Chapter 1: Introduction - drfiene.files.wordpress.com · Web viewThe purpose of this literature review is to describe the context and purpose of childcare and early education, a

Dissertation Proposal

Submitted to Northcentral University

Graduate Faculty of the School of Educationin Partial Fulfillment of the

Requirements for the Degree of

DOCTOR OF EDUCATION

by

Sonya Stevens

Prescott Valley, ArizonaAugust, 2016

Table of Contents

Chapter 1: Introduction........................................................................................................1

Background....................................................................................................................3Statement of the Problem...............................................................................................4Purpose of the Study......................................................................................................5Research Questions........................................................................................................5Hypotheses.....................................................................................................................6Nature of the Study........................................................................................................6Significance of the Study...............................................................................................7Definition of Key Terms................................................................................................9Summary......................................................................................................................10

Chapter 2: Literature Review.............................................................................................10

Documentation.............................................................................................................10The Social Context of Early Childcare Programs........................................................11Effects of Program Quality on Child Growth and Development................................17Oversight and Evaluation of Childcare Programs.......................................................19Summary......................................................................................................................33

Chapter 3: Research Method.............................................................................................33

Research Method(s) and Design(s)..............................................................................35Population....................................................................................................................38Sample.........................................................................................................................40Materials/Instruments..................................................................................................41Data Collection, Processing and Analysis...................................................................44Summary......................................................................................................................47

References..........................................................................................................................49

Appendices........................................................................................................................55

Dissertation Proposal Components – 1_Sonya Stevens 3

Chapter 1: Introduction

According to the U.S Bureau of Labor Statistics, 72 % of children were cared for

in non-parental situations beginning in the first year of life in 2013 (Huston, Bobbitt &

Bentley, 2015). As a result, childcare has become a primary environment where children

can be taught a range of physical and academic skills as well as guided in the areas of

positive behavior, social interactions and conflict resolution (Crowley, Sangchoon &

Rosenthal, 2013). Quality care provides children with many benefits including, but not

limited to, fewer injuries, early referral to health, developmental and behavior services,

and care for children with special needs (Crowley et al., 2013). Quality in early

childhood is directly related to children being safe, healthy and ready to learn (Alkon,

Rose, Wolff, Kotch & Aronson, 2015; Crowley et al., 2013; Huston et al., 2015).

Although the direct responsibility for ensuring the health and safety of children

lies with families and local childcare providers, most states have recognized the

importance of providing oversite and support to childcare providers through formal

inspections (Kayira, 2016; Lapp Payne & Testa, 2014). Agencies across the United

States are working to ensure provider meet overall health and safety standards as well as

improved quality through effective and reliable monitoring to ensure compliance with

regulations (Alkon et al., 2015; DEL.wa.gov, 2015). However, the reliability and content

and social validity (Wolf, 1978) of the monitoring tool to assess the quality of care for

children has yet to be considered. Without a reliable assessment tool, as well as

stakeholders’ (e.g., licensors, childcare program directors and staff, business owners and

parents) understanding of the inspections relevance to achieving program goals,

information from annual monitoring cannot effectively increase program outcomes for


children (Ledford, Hall, Conder & Lane, 2016; Strain, Barton & Dunlap; 2012; Wolf,

1978).

No matter how valid and reliable an assessment tool is, the results are potentially

meaningless unless the program stakeholders consider the inspection to be valuable

beyond receiving a passing grade on the inspection (Ledford et al., 2016; Strain et al.,

2012). Licensing staff and providers must build a partnership with all program personnel

centered on shared values of the inspection’s intended purpose. One of the largest

challenges licensing agencies face is establishing good working relationships with

providers and obtaining confidence in the monitoring process (Kayira, 2016). It is

important stakeholders understand that the purpose of the inspection process is to

facilitate quality programming necessary to effectively guide child growth during the

early years (Ledford et al., 2016).

In order to establish these relationships, agencies must be fair, objective and

consistent with all licensed providers across all regions; licensors must be objective, work

independent of external influences, and be consistent (Fiene, 2014; Kayira, 2016). Yet,

the performance of onsite inspections can vary greatly along a continuum of objectivity;

licensor objectivity is often centered on the frequency and ease of measures, potentially

undermining the validity of objective standards (Amirkhanyan, Kim, & Lambright,

2013). Licensing tools such as procedures and checklists must be aligned to ensure

objectivity and consistency between licensors, but it is also important to determine the

social validity of monitoring systems to reliably demonstrate the effects of childcare

programming on the well-being of young children.


Background

According to the Childcare in America: 2016 State Fact Sheet Report (2016),

Childcare providers across America care for approximately 11 million children five-

years-old and under. Because so many children are being cared for outside of the home,

it has become a focus nationwide to ensure children are being cared for in safe

environments. The Childcare Development Block Grant (CCDBG), a federal program

that provides states the financial means to award low income families subsidies to help

pay for the high cost of Childcare, was reauthorized in 2014 and required participating

states to impose stronger health, safety and quality regulations (Raikes, 2012). This is

due to fact children learn best when they have a foundation of safety and health (Cote-

Lussier & Fitzpatrick, 2016).

To meet these new requirements states are working to assess and put into place

new policies, procedures and systems. For example, Washington State, in an effort to

improve regulatory methods, assessed the use of monitoring procedures in a 2014

analysis of licensors compliance with procedure 10.1.8 (Appendix A). Licensing analysts

found that from a sample of 1401 monitoring visits conducted in 2014, approximately

11% of the total licensing visits did not switch from an abbreviated checklist to a

comprehensive checklist when required (DEL Data Analysis Report, 2015). This

discovery prompted the creation of an Ad Hoc committee to explore the systems and

procedures in order to improve licensor compliance.

Recommendations were made to alter the checklist system to allow licensors time

to focus on areas of critical non-compliance by creating a focused system; the ability to

focus on areas where corrections need to be made rather than in areas providers are

Author, 01/03/-1,

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currently in compliance (Ad Hoc meeting notes, 2015). Recommended changes did not

include elements of an adequate evaluation of the licensing system, nor any methods to

check for reliability and validity. This study will not only use stakeholder input to create

and evaluate a focused monitoring system but will also ensure the relevance of a focused

checklist system will help meet licensor and provider needs and lesson the unintended

effects of higher standards (Moloney; 2016; Strain et al., 2012).

Statement of the Problem

With so many children in licensed care, it is critical for state monitoring systems

provide an accurate baseline of protection through a reliable monitoring system and clear

methodology (Alkon et al., 2015; Kayira, 2016). Licensor consistency is critical to the

licensing system; without it, the effectiveness and the quality of early childhood

programs can be adversely affected. Without transparent demonstration of consistency

and fairness, providers and the public may become distrustful of the licensing system and

challenge the usefulness of the monitoring system (Kayira, 2016). As the childcare

licensing industry works to improve the health, safety, and quality of licensed childcare

for the millions of children in out-of-home care, minimal attention has been directed

toward determining the reliability, validity and social validity of monitoring tools

(NCCCQI, 2014).

Many states use licensing tools intended to measure performance; however, how

the checklist systems are designed often exposes the monitoring visits to a subjective-

objective dichotomy due to the tool allowing for individual judgement by the licensors

(Amirkhanyan et al., 2013). Kayira (2016) explained the consistency and objectivity of

monitoring systems is directly related to the equality of monitoring regulations between

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childcare providers; yet, few have examined the reliability and validity of monitoring

tools with a focus on social validity (Alkon et al., 2015). Therefore, it is not clear how

the tools used to conduct monitoring should be designed to ensure consistent inter-rater

reliability and content validity in addition to social validity as perceived by all

stakeholders. Without evidence of these factors, the effects of annual monitoring on the

licensed childcare programs cannot be effectively evaluated.

Purpose of the Study

The purpose of this mixed method evaluation study is to determine the reliability

and content and social validity of the focused monitoring tool used to monitor the

foundational health and safety of childcare programs in Washington State. Four licensed

childcare centers, four to eight licensors, and other advisory stakeholders in Washington

State will participate in the study. Data will be collected through a series of focus groups,

and 14 strategically designed focused monitoring visits that will include interviews with a

representative sample of the program stakeholders for each program.

Research Questions

The focus of the present study will be to evaluate the reliability as well as the

content and social validity of the annual monitoring tool used to provide focused

oversight to licensed childcare centers. A mixed method program evaluation research

design will be used to ensure multiple inputs from all stakeholders in order to understand

childcare monitoring practice in action (Frye & Hemmer, 2012). Data will be collected

using interviews and focus groups and analyzed using qualitative methodology to

evaluate the social validity of focused monitoring. Additional data will be collected

using the focused monitoring tool and analyzed using descriptive and inferential statistics


to evaluate the reliability and content validity of the tool used. Data will be collected and

analyzed to answer the following research questions:

Q1. How do stakeholders describe the value, usefulness, and effects of state

administrated focused monitoring?

