Deborah Stenseng had an unusual way of comforting infants in her home day care. When they got fussy or wouldn't take a bottle, the Duluth woman opened her shirt and had them suckle on her breast, even though she wasn't lactating or breast-feeding children of her own.
在一个位于明尼苏达州德卢斯的家庭托儿所中，德博拉·斯坦森用一种不寻常的方式来安慰婴儿。每当婴儿吵闹或不喝奶时，她会解开衣服，让婴儿吮吸自己的乳房，但她并没有分泌乳汁或在给自己的孩子喂奶。
Worse, Stenseng deceived some parents about the practice and defied others who asked her not to do it with their children, regulators later concluded. Eventually, a complaint reached St. Louis County authorities, who shut down Stenseng's day care in January and revoked her license in April. "Serious personal boundaries ... were crossed," licensing officials concluded.
监督机构后来发现，更糟的是，一些父母对斯坦森这种做法毫不知情，另一些父母要求她不要这样带他们的孩子，她却公然违背了这些父母的要求。最后，有人向圣路易斯县有关监督部门投诉，监督部门1月取缔了斯坦森的托儿所，4月吊销了她的执照。颁发执照的官员说：“她越过了身体接触的界限，事态很严重。”

Though extreme, Stenseng's case reflects an inherent problem in licensed family child care -- a problem that may be linked to a recent increase in child care deaths in Minnesota. Operating with minimal training, spotty inspections and inconsistent rule enforcement from one county to another, home-based providers can engage in practices that range from inappropriate to dangerous as they care single-handedly for as many as a dozen children.
斯坦森的例子虽然很极端，但也反映出获得营业执照的家庭托儿所中存在的固有问题——这个问题也许与近日明尼苏达州托儿所死亡事件增加有关联。缺乏培训、定期检查过少及各个县法律执行力度不一，在这种情况下营业的家庭托儿所负责人独自照料多达12个儿童时，可能会采取各种方法，包括不恰当或危险的方法。
Minnesota has some of the leanest training requirements in the nation for in-home child care, according to a Star Tribune review of licensing data. Providers don't need high school diplomas or child development expertise to get licensed. Inspections are required only every two years, and one watchdog group estimates that Minnesota's ratio of inspectors to providers is among the nation's lowest.
《星论坛报》检查执照的数据后发现，明尼苏达州对家庭托儿所的培训要求是全美最宽松的。家庭托儿所负责人无需有高中文凭或儿童发育的专门知识就可以获得执照；每两年才进行一次检查。一个监察组织估计在明尼苏达州，检查员与托儿所负责人的比率是全美最低的。
The risk is that low standards result in low quality, said Amie Lapp Payne, who wrote an influential 2011 report for the National Association for Regulatory Administration on child-care safety. "If it isn't a regulatory requirement, they aren't going to do it," she said.
“风险就在于低标准造成低质量，”阿米·拉普·佩恩说，“如果不是法规要求，那些负责人不会去做。”阿米曾在2011年为“全美儿童保育安全监督管理协会”写过一篇影响颇深的报告。
Even with lax standards, thousands of Minnesota day-care providers nurture children skillfully, with no deaths or safety violations. But a review of public records shows that the rules allow substandard operators to stay in business and place children at risk.One former provider in Delano, for example, shoved a child's face into a pool of urine on her floor in early 2010 after discovering that the child had had a toileting accident. Documents show that the woman pressed hard enough to bruise the child's forehead.Other providers dunked children in water, put hot sauce on their tongues, or grabbed or hit them hard enough to break bones. Altogether, the newspaper found 70 cases of corporal punishment since 2007 -- even though it is forbidden under state law.
在明尼苏达州，即使标准很松，成千上万的托儿所熟练地照顾孩子，没有儿童死亡或安全违规行为。但是查看备案材料后发现，宽松的法规纵容不合格的托儿所经营者留在托儿所行业，将儿童置于危险中。比方说，2010年，德拉诺曾有个家庭托儿所负责人发现孩子在地上小便后，把那个孩子的脸按到那滩尿液中。材料显示那个女人用力太大，擦伤了孩子的前额。
In the last decade, the Legislature has considered raising training and safety standards for home child care several times. But lawmakers have repeatedly hedged, out of concern that higher standards would increase costs or represent government intrusion for these small businesses.
