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State moves to revoke license of Watertown child-care facility after infant’s death

State regulators have shut down a Watertown child-care facility where an infant girl died last month and are moving to revoke the business’s license, citing negligence by staff who allegedly left her unattended for long stretches and failed to administer CPR when she stopped breathing.

In an order dated Sept. 20, the Department of Early Education and Care issued a notice of emergency suspension for Strawberry Child Care in Watertown, as well as a notice of revocation of its license.

Strawberry Child Care is appealing, according to the state agency. The facility cannot operate while the appeal is pending.

Monica Ryan, founder and director of Strawberry Child Care, which also has a Brookline location, could not immediately be reached for comment. The state agency separately barred the business from enrolling new children in its Brookline program, a spokeswoman said.

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The notice of suspension, from Caroline Hayes Lopez, the agency’s assistant general counsel, provided a timeline of events leading up to the infant’s death on Sept. 13. Lopez identified the victim only as Child A. Prosecutors previously said the infant was a 5-month-old female.

Surveillance video showed the baby rolling onto her stomach in a play area shortly before 11 a.m., while staff appeared “to be unaware of” her while they engaged “in other tasks and conversations,” Lopez wrote.

The girl lifted her head and struggled to keep it aloft for more than three minutes, and another infant crawled on top of her before a staff member placed her in a crib for a nap just after 11:10 a.m., the order said.

Lopez wrote that the crib area was separated from an infant classroom by a 3-foot-high wall and that the crib was not visible to staff when they weren’t in the “immediate vicinity” of the crib area.

“Between 12:03 p.m. and 2:15 p.m., there are several prolonged periods when no educators enter the crib area to check on the infants, including one period of 39 minutes, one period of 16 minutes, one period of 37 minutes, and one period of 35 minutes,” Lopez wrote. “At 2:15 p.m., an educator enters the crib area and discovers that Child A is unresponsive.”

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Lopez wrote that surveillance video captured staff placing the unconscious infant on a changing table in the center of the room, while workers were “moving about the room, cleaning up, and organizing papers. On two separate occasions, Child A is left unattended on the changing table. None of the program educators attempt CPR.”

A worker at another business in the building entered the room at 2:19 p.m. and began performing CPR on the child, and a Watertown police officer arrived “almost immediately” and took over performing CPR until paramedics arrived, Lopez wrote.

The girl was later pronounced dead at a hospital. Autopsy results are still pending.

Lopez faulted staff for being inattentive in the hours before the girl’s death, noting that employees confirmed during interviews that the girl had “just begun to roll over in this way.”

“Even with that knowledge, Program educators failed to notice or intervene when Child A rolled over onto [her] stomach while on a floor mat and struggled in a prolonged attempt to keep [her] head up,” Lopez wrote. “Two educators in Child A’s immediate vicinity did not intervene until 3 minutes and 24 seconds later when an educator eventually picked up Child A.”

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In addition, Lopez wrote, staff members who were present when the girl was later found unresponsive are all certified in CPR, yet none attempted mouth-to-mouth resuscitation. Staffers did call 911.

“[A] number of educators seemed distraught and did not provide possible life-saving intervention to a child that was clearly not breathing,” the order said. “If the Program was soundly administered, then staff could have appropriately used their training in CPR to resuscitate an infant that was clearly in distress. The Program’s lack of sound administration is so egregious that it creates an emergency situation endangering the life, health, and safety of children and warrants the suspension and revocation of the Program’s license.”

Facilities that have their licenses revoked must wait five years before seeking another one.

Lopez noted that Strawberry Child Care had previously been cited for safety violations, including in January, after a parent reported “unexplained scratches” on an infant. That child had been placed in an evacuation crib during a drill with two other infants, and one may have scratched another, the order said.

The program was also cited for incidents in 2013 and 2014 when workers failed to maintain proper staff-to-child ratios, according to Lopez.

That was an issue again at the time of the girl’s death, Lopez wrote, when employees “did not meet the required staff-to-child ratios for infants several times throughout the day on September 13, 2018.”

Meghan Kelly, a spokeswoman for Middlesex District Attorney Marian T. Ryan, said Tuesday that investigators were awaiting the medical examiner’s ruling on a cause of death, but no foul play is expected. The probe was ongoing.

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John R. Ellement of the Globe staff contributed to this report. Travis Andersen can be reached at travis.andersen@globe.com. Follow him on Twitter @TAGlobe.