Q2. Is the focused monitoring observation tool a valid and reliable measure of

the foundational health and safety concerns that must be met by state

licensed early childhood programs?

Hypotheses

Nature of the Study

The nature of the study is a mixed method program evaluation with the intent to

evaluate the reliability and validity of a focused monitoring tool used during annual

licensed childcare monitoring inspections in Washington State. This study will

concentrate on evaluating the tools’ value and usefulness in maintaining health and safety

quality and effective programming in licensed center childcare programs. The program

evaluation research design will be guided by the Context, Input, Process, and Product

Evaluation (CIPP) (Stufflebeam & Shinkfield, 2007). CIPP provides a framework for

integrating program evaluation with program management and development. Using this

framework, three broad tasks are performed for each type of evaluation: (1) delineating

the information needed for decision making; (2) obtaining the information; and (3)

synthesizing the information to make programmatic decisions.

CIPP (Stufflebeam & Shinkfield, 2007) will guide the evaluation by allowing

multiple inputs from various stakeholders in order to understand Childcare monitoring

consistency between licensors and the social validity of the tool (Fry & Hammer, 2012).


Participants will include licensing leadership, licensing staff and childcare providers in

order to develop, implement and evaluate the reliability and validity of a focused

monitoring system. Overall, descriptive statistics and input analysis will be conducted to

the target sample population in the form of focus groups and interviews.

Additional data will be gathered from a pilot implementation of the focused

checklist by licensors during unannounced monitoring visits of volunteer provider

childcare center programs. This will gather quantitative information regarding needed

changes to the monitoring tool as well as the relationships between monitoring

procedures and licensor inter-rater reliability. Finally, pre and post implementation

interviews of licensors and providers will gather qualitative data for the purpose of

assessing the validity of the tool. Using the four steps outlined in the CIPP process will

allow the input from a variety of stakeholders to effectively describe the value, usefulness

and effects of focused monitoring as well as ensuring its validity and reliability when

assessing foundational health and safety concerns that must be met by state licensed

childcare programs.

Significance of the Study

The majority of the health and safety concerns addressed in research has

concentrated on the licensing standards used for annual inspections and the frequency to

which licensing visits are conducted; there is very little research on the inspection tool

itself (Alkon, Rose, Wolff, Kotch & Aronson, 2015). Differential monitoring was

developed with the intent to save licensors time, thereby saving licensing agency’s

money by concentrating on sites with significant compliance issues with more in-depth


monitoring checklists and rewarding those programs with a history of high compliance

with the use of an abbreviated checklist (Fiene, 2014).

This research study is designed to refine the differential monitoring methodology

to include focused monitoring as a means for licensors to concentrate more heavily on

areas of non-compliance while limiting time spent on areas where providers need

minimal or no licensor support. An annual monitoring tools that is reliable and valid

could potential increase provider compliance demonstrating statewide childcare increases

in the areas of quality, safety and health in which children learn best. Additionally, by

concentrating on the monitoring tools’ reliability and validity, licensing agencies are

better informed on how to provide licensing consistency which could prove to increase

the agency’s liability protection (Kayira, 2016).

As more and more children are entering into the licensed Childcare systems, it is

critical to re-assess and maintain systems that provide appropriate oversight, ensuring

each child’s health and safety. While this study’s main audiences are policy makers and

licensing professional and practitioners within the State of Washington, the substantive

significance of this tool can be applied nationwide as it can be adapted to be inclusive of

any licensed childcare regulations. Furthermore, as this study concentrates solely on the

validity and reliability of a focused monitoring tool, it lays a foundation for future study

regarding its effectiveness in the area of increasing overall compliance: It is possible

providers receiving focused assistance in only the areas in which they struggle to be

complaint will, overtime, increase programming and environmental quality so children

can receive higher quality of care in which to learn (Alkon et al., 2015; Crowley et al.,

2013; Huston et al., 2015).


Definition of Key Terms

Annual monitoring. A checklist data system licensors use once a year to

evaluate the level to which licensed childcare facilities are in compliance to the state

regulations (Crowley et al., 2013). These are completed with either a full checklist where

all the rules are inspected or an abbreviated checklist where only a selected set of rules

are inspected (NCCCQI, 2014).

Checklist. A simple measurement tool licensors use to measures compliance

with state rules in a yes/no nominal format. Either the facility is in compliance with rules

or not in compliance. (Alkon et al., 2015).

Differential monitoring: A method to regulate child care facilities based on the

frequency and depth of monitoring based on the facility’s history of compliance

(NCCCQI, 2014). The use of differential monitoring/inferential inspections by licensing

agencies was developed as a time saving technique and a technique to focus regulatory

efforts on facilities that required additional inspections or technical assistance (Fiene,

2014).

Key Indicator. A licensing measurement system utilizing a shortened or

abbreviated version of a comprehensive checklist measuring compliance with rules

through a statistical methodology. Only key predictor rules are included on an indicator

checklist (Fiene & Carle, 2010; NCCCQI, 2014).

Rating scale. A more complex measurement tool in which a Likert type of rating

is employed going from more to less or high to low. A rating scale is always used in the

development of weighting/risk assessment systems. It is not used in measuring

compliance with rules or at least it hasn’t been used in the past.


Revised Code of Washington. The Revised Code of Washington (RCW) are

permanent laws now in force in the state of Washington. RCW are a collection of

Session Laws passed and ratified by the Legislature signed by the Governor or passed

through the initiative process (Washington State Legislature, 2016).

Risk Assessment/Weighting System. A Likert type of measurement that utilizes

a modified Delphi technique to determine the relative risk to children if there are

violations with specific rules. Risk assessment/weighting systems are developed by

sending a survey to a selected sample of persons/stakeholders in order for them to rank

the relative risk of violation with specific rules (Fiene & Carle, 2010).

Washington Administrative Code (WAC). WAC are regulations of executive

branch agencies for Washington State. These regulations are a source of primary law in

Washington State and are specific to a subject or agency (Washington State Legislature,

2016).

Summary

Licensing oversight agencies monitor childcare centers across the nation in order

to ensure children are cared for in safe and healthy environments. They are responsible

for the development and implementation of oversight tools such as checklists, policies

and procedures used by licensors to monitor and provide technical assistance. Through

this process, licensing is able to assure foundational guidelines and standards are met

providing a baseline for quality early learning programming (Alkon et al., 2015). This

mixed method CIPP research study is designed to evaluate and refine the licensing

methodology used by Washington State to include focused monitoring as a means for

licensors to concentrate more heavily on areas where providers need more support rather


than on areas of profiency. An annual monitoring checklist tool that is reliable, valid and

is perceived to be useful to both providers and licensors could potential increase provider

compliance (Fiene & Nixon, 1985; Fiene, 2014; Raikes, 2012).

Chapter 2: Literature Review

Millions of children spend a great deal of their week in formal childcare settings

for a variety of reasons (Houston, 2015). Early childhood centers are required by state

licensing agencies to ensure that young children are safe, healthy and ready to learn

(Crowley et al., 2013). Ensuring the practice of health and safety practices in early

childhood centers requires formal oversight via a monitoring system. The same

monitoring system also has the potential to increase program quality as well as increase

the value of childcare within the community (Li, Farkas, Duncan, Burchinal & Vandell,

2015). The purpose of this literature review is to describe the context and purpose of

childcare and early education, a brief review of research on the relationship between

quality programming and early childhood development, and the process used to evaluate

and monitor childcare programs.

Documentation

A preliminary literature search was conducted to identify studies that provided

information pertaining to childcare licensing in the United States specific to regulations,

monitoring/evaluation systems and the reliability and validity of monitoring tools. Given

the limited nature of current research in the specific area of childcare licensing, the search

was expanded to quality improvement measures. Documentation was gathered through a

variety of empirical and peer reviewed articles found in the Northcentral University

Library with specific search engines including EBSCOhost, Sciencedirect, Sage Journals,


and ProQuest. Additional background literature was found through the library of

Pennsylvania State University, the Department of Early Learning, the Administration for

Children and Families, and Researchconnectrions.org. All studies that reported on state

licensing systems and other relevant information such as information linking quality

improvement in childcare to licensing or specific elements of health and safety were

integrated into the literature review. Additional studies were identified by reviewing the

reference list of the studies previously identified.