还有些负责人把孩子泡在水里，给孩子喂辣椒酱，或者抓他们、打他们时用力过大，造成孩子骨折。《星论坛报》发现尽管明尼苏达州法律禁止儿童体罚，从2007年起，共发生了70起这样的事件。
Even the Minnesota Licensed Family Child Care Association, which represents small, in-home providers, has encountered resistance when seeking more funding so that providers could be mentored by experienced colleagues.
明尼苏达州获得执照家庭托儿所协会曾试图筹得资金，让家庭托儿所负责人接受有经验的同行的培训，甚至是此举都受到了阻力。这个协会代表着小型家庭托儿所。
"[It's] the idea that, 'Why do people who are taking care of little kids need this?' " said Katy Chase, the association's executive director. "There's just a feeling we're born able to properly care for children."
“大家的想法是‘照顾小孩子的人为什么需要培训？’”此协会的执行理事凯蒂·蔡斯说，“大家都觉得我们生来就会正确地照顾儿童。”
The result is a two-tier child-care system: Roughly 1,500 large child-care centers with more employees, higher training requirements and inspections by Minnesota regulators; and about 11,100 small in-home day cares, where providers often operate in isolation with little support and scrutiny.
结果就是双重托儿所系统：一重是约1500家大型托儿所中心，雇员更多，培训要求更高，由明尼苏达州的监管部门定期检查；另一重是约1.11万家小型家庭托儿所，负责人往往独立经营，没有人帮忙，很少有人来检查。
'Adults get worn down'
照看者筋疲力尽
Reviewing licensing documents and death records, the Star Tribune found that 82 of 85 deaths in licensed child care since 2002 have taken place in homes, not centers. The number of deaths has nearly doubled in the past five years.
通过查看执照文档和死亡记录，《星论坛报》发现，自2002年起，有85次儿童死亡事故，其中82起发生在家庭托儿所中，而不是托儿中心中。过去5年中，死亡数字将近增加了一倍。
One of the few researchers to examine the causes of child-care deaths nationally said the absence of oversight increases risks for children.
有几位研究者检查了全美托儿所儿童死亡原因，其中一人表示缺乏监督增加了儿童死亡的风险。
Julia Wrigley, a sociologist at the City University of New York, found a higher rate of deaths in the nation's licensed home day cares than in centers. She concluded that large child-care centers are safer because they have multiple workers on hand to monitor children and stop co-workers from making mistakes.
纽约城市大学的社会学家茱莉亚·里格丽发现获得执照的家庭托儿所中儿童的死亡率比托儿中心要高。她的结论是大型托儿中心更安全，因为托儿中心随时有多位雇员照看小孩，并阻止同事犯错。
"Adults can get worn down. They can get distraught and frustrated and these all can be risk factors when caring for a lot of little kids," she said. "If you have other adults there ... they can ensure that safe standards are maintained."
“成年人会筋疲力尽。他们会变得心烦、受挫。照顾小孩时，这些都可能是风险因素，”茱莉亚说，“但是如果有其他成人在那，他们可以保证安全。”过去十年中，明尼苏达州的立法机关多次考虑增加家庭托儿所的培训和提高对他们的标准，但由于担心提高标准将增加成本，让人觉得政府在干预小型企业，立法者对此多次闪烁其词。
A Star Tribune review of 1,100 disciplinary actions issued since 2007 against Minnesota licensed day-care homes showed that the isolation of providers can play a significant role. More than 300 sanctions resulted from lapses in child supervision -- often because providers were spread thin.
《星论坛报》查看了2007年以来针对明尼苏达州有执照的家庭托儿所发布的1100项惩戒性措施，结果发现隔离家庭托儿所负责人作用显著。超过300项处罚措施是因为负责人没有照看好孩子，这往往是因为她们无力同时照顾太多孩子。
In Rochester in 2010, a provider confined two preschoolers to a basement for seven hours (keeping one in a 4-foot-square pen) to keep them away from a furnace repair man. At a Rose Creek day care last fall, a 1-year-old was left unattended and wandered two blocks away to a hardware store.
2010年，罗切斯特有一名家庭托儿所负责人把两个学龄前儿童关在地下室7小时（有一个孩子被关在约1.2米的笼子里），以让他们远离修炉工。去年秋季，在罗斯克里克的一家日托所里，一个1岁的孩子无人照看，独自游荡了两个街区，到了一家五金店里。