Editor's Note: This is the latest in an occasional series of stories investigating Georgia day care centers and how they are regulated. Expect more coverage in coming weeks as we continue to dig into this vital issue affecting so many metro Atlanta parents and their children.
In three days, Amanda Hester would marry the quiet Army Ranger she met on Match.com. She took the rest of the week off to make final preparations.
The important details were covered — even the tiny tuxedo with a brown bow tie for the couple’s infant son Jace.
Hester’s cellphone buzzed as she was about to get her nails done.
The day care center called: Jace had stopped breathing.
Four-month-old Jace Hester is one of nine children who died in licensed day care programs across the state in the past five years.
Five of the deaths, including Jace’s, involved infants who died after they were put down for naps. Five of them were sudden unexpected infant deaths.
An Atlanta Journal-Constitution investigation into the infant sleeping deaths also revealed that:
• In four of those five cases, the children were put down to sleep on their stomachs — the dominant risk factor for SIDS.
• All but one of the infant sleeping deaths occurred at smaller, home-based programs.
• All five child-care providers had violated state regulations governing how infants should sleep at the time of the deaths.
• In cases in which infants are unharmed, the state does not fine day care programs that are caught putting infants to sleep on their stomachs.
Bobby Cagle, commissioner of the state agency that regulates child care, said this week that, as a result of the AJC’s reporting, he is hiring an expert to compare the deaths and injuries in Georgia’s programs to those in other states.
“Frankly, as [the AJC’s] investigation has continued, I have continued to ask questions myself,” Cagle said. “And my staff and I have decided that we really want to look more deeply at this.”
He also said he’s looking into providing more SIDS education and wants to find out why more infant sleeping deaths occur in smaller home-based programs.
News lead to more pain
Hester, 30, and Jace’s father called off their wedding.
The 100 or so family and friends who came to Albany to celebrate their wedding ended up mourning the death of their son. Hester refused to set foot in her home for a month, unable to look at Jace’s things.
Jace’s official cause of death: Sudden Unexpected Infant Death, or SUID. In such cases, the cause of death is not immediately obvious prior to investigation.
Sudden Infant Death Syndrome, or SIDS, defined as a death that cannot be explained after a thorough investigation, is a subcategory of SUID.
Deaths of children from any cause are rare in the nearly 7,000 day care programs in Georgia. The rate is slightly more than one death per 1,000 providers over five years.
Hester never saw Jace again, choosing not to view his body.
“People ask me if I regret it,” she said. “And I don’t, not for a second. I’ve spoken to a lot of mothers who have lost their children. And that’s how they remember them: laying there, gone.”
A month later, she and her fiancé, still feeling like they’d been mugged, found themselves in the county courthouse and walked out married.
No celebration. No honeymoon in Gatlinburg. She sold the dress that she never wore for about $200 on eBay.
Hester said she never felt anger toward Barbara Ann Fuller, the owner of the day care program where her son died, believing that Jace’s death was an accident and nothing more.
After Jace’s death, “I called her and asked her how she was,” Hester said. “And I thanked her for keeping Jace and told her how much Jace loved her.”
Then she read the report about the death released by the Georgia Department of Early Care and Learning, which regulates day care programs.
“My blood pressure when straight through the roof as soon as I saw that state report,” she said.
Pregnant with her second child, Hester miscarried the next day — and blames it on her reaction to the report.
The state revoked Fuller’s license after determining that she had violated 16 regulations, including having dog feces and urine on the floor of the room in which Jace died; having more children than allowed; putting Jace in a bedroom without proper supervision.
Though Jace’s death certificate lists the cause as SUID, it does not classify his manner of death as an accident, but rather “undetermined.” It also states that unidentified “external factors” contributed to his death.
“I was absolutely floored,” Hester said. “I could not believe it.”
Child care investigators did not cite Fuller for putting Jace to sleep on his stomach, but the Georgia Bureau of Investigation’s report states that Jace was found “laying on his stomach with his arms extended above his head. The position was the same as he was in when placed in the playpen.”
For three of the other infant sleeping deaths, the day care providers received violations for putting infants on their stomachs, among other violations.
“It just makes me really sad because people should know better,” said Dr. Rachel Y. Moon, a nationally renowned SIDS expert.
Moon said SIDS is not entirely preventable; one can only reduce the risk of a SIDS death.
And the most important way to do that, she said, is putting a child to sleep on his or her back.
Since 1992, when the American Academy of Pediatrics first recommended that infants be put to sleep on their backs, SIDS deaths nationwide have been cut in half.