The Social Context of Early Childcare Programs

In 2013, 72 % of American children were cared for by someone other than a

parent, many of them cared for in one of the over 107,286 childcare centers throughout

the United Stated (Alkon et. al, 2015; Huston, Bobbitt & Bentley, 2015). According to

the U.S. Bureau of Labor Statistics, this was due, in part, to the 63.9% of women with

young children being employed (Houston, 2015). Childcare has become such a

foundational part of a working parents’ life that in 2008, the U.S. Congress financed

approximately $5 billion in childcare subsidies to support parental employment for low-

income families and childcare quality improvement efforts with the Childcare

Development Fund (CCDF) (Raikes, 2012). The need for childcare is defined by the

social context in which it is used and or needed. This could have to do with increased

families with two income parents, the raise in increased single parents, the increase body

of evidence demonstrating the benefits of early education; especially for dual language

learners and children from low income demographics, among other reasons (Tucker-

Drob, 2012).


Families choose childcare based on a variety of reasons such as cost,

convenience, programming (Raikes, 2012; Sandstrom & Chaudry, 2012), developing.

positive relationships, and becoming autonomous learners in a positively focused social

environment, but parents’ greatest concern is for their child’s safety within the

environment and the quality of the educational programming (Scopelliti & Msatti, 2013).

Unfortunately, low income families are often forced into low-quality childcare options

lacking the desired safety qualities and high quality programming because of unstable or

unpredictable work as well as non-traditional work hours (Palley, 2012). Regardless of

income, the main parental preference for childcare is that children are safe and cared for

by trustworthy caregivers along with basic elements of quality programming. Parents

must rely on licensing systems to ensure these foundational levels of care, regardless of

their income status (Crowley, 2013; Sandstrom & Chaudry, 2012).

The purpose of childcare has evolved far beyond a parental need for a child to be

“watched over” while he or she goes to work. Global economic competition dictates the

United States has future generations be equipped with strong early learning foundations

and school success (Winterbottom & Piasta, 2015). Participation in preschool and early

education has demonstrated marked improvements in children’s learning. For example,

Tucker-Drob (2012) found preschool attendance was associated with higher reading and

math scores, especially for children from lower socio-economic families and racial

minorities. Results such as this have legislatures and policy makers, as well as parents,

look to early education as a means to help better prepare children for kindergarten and

beyond while lessoning the achievement gaps (Tucker-Drob, 2012; Lipscomb, 2013;

Yazejian, Bryant, Freel, & Burchinal 2015).


Early childhood education is characterized by early learning and development

theories and methodologies including foundational health and safety practices (Crowley

et al., 2013). While empirical evidence justifies the need for increased early education,

there is renewed interest by the federal and state government to ensure children are cared

for in safe and heathy environments as well as are provided quality educational

programming. In fact, global attention has recently been placed on national health and

safety standards including increased health and safety standards within licensed childcare

as well as unlicensed providers. In the United States, the interest is to not only increase

health and safety standards but to also keep in mind the social context as well as the

purpose of childcare (Crowley et al., 2013; Tucker-Drob, 2012).

At the foundation, children in licensed childcare should be cared for in

environments that are healthy and safe. Developing appropriate environments will set

children on a path to ongoing physical, emotional, social and academic development.

This is particularly important in early childhood because children’s brains are developing

rapidly through ongoing experiences laying the foundation for more complex learning

later in life (D’Souza & Gurin, 2016; Villanueva et al., 2016). Maslow (1973) described

this need through the theory of hierarchy of needs in which children need to be have their

basic needs met and a feeling of safety before cognitive learning and self-actualization

can be met (D’Souza & Gurin, 2016). Safe, healthy and developmentally appropriate

early learning environments provide exposure and opportunities for participation in these

essential experiences (Villanueva et al., 2016).

The theoretical concept of positive human growth beginning with a foundation of

trust and safety was introduced by Erik Erikson. A clinician and cultural anthropologist,


Erikson created a theoretical framework outlining connections between the different

stages of human growth with a particular emphasis on the relationship between societal

influences and the individual. For example, an infant learning to walk must deal with the

fears of being safe versus the desire to be autonomous. The surroundings in which the

child is learning a new skill may predict the chances of success (Batra, 2013): In a safe

environment, growth and development are nurtured when the child is given appropriate

encouragement and help as the child explores the environment. If the environment is

unsafe, the child may fear danger and revert to crawling instead of walking to avoid

injury, thereby reducing the desire and trust in the caregiver to try again.

It is essential educational facilities promote children’s ability to engage in

learning through assured health and well-being. According to Côté-Lussier and

Fitzpatrick (2016), children who do not feel safe at school have been linked to lower

academic outcome and lower levels of engagement. It was also found that children in

unsafe environments tend to engage in risky behavior and are more aggressive which

creates behavior issue that could potentially adversely affect the entire classroom (Cote-

Lussier & Fitzpatrick, 2016). The benefits of providing safe and healthy environments

are numerous and coincide directly with the need to provide quality early learning

environments for children, a fact that has not evaded national attention.

Because there is renewed interest in giving children a firm foundation of health

and safety in which to develop, the Childcare Development Block Grant (CCDBG, 2014)

was reauthorized with additional stipulations for health and safety accountability

measures and quality improvement (Administration for Children and Families, 2016;

Lapp-Payne & Testa, 2014;). With these new authorizations in place, states desiring to


use the CCDF funds to subsidize childcare for low income families were required to

address specific health and safety issues as well as training to license-exempt providers

such as Friends, Family and Neighbors (FFN) (Raikes, 2012). Nevertheless, Lipscomb

(2013) found that the financial assistance provided through the subsidy system is still not

enough to afford low-income children to enroll, and maintain enrollment, in quality

programs justifying the need to increase subsidy payments to income families and/or

require the increase of quality in all childcare programs.

Researchers have found that unlicensed care exposes children to particular risks

and hazards. Miller (2013) described some of those hazards as contaminated food,

unprotected pools, steep stairs, unclean pets, improper handwashing and so on. It has

also been argued environmental hazards of the childcare sites, such as high levels of lead

or mercury, can adversely affect children’s health and learning (Hudson, Miller & Seikel,

2013; Somer, Harvey & Rusnak, 2011). Unfortunately, systems throughout the United

Stated and Canada continue to struggle to find one system to provide consistent

monitoring and enforcement of unlicensed childcare (Miller, 2013).

When children are cared for in environments that are safe, healthy and

developmentally appropriate they experience fewer illnesses and injuries, are more likely

to have better health care, accurate referrals to developmental services when needed, and

are simply more prepared and ready to learn. When childcare lacks the foundational

elements of quality, children are put in greater risk for illness, injuries and other risk

factors limiting learning opportunities (Crowley et al., 2013). It is for these reasons there

have been multiple state and federal initiatives to improve health and safety for children

in childcare settings (Crowley et al., 2013; Meloy, Lipscomb & Baron, 2015).


Perhaps the largest initiative to increase health and safety in childcare comes from

standards outlined in the Caring for Our Children (CFOC) (Crowley et al., 2013; Hudson

et al., 2014). Crowley et al. described CFOC as an inclusive set of standards developed

in partnership by the U.S. Department of Health and Human Services and the American

Academy of Pediatrics and is aligned with accreditation standards of the National

Association for the Education of Young Children (NAEYC). CFOC presents common

health and safety standards which can reduce conflicting standards sometimes found

when considering multiple funding streams; it is for this reason the CCDF references

CFOC as a baseline to health and safety standards.

Table 1 outlines each of the categories covered in CFOC; within each category

are a set of standards specific to that topic. It demonstrates how national recommended

standards are firmly founded in health and safety practices with a few addressing minimal

educational and program requirements needed for a child’s learning. Nevertheless,

CFOC does not have the authority to mandate all standards for achieving foundational

quality programming, leaving each state to determine the licensing methods that work

best for their jurisdictions (Bromer, McGabe & Porter, 2013; Crowley et al., 2013; Lapp

Payne & Testa, 2014).

Table 1: Health and Safety Standards for Licensed Childcare (CFOC, 2011)

Standards Category Topics within the Category

Staffing Ratio/group size/age, recruitment background checks, qualificationsprofessional development, substitutes and consultants

Program activities Developmental activities, supervision and discipline, health education, parent/guardian relationship

Health promotion Health promotion, hygiene, cleaning, sanitizing


and protection disinfection, health protection, care plans and adaptation and illness management

Nutrition and food service

General requirements, requirements for special groups, staffing, meal service, seating and supervision, food from home, learning experiences, kitchen and equipment and food safety

Facilities, supplies, equipment and environment

Overall building requirements, outdoors, furnishing and equipment, play areas, playground & transportation

Infectious diseases (organized by type)

Detection and documentation, unimmunized children, immunizations of teachers and caregivers, informing parents, caregivers, authorities and communities, exclusions, attendance, staff education and records maintenance

Children with special health needs and disabilities

Inclusion, enrollment process, developing a service plan, coordination and document, re-evaluation, facilities assessment and additional standards

Administration Governance, policies, human resource management and records

Licensing and community action

Regulatory policies, licensing agency, facility licensing, role of the Health Department, caregiver and teacher support, public policy and resource management

Quality childcare is a necessity for millions of American families. Since it is also

the primary environment where many children learn, it also plays an important role in

closing the achievement gap and bringing families out of poverty. With so many children

in licensed care, it is critical that state monitoring systems provide an accurate baseline of

protection and quality programming using reliable, valid evaluation instruments and well

defined evaluation procedures (Alkon et al., 2015; Kayira, 2016).

