At a time when Canada is vastly expanding its child-care system, and just eight months after a major E. coli outbreak in Calgary child-care centres, an Alberta Health Services analysis shows the province is lagging in its rate of daycare inspections, falling far short of its guideline of at least two inspections per year at each of the province’s licensed daycare centres.
The report, titled Safe Healthy Environments – Childcare Inspection Analysis and obtained under freedom of information, is worrying to the mother of a child hospitalized during last year’s outbreak and concerning to public health experts who say the lag in inspection rates is putting kids at risk.
It shows 354 licensed daycares with food facilities did not see an inspection in the twelve months before March 18, 2024. That’s just over 20 per cent of Alberta daycares with food services.
Of the 1,315 that were inspected, more than 40 per cent were cited for food handling or hygiene violations. The analysis was prepared by AHS Environmental Public Health and covers the dates from April 1, 2022, to March 18, 2024.
AHS working toward 1 inspection per year
The most common violations were food handling, cleaning and sanitation. The report notes that 97.4 per cent of child-care centres have a kitchen on site, while about 50 facilities obtain their food from a central kitchen.
“This is pretty bad inspection rates considering the sort of high-risk populations,” said Keith Warriner, a professor of food microbiology at University of Guelph. He was particularly troubled by the rate of non-compliance, which often resulted in multiple follow-up inspections to correct problems.
Repeated critical food handling and sanitation violations at 145 facilities accounted for multiple health inspectors visits, according to the analysis.
“This tells me a lot of resources are dedicated to try and clean up messes which shouldn’t have occurred and letting facilities get away with things before making the ultimate decision to shut them down,” Warriner said.
While the province mandates two inspections per licensed daycare, AHS said in a statement to CBC News that it is still working toward meeting a minimum of one routine monitoring inspection of every childcare facility in Alberta, every 12 months.
The review period includes last September’s E. coli outbreak in Calgary, which sickened 448 people and hospitalized 39 children and one adult.
The source of the illness was traced to a central kitchen supplying food to multiple daycare centres.
A review panel looking into the incident was expected to report its findings in April but has now been granted an extension by the government until the end of June to give the group more time to talk to parents.
‘The system is not safe’
Sarah MacDonald, whose four-year-old son was hospitalized because of the E. coli outbreak, is troubled by the findings in the report.
“I have difficulty understanding why the safety of our children is not a priority,” she said in an interview with CBC News.
“We were assured the system was safe, and I think the data is telling a different story. The system is not safe.”
MacDonald says her son spent three days in hospital, then suffered at home for another three weeks.
“He was afraid to eat food for a little while afterwards,” she said, adding he was also traumatized by the needles and blood tests required for his treatment. “It was really difficult for him to understand.”
MacDonald says her son is doing well now, but will need to have his kidneys monitored for the foreseeable future. She still has questions about how such a large and devastating outbreak of E. coli could have occurred in a kitchen serving 11 daycare centres.
Shiga toxin-producing E. coli (STEC) is caused by eating contaminated food and is often associated with bloody diarrhea. Most patients get better on their own, but children are at greater risk of complications. Eight of those hospitalized during the Alberta outbreak were required to go on dialysis.
“I want to know what is going to change,” said MacDonald. “I want to know what the consequences are for these businesses, because I know my son has paid a very high price.”
The kitchen providing meals to her son’s daycare had been inspected 11 times before the E. coli outbreak, and new violations were detected on at least six of those visits, according to AHS inspection records, which show it was also cited for three critical violations in its first inspection after the outbreak was detected.
Alberta Health Services wrote in an email to CBC News that the role of public health inspectors is to identify hazards and provide education and direction. It said inspectors work to correct violations through ongoing communication and reinspection.
AHS says it has not issued any fines or prosecutions.
Alberta has about 200 public health inspectors responsible for ensuring safety at a wide range of facilities including long term care, restaurants, food trucks, shelters, public housing, nail salons, tattoo parlours and child-care centres.
High-risk population
The former manager of food safety at Toronto Public Health reviewed key elements of the analysis for CBC News. Jim Chan raised flags about rates of inspection and non-compliance.
“The number of child-care centres that have not been inspected for the full year is quite high,” he said.
“To me that is a very crucial type of risk,” he said, noting that child-care centres in Ontario that serve food receive a minimum of three inspections per year.
He also found Alberta’s 44 per cent non-compliance rate in 2023 to be high compared with Toronto, where he says he sees a rate of nine to 10 per cent in a given year.
“That can be a risk to the clients, which in a daycare are very young. Very young and very old can be classed as a high-risk population.”
Concerns about cutting corners
Concerns about inspections come at a time when Alberta’s child-care system is seeing a massive expansion.
The federal government is pouring $3.8 billion into lowering daycare costs and adding 68,700 new spaces in Alberta by 2026.
The number of children attending daycare in Alberta has already soared by about 35 thousand since 2021, according to the province.
The added demand coupled with lower fees paid to operators under the federal plan is placing a lot of pressure on the daycare business, according to Sarah Hunter, the owner of The Imagination Tree, a Calgary daycare.
Her centre is filled to capacity at 95 children. Though she says she takes care to ensure that her centre follows proper food handling procedures, she worries others may not as budgets become increasingly tight.
She says problems will arise when centres are desperate to stay in business.
“You’re gonna cut corners wherever you have to cut them,” she said in an interview. “So if that involves not meeting regulation on some days, maybe that’s what you’re … forced to do.”
“To run a clean, organized, well-staffed quality program costs money, and it costs a lot of money.”
The double whammy
Mike Parker, the head of the Health Sciences Association of Alberta representing health inspectors in the province, worries that his members can’t keep up.
“We don’t have the inspectors on the streets today to do the work,” he said.
According to the most recent annual report from AHS, the total number of food safety inspections has fallen by about fifteen thousand per year since 2018.
Parker says the problem is a growing number of facilities to inspect, coupled with demands to reinspect some places multiple times.
“That’s the double whammy,” he said. “Our members are stretched, trying to get to as many as they can.”
“Our kids are vulnerable to this when we can’t ensure their safety.”
Despite those concerns, the federal government says it’s satisfied with the province’s rollout of the new daycare plan.
Shortly after announcing more federal money for inclusive child care in Edmonton on May 16, federal Minister of Employment and Workforce Development Randy Boissonnault, told CBC News he had no issues with Alberta’s approach to inspections.
“I’m confident in the safety of kids and the province doing what it needs to do to make sure that kids are safe.”
In a written statement to CBC News, AHS said it was still working through a backlog of inspections resulting from the pandemic.
AHS also notes it has made substantial efforts to identify central kitchens that provide food to multiple child-care facilities in Alberta.
After initially agreeing to speak with CBC News, Alberta Health Minister Adriana LaGrange cancelled on Wednesday. Her office said she would provide written responses to questions.