Georgia has not seen the same decline; its SIDS deaths decreased significantly in the 1990s, but have fluctuated since.
Depression follows
Maddox Perry was a chubby baby, with bright blue eyes and big ears.
“He liked to eat a lot,” said his mother, Jennifer Perry. “He weighed almost 20 pounds already.”
On Oct. 12, 2009, Maddox’s day care provider, Sue Anne Clark, had a full house.
It was a state holiday — Columbus Day — and school was out. Her home filled with children.
She had a dozen that day, more than usual. The house was noisy, so she laid 4 1/2-month-old Maddox to sleep on a twin-size bed without safety rails in a back bedroom.
Then she called a cousin to chat.
A half-hour later, Clark found Maddox had fallen off the bed and gotten wedged between the bed and the wall.
He was resuscitated and taken to a local hospital, but never woke up. His mother took him off life support four days later.
Jennifer Perry said she wanted to sue Clark, whom she once considered a friend.
“I wanted to make her suffer, like she was making me and my family suffer,” Perry said.
But Clark had filed for bankruptcy nine months before Maddox’s death, citing $145,000 in debt, including $27,000 in taxes.
“My lawyer said that there wouldn’t be any money anywhere,” Perry said.
In its revocation notice to Clark, the state issued violations for failing to supervise Maddox, for putting him on his stomach to sleep and for caring for more children than allowed.
But the authorities decided not to pursue charges against her, saying they found no evidence of a crime.
Perry slipped into depression after losing Maddox. She gained 50 pounds. And she only recently started getting treatment for it.
“I just never really wanted to admit it and actually try to get help,” said Perry, who works as a medical biller and has an 8-year-old daughter. “I just tried to cope with it on my own.”
In a tiny town like Swainsboro — population 7,300 — Perry can’t help but run into Clark.
She has seen her taking her grandchildren to school. She’s seen her at the Walmart.
“It still makes me angry to see her out living her life with her grandkids and enjoying them,” Perry said.
Clark could not be reached for comment.
Sleeping guidelines
As recently as the early 1990s, most parents in America didn’t think twice about putting their children to sleep on their stomachs.
It wasn’t out of malice or neglect; babies sleep better and cry less on their stomachs, said Betty McEntire, executive director of the American SIDS Institute.
By 1992, however, researchers had documented the dangers and the word spread: Don’t put kids to sleep on their stomachs.
It wasn’t always an easy sell. New parents had to wrestle with skeptical grandparents who had raised children just fine by putting them on their stomachs.
Some child care providers have been reluctant to adopt the technique, McEntire said.
“So you have [child care providers] who’ve raised babies for years, including their own babies, and they’ve never had a death,” McEntire said. “And they’ve always put babies on their stomachs.”
It’s not clear how many Georgia child care providers have received violations for putting infants on their stomachs; DECAL could not provide that data.
The AJC did, however, determine that DECAL does not issue fines to providers for that violation, though it does fine providers who, for example, leave children alone on vehicles.
“I need to take a closer look at that,” Commissioner Cagle said. “Because I consider this to be as dangerous — if not more so — than leaving a child on a vehicle. So if we’re fining for leaving children on vehicles, and we’re not fining for leaving children on stomachs, then we need to take a look at that.”
It’s difficult to say whether more children are dying from SIDS or SUIDS in Georgia day care programs than in other Southern states. Two states don’t track that data; two others declined to respond to requests for information.
But, of four states reviewed, Georgia’s SUID rates do not rank highly.
Legislative effort
All five child care providers involved in the infant deaths had their licenses revoked, though one appealed her revocation and won. She is still operating a day care center, named Childfirst 24 Hour Childcare, in Decatur.
One of the five providers — the one involved in Jace’s death — faced criminal charges.
“That’s only because I fought,” Hester said. “I worked for the police department at the time. And so, I knew a little bit more than most people do.”
Hester graduated from the police academy in 2002. She first went to work as a Dougherty County police officer, then joined the county school district’s police force in 2005.
She didn’t start pushing for criminal charges against her provider, Barbara Ann Fuller, until reading the state report five months later.
A county grand jury charged Fuller with 10 counts of reckless conduct — one for each child in her care that day.
She pleaded guilty to one of those counts and was sentenced to probation for one year, received a $500 fine and can never operate or work in a Georgia child care program again, District Attorney Plez Hardin said.
Hester and her husband, Joe, moved to Colorado Springs, Colo., in August 2010, when the Army posted him to Fort Carson.
It’s hard being away from Jace’s gravesite in Albany, but she keeps in touch with the cemetery workers, making sure his grave is kept up.