Effects of Program Quality on Child Growth and Development

While quality has yet to be universally defined, recent research has suggested a

clear and definable benefit for children to attend high quality early learning programs

(Côté, Mongeau, Japel, Xu, Séguin & Tremblay, 2013; Kirby et al., 2015; Li et al., 2015).


Li et al. (2015) found that children who attend high quality childcare demonstrate

increased cognitive, language and social skills prior to beginning kindergarten.

Additionally, Yazejian et al., (2015) found that children who received high quality of care

earlier had higher kindergarten entry scores and dual language learners (DLL) show

greater gains than do English-only children.

Dual language learners and economically disadvantaged children were found to

have reduced levels of achievement gaps when they have consistent access to high

quality childcare (Yazejian et al., 2015). Other findings suggest DLLs show measurable

gains in social competencies when participating in quality preschool programs (Halle,

Whittaker, Zepeda, Rothenberg, Anderson, Daneri, &. Buysse, 2014). This is in part due

to the fact DLLs are able to increase language skills thereby increasing social standings

with English speaking peers. This is accomplished through quality programming which

benefits all children but specifically those learning English, giving them a better

advantage for success in later education (Yazejian et al., 2015).

Evidence showed a clear and definable value for the investment into

strengthening policy for the quality of care for early childhood (Heckman, 2011; Li et al.,

2015; Yazejian, 2015). In fact, evidence in favor of quality improvement is so conclusive

the Department of Defense (DOD) recognized that having reliable, high quality childcare

is an important part of combat readiness planning for military personnel (Floyd &

Phillips, 2013). To ensure quality, the military practices four categories of oversight;

certification including unannounced inspections, accreditation through the National

Association for the Education of Young Children, high education requirements for


teaching staff, and above average pay rates to ensure low staff turnover (Fiene, n.d.;

Floyd & Phillips, 2013).

Research has also provided evidence of the financial benefits of increased time

and exposure for children to attend high quality early education programs (Yazejian,

Bryant, Freel & Burchinal, 2015). One of the first studies to demonstrate this concept

was done by Barnett in 1993 (Campbell-Barr, 2012). This longitudinal study

demonstrated that for every dollar spent on quality early educational programming, there

was $7.16 saved (Campbell-Barr, 2012). Savings were seen through higher grade point

averages and reduction in the level of special education services over the child’s

educational career leading to higher earning as adults and lower levels of law

enforcement interventions (Campbell-Barr, 2012).

Investments to increase stable higher quality childcare, such as increased subsidy

for families to find and maintain quality childcare, have also been shown to provide the

community with a marked return on investment (Arteaga, Humpage, Reynold & Temple,

2014; Lipscomb, 2013). For example, the state subsidies that help family’s access quality

childcare have been shown to helped low income families stabilize their own income. In

addition, providers tend to increase investment into their own programs thereby

increasing the program quality (Lipscomb, 2013).

Oversight and Evaluation of Childcare Programs

The evaluation of childcare providers begins with a state mandated licensing

system which measures the compliance to state regulations in which childcare centers

must operate (Crowley et al., 2013). One type of monitoring system sometimes used is

the Quality Rating and Improvement Systems. An increasing number of states are


employing QRIS constructs to rate providers for quality levels above that required by

state licensing mandate (Boller, Paulsell, Grosso, Blair, Lundquist, Kassow, Kim &

Raikes, 2015). Nevertheless, providers have a choice to work toward an accreditation

system awarded by either a national or state specific agency. The accreditation process is

often considered an indicator of childcare quality because it examines many of the same

and often additional components found in QRIS. Nevertheless, providers have a choice

to work toward an accreditation system awarded by either a national or state specific

agency (Winterbottom & Piasta, 2015).

Quality Rating Systems. There are two quality rating tools commonly used to

evaluate program quality of licensed childcare centers; the Early Childhood Environment

Rating Scale-Revised (ECERS-R; Harms, Clifford, & Cryer, 1998) and the Classroom

Assessment Scoring System (CLASS; Pianta, La Paro, & Hamre, 2008). The CLASS

uses observations and a scoring system with a common metric and vocabulary for trained

professionals to examine instructional quality including teacher–child interactions

throughout early learning environments (Rodriguez & Garza, 2014). Likewise, ECERS-

R-R is widely used as an observational method to measure the quality of an early learning

classroom based on documenting relations between childcare quality and elements of

child development (Mayer & Beckh, 2012; La Paro, Hamre & Pianta, 2012). ECERS-R-

R has been used, adapted and validated in more than 20 countries, although it is limited

within a cultural context as studies on its effects have been done independently of cultural

and theoretical backgrounds (Mayer & Beckh, 2016).

While these tools are widely accepted and used throughout state QRIS systems, as

well as studied for reliability and validity, they are not without their faults. One


significant failing of the environmental rating systems is a limited knowledge around the

tools’ technical adequacy and the high need for inter-rater reliability (La Paro et al.,

2012). Additionally, within the ECERS-R there remains a concern regarding the

response process validity, structural validity, and criterion validity. By using a stop

scoring method (meaning when the environment rates low in one area the rating stopes

for the section without further credit given for aspect in higher quality that may be

observable in the environment), some of the higher quality indicators will be missed

(Mayer & Beckh, 2016). This will lead to structural validity issues and criterion issues

due to a heavy emphasis put on one set of factors and a tendency to underestimate the

associations between quality care and child outcomes (Mayer & Beckh, 2016). Finally,

evaluations of QRIS systems have focused on rating system only and not on the

components assisting quality improvement (Boller et al., 2015).

Over the past several decades, with pressure from policy makers to increase child

outcomes and public accountability for success in education, the early learning

community has recognized the educational and developmental benefits to ensuring

quality in childcare that rises above minimal health and safety measures (Elicker,

Ruprecht, Langill, Lewsader, Anderson & Brizzi, 2013). To this end, the majority of

states have begun the process of implementing childcare QRIS as a means to encourage,

measure, and assess the quality of childcare programs (Boller et al, 2015). This national

movement gained momentum when the Department of Education introduced the Race to

the Top Grant requiring state agencies awarded the grant to implement a QRIS system.

Unfortunately, there is no evidence demonstrating that one type of QRIS is better

than another (Boller et al., 2015; Elicker et al., 2013). Additionally, details of quality


have yet to be universally defined, although there is some agreement on the general

qualities of high quality childcare. Some of these areas are classroom curriculum

founded in research including elements of social, emotional and cognitive development

as well as appropriate child and program interactions and assessments, strong

professional development requirements, teacher support systems including child to staff

ratio and class size, programming that meets the needs of diverse learners, family

engagements, and availability of consistent and enough quantity of care (La Paro,

Thompson, Lower, Kintner-Duffy & Cassidy, 2012; Wechsler, Melnick, Maier & Bishop,

2016). These qualities, amongst other, are found in popular QRIS rating tools such as the

ECERS-R and CLASS (La Paro et. al, 2012; Rodriguez & Garza, 2014).

La Paro et al. (2012) expressed some cautions when using quality indicators to

increase regulations and other accountability systems in early education. Because

program quality is so strongly tied to child outcomes, there is concern that current

assessments are far too general and global in nature without providing enough

information on how programs can improve. In other words, the system of quality

improvement is moving faster than a common definition and improvement constructs can

be put into place. There is limited understanding by stakeholders as to what exactly is

being measured and how to improve program quality which can potentially lead to

increased spending with weakened returns. Karoly, Zellmaon and Perlman (2013) also

found that the systems are designed to rate the overall quality of the program and often do

not reflect the individual qualities of the classrooms.

The limitations of the rating systems are not the only concern that should be

considered. Hotz & Xiao (2011) argued that imposing regulations on quality may have


unintended negative influence on the market for childcare services. It is possible stronger

regulations reduce the number of childcare centers in the lower-income markets which is

not offset by increased workers or increased family home providers. This may be due to

the fact it costs more money than a provider in a low income neighborhood may be able

to charge for services to employ and maintain a higher quality program (Hotz & Xiao,

2011). It may also be due to a lack of social acceptance for the need for higher quality

care (Artz & Welsch, 2014).

