hire Ms. Hyacinthe at that time because she was not impressed with her interview or responses to case scenarios. Ms. Hyacinthe expressed to Ms. Thompson that she needed to be in Circuit 15 because traveling to Lake County (in Circuit 5) had become a hardship; therefore, when an SCPI position became available in Circuit 15, Ms. Thompson reached out to Ms. Hyacinthe to inform her of the position. TE D On Monday, September 11, 2017, Ms. Hyacinthe informed Ms. Thompson that she did not have any power at home and her cellular telephone was about to “go out.” Ms. Thompson instructed her to charge her cellular telephone in her vehicle and Ms. Hyacinthe replied, “Okay” via text message. Ms. Hyacinthe never contacted Ms. Thompson to indicate that she was not able to follow through with this instruction. Ms. Thompson subsequently assigned two other cases to Ms. Hyacinthe that day and notified Ms. Hyacinthe of the case assignments. She did not assist with the QAR of Ms. Hyacinthe’s caseload. Ms. Thompson’s concern with Ms. Hyacinthe’s work performance was the one-line instructions Ms. Hyacinthe provided to her staff. She discussed with Ms. Hyacinthe during her Annual Performance Appraisal (date not provided) that she needed to provide more detailed instructions. AC Ms. Hyacinthe met with Ms. Thompson and Mr. Shea on October 2, 2017 to discuss the cases that were of concern. They gave her (Ms. Hyacinthe) a list of the cases and asked her to provide an explanation for the discrepancies. Ms. Jolicoeur stated that when she began working under Ms. Hyacinthe, Ms. Hyacinthe was very helpful to her. She provided guidance and Ms. Jolicoeur felt “steady” for the first time since coming into the position. When she called, Ms. Hyacinthe would always respond. ED Ms. Jolicoeur did not complete her PDAs with Ms. Hyacinthe; however, during the PRCM, Ms. Jolicoeur would have discussed the case several times before putting any information on paper. At the completion of the PDA, Ms. Hyacinthe would have previously directed her on what steps to take and the outcome of the PDA. R Ms. Banks has been a CPI since approximately October 2014 and began working in Ms. Hyacinthe’ s unit in February 2017. She completed her PRCM with Ms. Hyacinthe after researching the background of the client. If she was unable to reach Ms. Hyacinthe, she left a detailed voicemail with case background information and the steps she was preparing to take. She believes Ms. Hyacinthe completed all the steps required on her cases and provided the supervision and guidance based upon the individual needs of each CPI. She did not complete or review her PDAs with Ms. Hyacinthe; however, she would discuss the PDA with Ms. Hyacinthe prior to completing it in FSFN. Ms. Miller was hired as a CPI in December 2016 and met Ms. Hyacinthe around the middle of March 2017. Ms. Hyacinthe was available, cooperative, and helpful, but did not always provide the answers she needed, in that the answers were vague and not specific. Ms. Hyacinthe would listen and provide only general feedback when she was seeking specific instructions. For example, if Ms. Miller asked Ms. Hyacinthe, “Do you think I should drug screen?” Ms. Hyacinthe would answer, “Maybe.” When she did not receive the answers she needed from Ms. Hyacinthe, she would reach out to Circuit 15 SCPI Travis Amos, who would normally provide her with the specifics needed. 4 Office of Inspector General Investigative Report #2017-0070 TE D Ms. Miller received e-mail notification of case assignments, obtained the background information needed on the case, and completed the PRCM for each case with Ms. Hyacinthe before going into the field. After speaking with the parties in the field, Ms. Miller completed the PDA; however, any questions, issues, or concerns were normally discussed with Ms. Hyacinthe prior to completing the PDA. She maintained continual communication with Ms. Hyacinthe regarding the case from beginning to closure and notified Ms. Hyacinthe by telephone or e-mail when the PDA was complete and a discussion was needed. Ms. Miller recalled speaking with Ms. Hyacinthe generally about cases, but not specifically about the PDA. Ms. Carter was hired as a CPI in 2011 and promoted to an SCPI in May 2017. Based upon her experience working under other CPISs, Ms. Carter opined that Ms. Hyacinthe did not provide proper case guidance, in that she gave instruction without providing justification. At one point, Ms. Hyacinthe gave a directive to establish present danger on a case. When she pressed for the reason, Ms. Hyacinthe stated, “Well, I don’t know. I’m not out there…You’re the investigator out there investigating.” Ms. Hyacinthe did not sit with her while she completed the PDA. She completed her PDAs alone and would notify Ms. Hyacinthe via email once they were completed. RECORDS REVIEWED AC QAR Summary The Central Region Circuit 5 Program Office randomly selected 20 investigative cases closed by Unit 135020 [Ms. Hyacinthe’s unit] within 60 days of May 4, 2016. The cases reviewed were