“Since we’ve been here, it’s been stressful being without him and me not being able to go out there and sit and visit with him,” she said.
She and Joe had another child, Ethan, in December 2009. He has a familiar middle name: Jace.
Jace’s name also will live on in Georgia.
The Legislature this year enacted a new law — it will be named Jace’s Law — that enables DECAL to close a child care program immediately upon the death of a child, pending an investigation. The day after Jace’s death, Fuller opened her day care center, business as usual, Hester said.
Hester, who worked with a state senator to create the law, said she hopes it can help keep other day care children safe. The state has already used the law once.
“We’re proud to have Jace honored,” she said. “We want him to be remembered, of course. But there’s no satisfaction anywhere in this for me. We lost our son.”
Ethan’s almost 2 now and his parents aren’t taking any chances with him.
Amanda Hester has left law enforcement and is a stay-at-home mom. Though Ethan is long past the danger of a SIDS death, he still sleeps with a device that monitors his heart rate and breathing.
And, unlike his late brother, he will never see the inside of a day care center.
“There is no way. I don’t let anybody keep him,” Hester said. “My kids will never, ever, ever go to another day care facility.”
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Infant sleeping deaths
All details are based on public documents, including reports filed by state and local police, local coroners and state regulators.
Jace Michael Hester
- Age: 4 months old
- Hometown: Albany
- Day-care provider: Barbara Ann Fuller (Miss Ann's Daycare)
- Date of death: Feb. 13, 2008
- Cause of death: Sudden unexpected infant death, with undetermined external factors.
- What happened: Fuller put Jace, who suffered from allergies, to sleep on his stomach in a back bedroom that had dog feces and urine on floor and mold on the ceiling and doorway, public documents show. She found him a half-hour later unresponsive. Fuller also was caring for three more children than she was allowed. She pleaded guilty to reckless conduct, a misdemeanor.
Maddox Perry
- Age: 4-1/2 months old
- Hometown: Swainsboro
- Day-care provider: Sue Anne Clark (Rugrat's Resort)
- Date of death: Oct. 16, 2009
- Cause of death: Positional asphyxia, a subcategory of sudden unexpected infant death
- What happened: Clark put Maddox on a twin bed without guard rails in a back bedroom on Oct. 12, 2009, according to reports. A half-hour later, she found Maddox had fallen off the bed and gotten wedged between the bed and wall. Clark was caring for 12 children that day, more than she was allowed, because it was a state holiday and school was out. Maddox was kept on life support for four days.
Isaura Cortez-Mendoza
- Age: 3-1/2 months old
- Hometown: Cairo
- Day-care provider: Telisa Washington
- Date of death: Dec. 10, 2007
- Cause of death: Sudden unexplained infant death
- What happened: Washington left Isaura and two other children in the care of her mother while she ran errands. Washington's mother put Isaura on her stomach on an adult-size bed for a nap while she did laundry and cared for the other children. She then discovered that Isaura, who was born with a minor heart problem, wasn't breathing.
Qua’naiya Wilson
- Age: 2-1/2 months old
- Hometown: Athens
- Day-care provider: Lenita Howard
- Date of death: Sept. 22, 2008
- Cause of death: Sudden unexpected death in infancy
- What happened: Howard laid Qua'naiya, who was born premature, on her stomach in a crib for a nap that morning. When she went to get her for lunch, Howard discovered that Qua'naiya was limp and unresponsive. She went outside and found someone to perform CPR on the infant.
Darryl Love
- Age: 3 months old
- Hometown: Decatur
- Day care provider: Childfirst 24 Hour Childcare
- Date of death: Sept. 15, 2009
- Cause of death: Sudden unexpected death in infancy
- What happened: A child care worker put Darryl, who had been coughing and sneezing that week, down for an afternoon nap in the facility's infant room. When another worker checked on Darryl, he had turned blue and was unresponsive. Workers put him on the floor and performed CPR on Darryl, but he was taken to a local hospital and pronounced dead.
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How we got the story
The AJC has been investigating child care programs – and the state agency that regulates them – since June. This article grew out of the newspaper’s decision to take a close look at all of Georgia’s day care deaths in the past five years. To do so, the AJC obtained police reports, coroner’s reports, death certificates and state child care reports and tracked down people involved in those deaths.
Tim Eberly is an investigative reporter who joined the AJC in 2007. Previously he covered the Atlanta police beat. A native of Maryland, Eberly came to the AJC from The Fresno Bee in California. He is the father of a 2-year-old daughter.
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