Artz and Welsch (2014) found that, even with the complication of limited quality

measures, quality programming has limited impacts on the cost of childcare. Cost is

primarily determined by the degree of market forces, the influences of geographic regions

and, to a small degree, the quality of the program (Artz & Welsch, 2014). This may be

because the consumer may not understand and/or recognize the attributes and benefits of

quality childcare; therefore, there is little incentive for a provider to invest in higher

quality standards (Artz & Welsch, 2014).

Licensing. Childcare programs are required to have and maintain a childcare

license as the first step in quality rating (Kirby, Caronongan, Malone & Boller, 2015). In

fact, this is a beginning requirement for all QRIS rating tools and accreditation programs;

without licensure it is not possible to become rated on the quality rating scale or be

considered for accreditation (National Association for the Education of Young Children,

2016). The process of evaluating licensed childcare remains critical because children are

a vulnerable population and often do not have the communication skills nor knowledge to

sufficiently advocate for their right to a safe, healthy and developmentally appropriate

care situation (Kayira, 2016; Lapp Payne & Testa, 2014; Moloney, 2016).


The monitoring of licensed childcare centers for the purpose of continued state

licensure requires impartial, objective and independent observations and documentation

and adequate follow up (Kayira, 2016). Additionally, stakeholders need to understand

annual licensing oversight is more than simply a way to keep children safe but also as

tool to reach and maintain program objectives and a foundational level of quality goals

(Strain et al., 2012). According to NAEYC’s position statement, public regulations

ensure children’s rights to environments protecting them from harm and that provide an

outlet for healthy development are the minimum requirement for a childcare business to

operate (Crowley et al., 2013).

Even though every state regulates licensed providers differently and with a variety

of regulations among states, there exists general agreement of licensing standard

categories across the nation. The licensing regulations center on reducing environmental

hazards in which to protect children from injury, illness and abuse (Connors & Morris,

2014). Many states have begun to include regulations which address some level of

developmentally appropriate programming, requirements for communication with

families, staffs experience requirements, and professional development, and some limited

educational components (Connors & Morris, 2014). For example, Table 2 provides the

eight sections of licensing regulations from Washington State. Each topic includes

subtopics of the category and is assigned individual administrative code numbers. Table

2 is summation of the Washington State regulations monitored during routine monitoring

visits as well as complaint inspections (when there is an external complaint regarding a

facility) and health and safety re-checks after violations are found and corrected by the

provider. It is important to note that Washington State has separate Washington


Administrative Code (WAC) for licensed family home providers and school age

providers. While each set of regulations are similar, the example below is specific to

licensed childcare centers (DEL.com, 2016).

Table 2: Washington Administrative Code Chapter 170-295: Minimum Licensing Requirements for Childcare Centers

Standards Category Topics within the Category

Licensing

Staffing

Licensing authority, definitions, who needs licensed, subsidy eligibility, other required regulations, Waivers, dual license, application requirements, personal characteristics, capacity determination, initial and non-expiring licensing, denial, civil fines, revocation, probationary license, location of facility,

Director requirements, lead teacher requirements, assistant requirements, volunteer requirements, ongoing training requirements, orientations, first aid and CPR, HIV, AIDS and blood borne pathogen training, TB testing requirements.

Program Play materials, equipment and activities, length of time a child can be in a center, staff interactions, behavior management and guidance practices, rest periods, evening and night time care requirements, offsite, kitchen activities, special requirements for infants and toddlers, outdoor play area.

Health and nutrition Required health policies and procedures, hand washing, illness exclusion, medications (requirements, consent, documentation and storage), use of bulk medications, left over medications, delivery of medications, promotion, hygiene, cleaning, sanitizing disinfection, health protection, care plans and adaptation and illness management, milk requirements, meals and snacks (food types, sources, service, storage and thawing), kitchen materials and equipment, eating and drinking equipment.

Care of young children

Minimum age, nutritional needs, Bottles including formula and breast milk (preparation, storage, cleaning), feeding infants and toddlers, toileting, sleep equipment, safe sleep practices, diaper changing, nurse consultant, change of clothing

Safety and environment

First-aid supplies, safety maintenance, disaster planning, cleaning and sanitizing, water activities, maintenance and storage of janitorial supplies, water health, sewage and liquid waste, fence requirements, toilets, handwashing sinks and


bathing facilities, laundry, sleep and nap equipment, children’s storage space, facility temperature, pesticides, animals

Agency practices

Records, reporting, and posting

Discrimination, religious activities, American Indian children, child abuse and neglect, prohibited substances, unsupervised access

Child files, immunizations, attendance records, record availability and electronic records, facility records, policies, reporting, and postings

Administration Governance, policies, human resource management and records

Licensing and community action

Regulatory policies, licensing agency, facility licensing, role of the Health Department, caregiver and teacher support, public policy and resource management

One of the common trends revealed in an analysis completed by the National

Center for Childcare Quality Improvement (NCCCQI) (2013) is the predominate

inclusion across all states of increased safe sleep practices, increased preservice training

requirements for center directors and all staff training hours, increased background check

requirements, and added health and safety requirements. Enforcement trends included an

increase in inspection frequency, publicizing licensing information on websites, and use

of electronics during licensing visits. The report by NCCCQI (2014) outlined strategies

used by states to identify and limit harm to young children including educational

campaigns, increasing data systems, increasing monitoring visits and technical assistance,

and more.

There are cautions when making regulatory design overly complicated and strict.

Maloney (2016) found, teachers in England overwhelming reported an increase in

concern around inspector inconsistencies and their lack of understanding for the needs of

early learners. Because of this lack of confidence toward the inspectors, the weight of the


findings was lessoned in relevancy (Maloney, 2016). Therefore, there is concern that

policies and inspections become more about simply controlling the environment rather

than including systems to support childcare providers within the early learning

community (Maloney, 2016). It is for these reasons individual states must continuously

assess monitoring systems to include holistic programming support.

All states require some routine inspections to monitor compliance of state

mandated childcare regulations but no two systems are alike (Alkon et al., 2015; Crowely

et al., 2013). Much of the research completed over the past three decades defines three

key theoretical approaches to monitoring licensed childcare for improved health and

safety in group care as well as limited requirements addressing social and emotional

development (Fiene, 2014; Fiene & Carl, 2010; Fiene & Nixon, 1985). Common

methodologies include routine unannounced inspections with a combination of standard

weighting (the classification of regulation importance) and/or a key indicator system

(standards with statistical evidence of reliability or probability of full compliance or non-

compliance) and differential monitoring (the frequency of inspections) (Fiene, 2014;

Crowley et al., 2013). Most states use either a weighted system of monitoring or an

indicator system, but not both (Fiene, 2014).

Differential monitoring is a regulatory method for determining the frequency and

depth of monitoring based on an assessment of a facility’s history of compliance with

licensing standards (Fiene, 2013). A differential monitoring system can be used to

recognize a provider’s strong record of compliance with abbreviated, or less frequent,

inspections (Fiene, 2013). For example, Oklahoma uses a differential monitoring system

requiring three monitoring visits per year for providers with a clear history of compliance


while providers with serious noncompliance issues may receive as many as 12 monitory

visits each year with intensive technical assistance (NCCCQI, 2014). This type of

monitoring system was also shown to be implemented at increasing frequency across the

nation within the past decade (NCCCQI, 2013).

A licensing key indicator system is defined as specific rules statistically

predicting overall compliance with all the licensing rules (Fiene & Carl, 2010). It is

important to note, key indicators are not necessarily those rules most frequently out of

compliance, nor place clients at the greatest risk (Fiene & Carl, 2010). Fiene found the

13 areas most likely to predict compliance include child abuse prevention,

immunizations, adult child ratio, group size, staff qualifications and training,

supervision/discipline, fire drill, medication administration, emergency plan/contact,

outdoor environment, inaccessibility of toxic substances, and proper hand

washing/diapering (NCCCQI, 2013). The methodology outlines that if one of the

indicators within the key categories are found to be non-compliant than it probable other

areas within the program will also be out of compliance (Fiene, 2010).

For example, Washington State uses a combination of both the key indicator

system and the differential monitoring system (Hyde, 2011; NCCCQI, 2014). Feine’s 13

Key indicators (2010) are used as the core of an abbreviated checklist used for

monitoring visits by providers with high levels of compliance (NCCCQI, 2014). Being

found in non-compliance on one of the key indicators triggers the licensors to move to a

comprehensive checklist making the system both a differential and key indicator system

(DEL.com, 2015; Hyde, 2011; NCCCQI, 2014).


The key indicator system was predicted to reduce workload gradually as licensors

would have additional time to provide technical assistance thereby increasing areas of

compliance (Hyde, 2011). Other advantages of the key indicator system were thought to

include a systems responsiveness to changes, consistency between monitoring visits,

coverage of all regulatory areas, and a potential to be a cost effective monitoring method

(Fiene & Nixon, 1985; Fiene, n.d.). Nevertheless, research has not demonstrated the

efficiency of monitoring theory including the social acceptance of the monitoring system

and the effects of licensor- licensee relationship on monitoring compliance.

