Some Washington State Group-Care Facilities for Children in Foster Care Did Not Always Comply With State Health and Safety Requirements

Although Washington State performed the required onsite monitoring at all 20 of the group care facilities that we reviewed, this monitoring did not ensure that these facilities complied with State licensing requirements related to the health and safety of children in foster care, as required by Federal law. We determined that all 20 group care facilities did not comply with 1 or more State health and safety requirements. Specifically, these facilities did not comply with requirements related to medical safety (20 facilities); environmental, space, and equipment safety (18 facilities); background checks (16 facilities); food safety (11 facilities); and fire safety and emergency practices (7 facilities).

We recommended that Washington State (1) ensure that all instances of noncompliance that we identified are documented and corrected, (2) conduct unannounced visits for health and safety reviews of group care facilities, (3) ensure that regional licensors perform and document a site inspection during each health and safety visit at a group care facility, (4) ensure that regional licensors and group care facilities have adequate training and guidance on the best practices for administering medications and maintaining related documentation, (5) provide regional licensors and group care facilities with adequate guidance and supervision regarding background check requirements, (6) ensure that the handbook Minimum Licensing Requirements for Group Care Facilities is updated with the latest background check requirements, and (7) consider requiring Federal Bureau of Investigation fingerprint-based background checks for all group care facility employees, seeking additional legislative authority as needed.

Washington State concurred with all of our recommendations and provided information on actions that it had taken or planned to take to address our recommendations.