At least two senior officials from the Department of Children and Families have been removed in connection with the case of David Almond, a 14-year-old Fall River boy with autism spectrum disorder who died last October while living with his father and father’s girlfriend.

Linda Spears, commissioner of the Department of Children and Families, announced the terminations of the Fall River area director and clinical program manager during a virtual press conference Tuesday. Spears hinted that more terminations and other changes could soon be on the way.

“It is clear to me and to the leadership of this organization that the safety net that we’ve been putting in place in the agency failed this child and failed this child in a signifcant way,” Spears said Wednesday. “We also move forward to make changes and to hold those staff that we believe to be accountable … for the failure to use available systems to protect this child.”

The announcement came after the Office of the Child Advocate, Massachusetts' independent child-services oversight agency, released a 107-page report that said DCF and others failed to identify and act upon critical warning signs in the case leading to the Fall River teens’ death. DCF had removed Almond from his father's care but the teenager was returned to his father's custody at the beginning of the COVID-19 pandemic.

Spears, who has led DCF since her appointment in 2015, said the agency has placed a new team in the Fall River office and is working to implement the recommendations from the OCA report.

At a separate press conference Wednesday, Gov. Charlie Baker called the report both “thorough” and “hugely distressing.”

“It’s very clear from reading that report that David Almond’s [death] was preventable,” he said. “I expect and anticipate that everything in there is going to get implemented, and is going to get implemented on a statewide basis, and is going to get implemented as fast as it possibly can be.”

The report came as part of OCA’s multi-system investigation triggered by Almond's death. Earlier this month, the chief medical examiner's office ruled the teenager’s death a homicide caused by starvation and neglect. The father and girlfriend, John Almond and Jaclyn Coleman, are now facing criminal charges in connection with David Almond’s death. Both John Almond and Coleman were in DCF custody for parts of their childhoods with histories of abuse, neglect and physical violence.

David Almond and his triplet siblings had previously been removed from their father’s care three separate times because of parental substance abuse, mental health challenges and general lack of basic care, the report found. Despite that history, New York Family Court awarded in 2016 full custody of the three boys to John Almond while he lived in Massachusetts — a decision that OCA said “remains a mystery” and is still being investigated.

DCF removed the triplets and a younger half sibling from John Almond once more in 2017, but moved to reunite the smaller child, then eventually the triplets, with their father again.

David Almond and one of his triplet siblings, Michael, were sent back to their father most recently in March 2020. The third triplet refused to return. From there, the OCA report concluded, missteps across several state agencies and the COVID-19 pandemic facilitated the neglect of the two boys, which led to David's death in the fall of 2020.

Maria Mossaides, OCA director, noted that even though David Almond’s caregivers exploited pandemic safety concerns and obscured him and his siblings from the view of people who could have helped, the situation was still a miscarriage of the state’s child welfare safeguards.

“While there are only two people ultimately responsible for David’s murder,” she said Wednesday referring to the teen’s father and girlfriend, “the OCA has determined that there was a multi-system failure, complicated by the pandemic, and that the safeguards that we expected to be in place, especially in the Department of Children and Families — the agency which had decision-making authority into the court returned custody to the father — turned out to be inadequate.”

The OCA’s report recommended that the Massachusetts Departments of Children and Families, Juvenile Court, Probation Service and all school districts should each review and revise their policies and practices meant to protect children in the care of their systems. In some cases, these agencies may also need to retrain their employees, the report added.

Mossaides also urged the state’s Department of Elementary and Secondary Education to devise a policy to track and respond to school absences since David Almond’s 7-month lack of contact with any school staff was a “red flag” that was missed in this case.

Even though most of OCA’s recommendations can be made without legislative changes, the agency has been in contact with lawmakers and new legislative mandates could be forthcoming, Mossaides said.

“The Senate is fully committed to listening to and working with stakeholders to address the numerous failures in the complex child welfare ecosystem to safeguard against this kind of tragedy in the future," said Senate President Karen Spilka in a statement following Wednesday’s press conference.

The pandemic, the report said, created an unprecedented strain on children, families and the entities that support them.

“Economic stress, social isolation, and uncertainty in times of crisis can affect rates of child abuse and neglect,” said the report. “Child-serving agencies, especially DCF, are in the unenviable role of trying to protect and care for their own workforce in addition to dealing with the new and challenging landscape of abuse and neglect in the time of a nationwide pandemic,” the report said, adding that shifting saftey protocols have caused confusion for service providers.

“I hope that the changes that we recommend [and] that we have evaluated will be able to be operationalized across the Commonwealth, and that we will not have the horrific circumstances that led to David’s death and Michael’s near death,” Mossaides said.