In addition to ensuring children’s health and safety, states are working on

additional oversight methods to incorporate important elements of program quality that

have foundational programming requirements to optimize children’s ability to learn and

develop (Crowley et al, 2013; Li et al., 2015). Licensed oversight agencies are working

with quality rating administrators to provide holistic evaluations of all childcare

providers. In fact, the 2014 Childcare Development Block Grant (CCDBG)

reauthorization included specific requirements for monitoring agencies of all types to

coordinate efforts (Maxwell, Sosinsky, Tout & Hegseth, 2016). Even with the

coordinated efforts, state licensing requirements and monitoring tools remain restricted to

state administrative codes and revised codes passed only by state legislative bodies. The

main focus of state licensing standards remains centered on the health and safety

standards that provide the foundation for quality standards.

An overwhelming majority of directors reported using the state licensing

regulations as the main standards guiding program expectations and curriculum planning

rather than using early learning standards. Early learning standards have been developed


by national and state organizations such as NAEYC, Head Start, etc. These standards

outline the kinds of things children should be learning and doing as a result of early

learning programming. Juxtaposed to early learning standards, licensing regulations

provide the foundational guidelines for children to meet learning standards by ensuring a

foundational level of quality; those regulations that ensure children are cared for in safe

and healthy environments (Ackerman & Sansanelli, 2010).

Even though there are no federal guidelines for states to design licensing

regulations there is a high relative consistency in licensing regulations across the country

in the area of minimum health and safety standards and a common understanding that

health and safety standards are the foundation of quality programming (Connors &

Morris, 2015). Because directors overwhelming uses these regulations as the guide to

their programming, it is critical to ensure licensing regulations are effective in providing

foundational quality programming and reduce instances of licensing violations

(Winterbottom & Jones, 2014). Every state has a different method in assisting programs

move beyond basic licensing compliance to quality improvement programs.

Social Validity of the Evaluation Process. Bronfenbrenner’s ecological theory

(1978) is used to provide the framework in which the importance of social acceptance in

childcare oversight is justified. The value society places on childcare programs plays a

critical role in licensing oversight. The ecological systems theory identifies four

environmental systems that influence human development; the microsystem (individual

traits and social interactions affecting individual perceptions including family, friends,

teachers and so on) the mesosystem (the system including the environment in which

children live such as home, church, school and the neighborhood), the exosystem (the


cultural context such as media, dominant industries and political climate) and the

macrosystem (the greater social context such as culture, beliefs, laws and ideologies)

( van Dijken, Stams & Winter, 2016; Kohl, Recchia, & Steffgen, 2013). Each of the

systems interact with one another to make up the totality of a child’s learning influences.

In order to ensure children have healthy and safe environments in which to learn,

licensing systems must consider each of the systems within the ecological theory in order

to be affective. For example, the interactions of peers and family interactions influence

the entire school climate (Kohl et al., 2013). If parents do not trust the school system to

ensure their child’s safety, children will likely adopt those feelings limiting learning

success. Likewise, if providers do not trust the outcomes of monitoring visits as an

effective tool for improvement, the regulatory outcomes are less likely to be important to

the provider. Additionally, if providers have limited investment and communication to

the licensing agency, the licensing agency may hold negative views about the provider

community.

Many childcare licensing issues cross the ecological systems including

community culture, ideological factors, political climate, socioeconomic factors, and

family structure. Van Dijken et al. (2016) explained how a high value for identifying

and understanding protective factors to young children and the role of the exosystem such

as neighborhoods and childcare communities can limit child injury and maltreatment.

When providers understand and incorporate the context of keeping children safe as a

foundation of early learning, licensing systems are able to effectively implement

protective factors through appropriate law development and oversight methods inclusive

of each of the ecological systems (Kohl et al., 2013).


In 1978, Wolf introduced the concept of social validity. The concept states that

society needs to validate critical work in order to ensure it is what they really want, that

the results of the work justify the means to get there, and that they are satisfied with the

work being done. By ensuring the social buy-in of childcare licensing tools, the work

licensors and providers do to ensure the health and safety of children is not only socially

valid but also relevant. Therefore, monitoring licensed childcare centers requires

impartial, objective and independent observations and documentation and adequate

follow up ensuring the childcare industry’s commitment to providing the best care and

early education possible for young children (Kayira, 2016). On the other hand, it is not

clear if the monitoring tools used to conduct childcare evaluations are consistent, reliable

and valid for the purpose for which they are used, and perceived by all stakeholders to be

valuable and useful

Many children spend a great deal of time in formal childcare; therefore, it is

critical that early childcare programs provide environments that are safe, healthy and

provides quality for learning (Crowley et. al, 2013; Houston, 2015). The tools used to

assess early learning programs must be valid and reliable in order to provide a firm

foundation of health and safety standards that ensure that children are ready to learn

(Crowley et al., 2013). Developing reliable and valid assessment tools that provide a

clear understanding of the inspections relevance and significance to achieving program

goals can only increase the benefits of early childhood programming (Li et al., 2015;

Strain et al., 2012).


Summary

Balancing the need for regulation to contribute to the health and safety of young

children as well as improve quality in licensed childcare without providing excessive

oversight is not an easy task. With so many children being cared for in licensed facilities

it is critical licensors and providers understand that regulatory processes are reliable,

compatible and effectively evaluated to meet their needs and will effectively aid to lessen

the unintended effects of higher standards (Moloney; 2016; Strain et al., 2012). Moloney

(2016) explained how when early educators do not value the results of regulations due to

adversarial relationships, or believe they are being unfairly regulated, the results have

little to no meaning. One way to ensure this does not happen is by concentrating on the

consistencies of licensing as a logical way to improve the quality of health and safety of

early learning environments. In this way the licensing tools’ usefulness provides a clear

understanding to all stakeholders how licensing guidelines can be used to develop a

partnership around the best evaluation of programming and quality improvement (Wolf,

1978).

Chapter 3: Research Method

When concentrating on only the standards licensed facilities must meet, and not

evaluating the reliability and validity of the monitoring process, the effects of annual

monitoring on quality program development cannot be determined. The purpose of this

mixed method program evaluation is to evaluate the reliability and validity of the focused

monitoring tool used in Washington State, as well as its value and usefulness in

maintaining quality and effective programming in licensed center Childcare programs.

This section describes the research methods and study design as well as how data will be


collected and analyzed to answer the following research questions: (1) How do

stakeholders describe the value, usefulness, and effects of state administrated focused

monitoring; (2) Is the focused monitoring observation tool a valid and reliable measure of

the foundational health and safety concerns that must be met by state licensed early

childhood programs?

The Washington State Department of Early Learning (DEL) made changes to the

monitoring system in 2011 to increase efficiency and improve relationships between

licensors and providers (Alkon et al., 2015; Hyde, 2011). Changes to the licensing

system included the use of an electronic checklist during monitoring visits and the use of

a differential key indicator model (Hyde, 2011). Policy (located in Appendix B)

currently states that when one of the key indicators is found to be non-compliant during

an abbreviated inspection (Appendix C), the licensor must move into a longer and more

inclusive checklist (Appendix D) (DEL.wa.gov, 2016). Differential monitoring was

intended to focus on the indicators proven to keep children safe in licensed Childcare

when using the abbreviated checklist, saving both time and resources (Fiene & Carl,

2010).

The key indicator-differential monitoring system was predicted to reduce

workload gradually which would give licensors additional time to provide technical

assistance, build trusting relationships with providers, and increase compliance with

quality programming standards (Hyde, 2011). With so many children in licensed

Childcare, it is critical Washington State uses a reliable and valid monitoring checklist

system.


Research Method(s) and Design(s)

The program evaluation research design will be guided by the Context, Input,

Process, and Product Evaluation (CIPP) (Stufflebeam & Shinkfield, 2007). CIPP

provides a framework for integrating program evaluation with program management and

development. Using this framework, three broad tasks are performed for each type of

evaluation: (1) delineating the information needed for decision making; (2) obtaining the

information; and (3) synthesizing the information to make programmatic decisions.

The context evaluation involves the identification of problems and needs that

occur in a specific setting and provides the basis for developing objectives that will lead

to program improvement. The input evaluation involves collecting information about the

resources and strategies needed to accomplish program goals and objectives and

determining constraints, which requires a wide range of knowledge about possible

resources and strategies and their effectiveness in achieving the desired outcomes. The

process evaluation requires the collection of evaluative data to monitor the program as it

operates day to day, which allows for the identification of problems in their early stages

so they can be solved before they cause irreparable damage to the project but can also

provide useful information about the strengths and weakness of the project that may

account for the observed outcomes. The product evaluation is conducted to determine

the extent to which the goals of the program have been achieved by developing measures

of the program goals, administering them, and then using the results to make decision

about continuing or modifying the project.