originally opened in January 2016 and March 2016. The results of the QAR were documented in a memorandum dated June 3, 2016. The memorandum contained the following information, quoted in pertinent parts: ED Program Office QA management staff developed a qualitative review tool based around the Rapid Safety Feedback (RSF) tool to examine six significant areas regarding practice related to the fidelity model, safety decisions and consultation/guidance with the following representing the areas of focus: R 1. Background History: Based on the review of 20 cases, 12 did not appear to provide adequate assessment of background history…Discussion and assessment of background check information should occur during the initial supervisory consultation and the supervisor should ensure a review of the FFA prior to case closure… 2. Present Danger Assessment: Review of the 20 cases, showed that eight cases did not appear to have a sufficient assessment present danger or did not have a PDA that supported the decision…there should be discussion during the initial supervisory consultation whether caregiver protective capacities are sufficient… 3. Present Danger Safety Plan: Of the 20 cases, 14 did not require a safety plan. Regarding the other six cases…in two cases, the safety plan was insufficient; and in two cases, the CPI did not develop a safety plan when warranted…The initial supervisory consultation in [one] case did 5 Office of Inspector General Investigative Report #2017-0070 not document discussion specific to the actual safety plan developed, the safety actions, if the CPIS agreed that it was sufficient and the need for a perpetrator safety plan…in [another case]…[t]he initial supervisory consultation in this case did not document the CPI’s initial contact and findings, the concerns for the prior report and criminal histories and if the CPIS agreed with the CPI’s assessment… TE D 4. Family Functioning Assessment [FFA] and Safety Decisions: …A review of the overall safety decisions made in the 20 cases found that in five cases, the FFA contained sufficient information to support the safety decision. In the other 15 cases, the CPI did not necessarily make the wrong assessment…rather it was the CPI not gathering sufficient information or not including in the FFA all the information gathered…During the in-person follow-up supervisory consultation on this case, there was discussion regarding the FFA, but the CPIS needed to document the discussion regarding the impending danger threshold…In five of the 15 cases…the follow-up and/or closure consultations did not document discussion of the FFA and the FFA audit screen did not reflect that the CPIS viewed it… AC 5. Initiation of an Impending Danger Safety Plan: In 18 of the 20 cases, the CPI accurately identified that there was no impending danger therefore an impending danger safety plan was not warranted…During the initial supervisory consultation, the CPIS should begin to explore with the CPI the identification of impending danger threats… Overall, the CPIS consultations are not documenting discussion of the impending danger criteria or threshold… 6. Supervisory and 2nd Tier Consultation and Guidance: …Overall, there was a lack of required pre-commencement consultations on cases assigned to provisionally certified CPI’s. SUBJECT TESTIMONY ED Former Circuit 15 CPIS Beverlie Hyacinthe The OIG Investigator telephoned and left voicemail messages for Ms. Hyacinthe on April 4, 2018, April 10, 2018, and May 31, 2018, requesting a return call. On July 18, 2018, the OIG Investigator left a business card with an individual at the residence, who identified herself as a family friend and confirmed it was the residence of Ms. Hyacinthe, and requested that she have Ms. Hyacinthe telephone the OIG Investigator; however, Ms. Hyacinthe has not responded to the OIG Investigator. R RISK ASSESSMENT On September 27, 2017, Mr. Shea conducted a risk assessment of the active investigations for which Ms. Hyacinthe was the supervisor (this assessment included the investigations that were part of the QAR as cited in the June 3, 2016 memorandum). The 31 families were seen and determined to be safe. The cases that had concerns pertaining to the lack of supervisory oversight have been noted in this report and, except for those noted, there were no additional concerns. 6 Office of Inspector General lnvestiqative Report #2017-0070 SUMMARY The allegation that Circuit 15 Child Protective Investigator Supervisor (CPIS) Beverlie Hyacinthe falsified supervisory consultations and reviews in FSFN Investigations #2017- 259504, #2017-259509, #2017-259523, #2017-259582, #2017-265938, #2017-270133, #2017-270163, #2017-270992, #2017-271486, #2017-271546, and #2017-571587 is supported. The finding is based on the following: 0 Ms. Hyacinthe documented in the FSFN Supervisory Hyperlink of investigations that she held initial consultations with under her supervision to review and approve PDAs. 0 Mr. Shea testified that the QAR performed on cases assigned to Ms. Hyacinthe revealed that she falsified documentation in multiple FSFN Investigations. 