CIPP (Stufflebeam & Shinkfield, 2007) was the model chosen to guide the

evaluation because the goal of the study is to allow multiple inputs from all stakeholders


in order to understand Childcare monitoring consistency between licensors in action (Fry

& Hammer, 2012). Table 3 presents a timeline that will guide the program evaluation

and shows that the project will be initiated by engaging representative stakeholders (e.g.,

childcare centers, licensors, and Department of Early Learning leadership). The process

will begin with a context evaluation: The intent of this stage is to assess and choose an

appropriate strategy to identify and resolve program problems (Frye & Hemmer, 2012).

An Ad Hoc focus group consisting of licensors and licensing supervisors from across the

state as well as a representative from Information Technology (IT) will identify the

problems and needs of the current licensing checklist system and create the objectives

that will lead to program improvements. This will take place over a two-week period

with one to two meetings each week.

Next, an input evaluation will utilize the same Ad Hoc committee to identify the

WAC and RCW that will be placed on the core items of the focused monitoring checklist

as well as the procedures licensors will use in conjunction with the tool. The

identification of WAC and RCW will utilize a collection and analysis of those items most

cited within the current checklist system over that previous 12-month period leading to

significant risk to children. Significant areas of risk will be identified through those

citations that have led to injury or illness of children and or adverse actions to the

childcare license such as summary suspension, civil penalties, or revocation. Information

will be gathered through the FamLink database. The input evaluation will take place

over a 2 to 3- week period of time.

The process evaluation will consist of a pilot where 4 to 8 sites will be evaluated

using the focused monitoring tool and identified procedures over a one-month period of


time. In order to identified the usefulness of the focus monitoring tool for licensor (social

validity), post focus groups of licensors and their supervisors will be gathered to discuss

the findings as a baseline for the formative and summative assessments. Interviews of

the providers will also be used to assess the social validity of the focused monitoring tool

from the licensee perspective. Finally, the final months of the study will consist of the

product evaluation where the researcher will gather and analyze the data to determine the

extent to which the goals of the program have been achieved. The results will be used to

make recommendations of the reliability and validity of the focused monitoring tool as

well as any recommendation to the continuation and needed modifications of the project

(Stufflebeam & Shinkfield, 2007).

Table 3: Project timeline

Dependent on IRB approval in September 2016

September-November(a) Context evaluation

Facilitate internal (licensing staff and supervisors) focus meetings to identify current challenges and needs of the monitoring system

December(b) Input evaluation

Identify and contact providers for participation Identify and contact center licensor from each region

for participation. Facilitate focus meetings to design the focus

monitoring tool (four meetings minimum) Collect data from the DEL database to create the

checklist specific to each site previously identified

January-February(c) Process evaluation

Conduct licensor training for the use of the monitoring tool

Conduct monitoring visits with the focused monitoring tool

Conduct post visit interviews with the licensors and providers

February-April(b) Product Evaluation

Complete final dissertation project Present finding to the appropriate

stakeholders/defense


Overall, descriptive statistics and input analysis will be conducted to the target

sample population in the form of focus groups and interviews pre and post pilot

implementation. This will gather information regarding intended changes as well as the

relations between monitoring procedures and licensor reliability through literature review

and focus groups. Licensors and providers will be identified and invited to participate in

a controlled study to discover how using the focused monitoring checklist system effects

the consistency of annual regulatory oversight. The overall design of the study requires

an understanding of how licensor reliability and validity affects the outcomes of health

and safety for children in care; making the evaluation method appropriate for this study.

Population

According to a report by Childcare Aware of Washington (Washington’s source

for Childcare resource and referral), there were more than 23,500 requests for referrals

for families seeking licensed care in Washington State in 2015 (Kelly, 2016). Of the age

of children seeking care, about half were for children 3 years and younger. Of those who

provided demographical information, roughly half the children needing care were from

single-parent families and more than 80% considered themselves low income. Licensed

facilities available to meet the need totaled more than 5,700 including Childcare centers,

family home providers and school age programs with a Childcare capacity of over

166,000 (Kelly, 2016).

Childcare centers are located throughout Washington State and is inclusive of

both urban and rural settings. According to Washington States’ Office and Financial

Management Population Trends Report (2015), Washington has a population of over 7

million individuals with more than 15 main languages spoken; The most prevalent used


in Childcare centers being English, Spanish, Russian, Somali and Vietnamese. The

licensing division is separated into four different regions. Region 1 (Eastern Region) is

the largest geographically covering all 20 counties west of the Cascade mountains. This

region provides oversight from four licensing offices located Yakima, Wenatchee, Tri-

Cities and Spokane and is responsible for approximately 1548 childcare providers

speaking. Region 2 (Northwest) contains the five northwestern counties in the state and

provides oversight from four offices located in Bellingham, Mount Vernon, Everett and

Bellevue. Region 2 is responsible for approximately 1412 licensed providers. Region 3

(Southwest) contains 13 counties northwest of the San Juan Islands down to the Oregon

border and has about 1431 licensee. Region 3 has three main licensing offices in

Olympia, Tacoma, and Vancouver with three satellite offices in Aberdeen, Kelso and

Port Angels. Finally, Region 4 (South King County) is located in South King County and

provides oversight by three licensing offices in Renton with approximately 1366

licensees (DEL, 2015). Figure 1 shows the licensing map by region and office.

Figure 1: DEL Childcare Licensing Map

To be a licensor in the state of Washington applicants must have at minimum of

one-year experience as a social worker or have a master’s degree in social services,

human services, behavior sciences or a related field as well as related work experience.


Also a licensor may be hires if they have a bachelor’s degree in those same fields of

study and three years of equivalent experience. Additionally, licensors are expected to

have knowledge of child development, risk assessments, interview techniques, service

delivery, community resources and others. Childcare licensors in Washington State vary

in age, gender and ethnicity and all are fluent in English.

Sample

Four licensing field offices, one from each of the four regions of Washington

State (Eastern, northwest, South King County and Southwest) will be selected to

participate in the study. One or two licensors from each office will be recruited for a total

sample of 4-8 licensors. The sample will be generated from data gathered through DEL’s

internet database called Toolkit. The licensor Toolkit is an electronic system that is used

to track due dates of required licensor actions including complaint inspection timelines as

well as due dates for annual monitoring visits, health and safety rechecks, and more.

Individuals vary in gender, age and ethnicity and all speak English proficiently.

Four to eight different center licensors will be recruited from varying locations

around Washington State. Provider sites will be identified by searching through the

licensor Toolkit to select multiple sites from the participating licensor database with

annual monitoring visits due during the study timeline. Office supervisors will be

consulted to identify those sites who might be interested in the participating in the study

and then the researcher will contact the site administrator to recruit the provider

participants. It is possible not all providers are English speakers; therefore, it may be

important to consider enlisting translators for the interview process. Provider interviews

Author, 01/03/-1,

I retrieved this information via an email document sent to me by an HR staff. Do I cite this as an email?


will be conducted in the providers’ place of business or by phone as to not require

participants to travel or unduly interrupt daily operations.

Materials/Instruments

Context. In order to apply the study to the appropriate context, archival data will

be presented at the first round of Ad Hoc meetings including foundational information

uncovered during the literature review process to create a shared understanding of the

monitoring methodology and process. Additional data for the context evaluation will be

collected within the DEL internal databases previously described to adequately identify

the strength and weaknesses within the current annual monitoring system. This two-

week process will allow the identification of needed program improvements and the

creation of program objectives.

Input. Input evaluation data will be collected through focus group meeting notes,

electronic input from licensing database and post-pilot interviews. A second round of

meetings with key stakeholders, including program leaders and licensing staff will be

used to identify procedures that will be utilized in the input phase of the study as well as

identify and incorporate the political climate factors that could influence the success of

the study. Data collection in this phase of the study will include both formative and

substantive measures in the form of document analysis from meting notes and interviews.

A second set of archival data will be collected from the DEL internal data base FamLink

to identify the focused monitoring checklist contents. FamLink is a Web based system

used to track monitoring information recorded from licensors including date and time of

monitoring visits, narrative notes and documented areas of non-compliance in the form of

Facility Licensing Compliance Agreements (FLCA) (Del.wa.gov, 2016). Field notes


written by the licensors and information provided on the FLCA associated with the

identified participants will be collected to provide a partial baseline for the focused

monitoring tool including but not limited to specific standards in which a provider has a

history of non-compliance and citations leading to adverse actions such as civil penalties,

summary suspension and license revocation.