0 Ms. Jolicoeur, Ms. Banks, Ms. Miller, and Ms. Carter testified that Ms. Hyacinthe did not complete their PDAs with them as documented. 0 FSFN Audits show that in each of the investigations, Ms. Hyacinthe viewed PDAs either later than the documented supervisory consultation, prior to completion of the PDA, or not at all. Ms. Carter and Ms. Miller testified that Ms. Hyacinthe did not provide specific supervisory guidance or direction to the under her supervision. 0 Ms. Hyacinthe did not respond to the OIG lnvestigator?s requests for an interview. RECOMMENDATIONS AND ACTIONS The OIG recommends that the Southeast Regional Managing Director: 0 Review this report and ensure Ms. Hyacinthe?s personnel ?le is updated to reflect the findings of the investigation. According to the Florida Certification Board, Ms. Hyacinthe obtained her Child Welfare Protective Investigator certification on November 30, 2012. As such, and based on the findings of this investigation, it is also recommended that the Southeast Regional Managing Director: 0 Determine if initiating the decertification process regarding Ms. Hyacinthe?s Child Welfare Protective Investigator certification is warranted or appropriate. POST-INVESTIGATIVE ACTIVITIES In accordance with Florida Statutes (F.S.), on November 9, 2018, this investigation was coordinated with the Florida Department of Law Enforcement (FDLE) for a possible violation of F.S. (Official Misconduct), and and F.S. (Falsifying Records). On December 13, 2018, FDLE advised that they would not initiate a criminal investigation. This investigation has been conducted in accordance with the ASSOCIATION OF INSPECTORS GENERAL Principles Quality Standards for Investigations. Office of Inspector General Investigative Report #2017-0070 REFERENCES FSFN INVESTIGATION INFORMATION TE D FSFN Investigation #2017-273420 was opened based on a September 19, 2017 report to the Hotline alleging Physical Injury to (Child 1). The CPI commenced the investigation at 1:00 p.m. that same date. Child 1 reportedly lived with (the Grandmother), (the Father), and her cousins, eight-year-old (Child 2) and 10-year-old (Child 3). Child 1 was sheltered on September 21, 2017 and the case was accepted for case management services and closed on October 5, 2017. FSFN Investigation #2017-265938 was opened based on a September 11, 2017 report to the Hotline alleging sexual abuse, molestation, and exploitation of Child 2 and Child 3, whose parents are and her paramour, . The CPI commenced the investigation on September 11, 2017 at 10:40 a.m. It was learned that Child 1 was residing in the same home and was also sexually assaulted. Child 1, Child 2, and Child 3 were sheltered on September 21, 2017 and the case was closed on October 5, 2017. EXPLANATION OF TERMS Commencement Commencement is the date and time the investigator attempts or achieves face-to-face contact with the victim by actually visiting the site where the victim was reportedly located. Continuity of Operations Plan (COOP) establishes policy and guidance to ensure the execution of mission-essential functions in the event that an emergency threatens or incapacitates operations. ED COOP Circuit 5 consists of Citrus, Hernando, Lake, Marion, and Sumter Counties. AC Central Region The Florida Abuse Hotline (Hotline) serves as the central reporting center for allegations of abuse, neglect, and/or exploitation for all children and vulnerable adults in Florida. FSFN The Florida Safe Families Network (FSFN) is the legal electronic system of record used by the Department to track child and adult intake/reports and investigations and case management for children. R Hotline Home Study A Home Study is the written documentation of an on-site assessment completed prior to the child’s placement that is meant to evaluate the caregiver’s capacity to provide a safe, stable, and supportive home environment, and to determine if the physical environment is safe and can meet the child’s needs. PRCM Pre-Commencement Supervisory Consultations (PRCM) are guided discussions at specific points in the case management process that 8 Office of Inspector General Investigative Report #2017-0070 apply the child welfare practice model criteria focused on promoting effective practice and decision-making. The Present Danger Assessment (PDA) represents one component of the Florida Safety Decision Making Methodology (FSDMM) used by Child Protective Investigators (CPIs) and Case Managers to guide decision-making relevant to child safety during initial child protection intervention and support a more efficient FSFN user interface. Safety Plan A Safety Plan is a written agreement between the Department and a client or caregiver/guardian that outlines steps necessary to ensure the safety of the child. Southeast Region The Southeast Region consists of Circuit 15 (Palm Beach County); Circuit 17 (Broward County); and Circuit 19 (Indian River, Martin, Okeechobee, and St. Lucie Counties). R ED AC TE D PDA 9