Narrative data will be collected through pre-participant interviews to establish a

baseline of social validity of a focused checklist system. Interviews will be completed

with each of the participating licensors and providers containing 15 questions, open and

close ended, pertaining to monitoring visits, the use of the differential checklist system,

and the value of Washington Administrative Code (WAC). Questions will be both open

and closed ended such as: What are the expectations you have during monitoring visits?

What are the Washington Administrative Codes and/or Revised Codes of Washington

(RCW) that justifies a move from an abbreviated checklist to a comprehensive checklist?

What is the process of completing a checklist upon entry into the site and why? Still to

be developed includes interview protocol and finalized questions as well as any survey

materials and apparatus.

Process. The first step of the process evaluation is to conduct licensor training in

which to evaluate the reliability and validity of the monitoring tool. This will be done on

a one-day workshop with the presentation of the guidelines identified by the Ad Hoc

committee through paper and PowerPoint presentations. Once this is completed, the pilot

using the focused monitoring system will be implemented with specific measures of

inter-rater reliability considered.


Data in the process evaluation will be collected by information from the focused

monitoring checklists system as well as provider post visit surveys. Current licensing

checklists are on a data base called Electronic Licensing Forms (ELF) and may not be

able to be altered to fit the needs of a focused monitoring checklist. Therefore, the tool

used for the pilot will most likely be in a paper format of the checklist system designed

by the Ad Hoc committee with specific input from the IT representative with a focus on

future implementation abilities. Completed forms will be submitted to the researcher and

will be stored on a secure state computer hard drive with a backup on the researchers

personal USB drive with any confidential information redacted.

Post interview questions will then be used to collect additional data regarding the

usefulness and validity of the focused monitoring tool. They will take place using an

unstructured format in order to allow for a wide range of input via phone calls or in

person interviews. Interviews will be completed with each of the licensors and providers

containing approximately 15 questions, open and close ended, pertaining to the focused

monitoring visits. Questions will be both open and closed ended such as: How did the

monitoring visit meet your expectations? What was the value you perceived about the

focused monitoring system? What were the challenges found while completing the

focused monitoring system? What was the process of completing a checklist upon entry

into the site and why? Still to be developed includes interview protocol and finalized

questions as well as any interview materials and apparatus.

Product. The product evaluation will measure the extent to which the goals of

the program have been achieved. This section of the study is where the licensor activities

are documented and assessed by the researcher. This study will focus on a close


examination of the oversight outcomes and any other relevant groups or individuals

affected by the study with a special focus on the social validity and consistency of

licensors focused monitoring outcomes (Frye & Hemmer, 2012; Strain et al., 2012;

Stufflebeam & Shinkfield, 2007). Additionally, it will evaluate the effects of the changes

on practice and outcomes including the positive and negative effects along with possible

short and long term effects (Frye & Hemmer, 2012).

The tools used to accomplish this task will include ?. Results will inform

program improvement of Childcare licensing monitoring tools, training procedures and

the successes and challenges of a collaborative monitoring process.

Data Collection, Processing and Analysis

Context. Background summation and analysis will be conducted by the

researcher over a period of one month during the first stage of the four-month study and

will done from the researcher’s place of study. It will include an analysis and written

summation in a single written document of existing documents inclusive of previous

licensing analyses, Ad Hoc meeting notes, policies regarding the current monitoring

process, stakeholder input and any other narrative information collected in the context

portion of the study. This will then be shared with the focus group to create a shared

understanding of the process goals as well as the methodology for the focused monitoring

system.

Input. Ad Hoc meeting notes will be complied and used as the baseline analysis

for the creation of the focused monitoring tool using. Subsequent data will be collected

through CIPP surveys including both closed- and open-ended questions. The pre and

post interviews will be conducted of the research participants by the researcher at the

Author, 01/03/-1,

I assume the tools used here will be the statistical processes – I don’t know what these would be yet


participants’ place of business as to not place undue burden on the participants.

Interviews will be taped and transcribed verbatim and entered into the coding software

database called NVivo™ for organization and analysis. This will be done over a three-

week time period following the first month of the project by the researcher. Descriptive

analysis will be applied to the data collected from the CIPP survey close-ended questions.

The data collected from the open-ended question will be analyzed using the NVivo™

coding analysis software with data categories found within significant statements.

Codes will be taken from primary data collection and may include themes from

key words or phrases such as: Indictors, Fiene indicators, administrative code,

compliance, non-compliance, technical assistance, interruption/interruptive, routine,

safety, Facility Licensing Compliance Agreement and so on. These words will then be

clustered together into five main categories such as regulation (RE), technical assistance

(TA), routine (RO), health (HE), and safety (SA). Codes within the categories may

include critical indicators (CI), non-critical indicators (NCI), Fiene indicators (FI),

differential monitoring (DM), Washington Administrative Code (WAC), and so on.

Codes will be adjusted as needed based on the interview outcomes. Data will be

compiled and cross compare in order to establish commonalities in practice and thought

which will be incorporated into the focused monitoring tool.

Process. Once the focused monitoring process is developed, licensors will be

trained to use the tool to monitor identified sites following a developed protocol over a

one-month time frame at the licensed facility. Licensors will conduct the unannounced

monitoring visit within the required timeline using the paper format of the monitoring

checklist system. The checklist will contain a series of standards to be observed during


the site visit within each of the main identified sections. The focused checklist may

include 2 to 3 WACs that put children at the highest risk (weighted), 2 WACs identified

as Key Indicators, 1-3 WACs with a history of compliance issues specific to that site, and

at least 1 random WAC for a total of no more than 8 WACs in each of the eight standard

areas (Staff requirements, cleanliness and sanitation, programming, environment, etc.).

The amount and combination of WACs to be included on the checklist may be altered

during the input phase of the study. Each of these items will be marked by the licensors

as compliant, non-compliant, or not observed. If any of the identified WACs are found to

be non-compliant in a section, the licensor will complete the comprehensive checklist for

that section only and then move onto the next section repeating the process for each

section. Once the checklist is complete the licensors will complete the electronic version

of the Facility Licensing Compliance Agreement (FLCA) with the provider in accordance

to DEL monitoring policy.

Licensors will record visit results and narratives within the current electronic

database and send an electronically scanned copy of the focused monitoring checklist to

the researcher via secured state email. Information will be gathered under the new

operating systems to identify critical consistencies of the monitoring visits during each

licensors monitoring visit. This will include, but may not be limited to the length of visit,

the amount and type of technical assistance provided by the licensor, and the amount and

type of areas found in non-compliance and so on. Information will be transferred onto an

Excel spreadsheet and stored on the researchers secured hard drive. Post-interviews will

be conducted by the researcher for analysis.


Product. Narrative data will be gathered through post interviews conducted by

the researcher with the providers and licensors as well as the licensors written narratives.

This will take place in the final two months of the six-month study and at the

participants’ place of work as to not place undue burden on the participants. Post

monitoring visit interviews will be conducted using the same guidelines as the interviews

in the input phase of the study. Once again, interviews will be taped and transcribed

verbatim and entered into the coding software database called NVivo™ for organization

and analysis. Descriptive analysis will be applied to the data collected from the close-

ended questions. The data collected from the open-ended question will be analyzed using

the NVivo™ coding analysis software using the same data categories used previously.

This will allow for a cross analysis of the data to evaluate the effects of the focused

monitoring system on programming and general value of the monitoring system.

Summary

The responsibility for compliance at all times ultimately lies with the licensed

Childcare provider. Previous research has concentrated on the validation of tools such as

standardized health and safety instruments, key indicators and differential monitoring

(Alkon et al., 2015; Fiene, 2014; Fiene, 2013). However, the best application of this

program evaluation study is to re-assess and make improvements of existing licensing

oversight monitoring tools in an attempt to improve licensor consistency through focused

technical assistance.

What is unique to this mixed method academic research project is it is centered on

how these systems can be used in conjunction with a focused monitoring system. This

study is designed to concentrate on how using the indicators and weighted indicator


system could potentially be used in conjunction with oversight in only the areas found in

non-compliance and if focused monitoring visits will increase social validity and

programming quality for children. As more and more children are entering into the

licensed Childcare systems it is critical to re-assess and maintain systems that provide

appropriate oversight, and ensuring each child’s health and safety.


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Appendices

Appendix A: Analysis of Licensor Compliance


Appendix B: DEL Monitoring Policy



Appendix C: DEL Abbreviated Monitoring Checklist







Appendix D: DEL Comprehensive (Long) Monitoring Checklist

nsive













Documents

Chapter 1: Introduction - drfiene.files.wordpress.com · Web viewThe purpose of this literature review is to describe the context and purpose of childcare and early education, a