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On May 31, 2023, the Office of Childhood (OOC) received an allegation that Parent A (parent of Child A) was not notified immediately after Child A (4-years-old) broke their arm at Kids Kompany Child Care Services Inc. After conducting an investigation, Compliance Inspector (CI) Ian Fyfe has found this allegation to be substantiated based on the following evidence:
5 CSR 25-500.192(5)(A), which states the following: "In case of accident or injury to a child, the provider shall notify the parent(s) immediately. If the child requires emergency medical care, the provider shall follow the parent's(s') written instructions."
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5 CSR 25-500.102(1)(A), which states the following: "Child care personnel shall be of good character and intent and shall be qualified to provide care conducive to the welfare of children."
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5 CSR 25-500.102(1)(F), which states the following: "Caregivers shall be capable of handling emergencies promptly and intelligently."
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5 CSR 25-500.102(2)(A)2., which states the following: "Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours."
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5 CSR 25-500.222(1), which states the following: "The child care provider shall maintain accurate records to meet administrative requirements and to ensure knowledge of the individual needs of children and their families."
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5 CSR 25-500.182(1)(C)5., which states the following: "Brief, supervised separation from the group may be used based on a guideline of one (1) minute of separation for each year of the child's age."
On June 6, 2023, Compliance Inspector (CI) Ian Fyfe conducted an interview with Parent A (parent of Child A). On May 30, 2023, at approximately 3:45 PM, Parent A received a text message from staff member Darlene [Patrick] stating that Child A's arm was swollen and was possibly needing medical attention. Ms. Darlene claims that Child A fell off of a jungle gym at the facility at 12 PM earlier in the day three to four times and that Child A's caregiver, Ms. Tracy [Williams], called Parent A immediately after. Parent A denied receiving a phone call from any staff members on this day. Following Child A's fall, Child A ate lunch and took a nap at the facility. After Child A woke up from their nap with a swollen arm, Ms. Darlene texted Parent A as stated above. On May 30, 2023, Child A was taken to an urgent care and was found to have a broken arm. Urgent care staff advised that Parent A take Child A to Cardinal Glennon. Due to the location of the break in Child A's arm, Child A was admitted to Cardinal Glennon and required surgery on May 31, 2023. Child A was discharged from Cardinal Glennon on May 31, 2023, after their surgery.
On June 7, 2023, CI Fyfe conducted an unannounced inspection to Kids Kompany Child Care Services Inc. and interviewed staff members Tracy Williams and Darlene Patrick. Both Ms. Williams and Ms. Patrick provided similar information. Ms. Williams was Child A's caregiver when Child A attended the facility. On May 30, 2023, Ms. Williams and Child A's class went on the playground from approximately 11:15 AM to 11:45 AM. Ms. Williams was the only staff member on the playground. Between 11:15 AM and 11:45 AM, Child A was involved in three separate incidents in which they climbed to the top of the structures on the playground. During the first two incidents, Ms. Williams was able to observe Child A and assist them in getting down safely from the structures. After the second incident, Child A was discipline with a timeout that lasted sixteen minutes. During the third incident, Child A jumped from the structure and broke their right arm. Child A immediately began crying and holding their arm. Ms. Williams gathered her class and took the children inside.
Once inside, Ms. Williams and Ms. Darlene assessed Child A. Child A was no longer crying at this point but was rather yelling for attention. Ms. Williams created an accident report for the incident and allegedly attempted to contact Parent A twice, but Parent A never answered their phone or called the facility back. Ms. Darlene provided CI Fyfe with conflicting information on whether Ms. Williams actually called Parent A immediately, or if Ms. Williams waited until 3 PM to call Parent A. Ms. Darlene stated that Parent A was not contacted immediately due to the fact that Child A told staff members that their arm did not hurt. Ms. Williams and Ms. Darlene did not believe that Child A's arm was broken at this time and allowed Child A to continue with their day. Child A's day involved eating their lunch, setting up their cot, and taking a nap from approximately 12:15 PM to 2:45 PM. Prior to napping, Ms. Darlene noticed that Child A's arm appeared to be red. While eating their lunch and setting up their cot, it was apparent that Child A was attempting to not use their injured arm. While Child A napped, Child A laid on top of their injured arm. When Child A woke up, Ms. Williams and Ms. Darlene observed Child A's arm and described it to CI Fyfe as, "swollen", "broke", "fractured", and "hot to the touch". Ms. Darlene ultimately called Parent A at 3:24 PM and informed Parent A about Child A's injury. Ms. Darlene attempted to provide Parent A with an accident report, but Parent A left the accident report at the facility after reviewing it. Despite observing Child A actively not using their arm, observing Child A yelling for attention, and observing Child A's arm to become red and show a lack of mobility, Ms. Darlene and Ms. Williams failed to act appropriately in pursuing medical attention for Child A.
While present at the facility, CI Fyfe spoke to Ms. Darlene and Ms. Williams about Director Marilyn Stubblefield. When CI Fyfe noticed that Ms. Stubblefield was not present during the inspection and was informed that Ms. Stubblefield was not present for the reported concerns either, CI Fyfe asked Ms. Williams how often Ms. Stubblefield is present at the facility. Ms. Williams stated that Ms. Stubblefield is hardly ever at the facility and that her absence is an issue. This has been an ongoing issue since Ms. Williams began her employment in January of 2023. Ms. Darlene informed CI Fyfe that Ms. Stubblefield is at the facility for thirty-five hours a week initially, but then admitted that she lied to CI Fyfe, and that Ms. Stubblefield is hardly ever at the facility, and that it would be difficult for CI Fyfe to find a time to meet with Ms. Stubblefield due to her absences. CI Fyfe spoke to Ms. Stubblefield via phone call while he was at the facility. Ms. Stubblefield informed CI Fyfe that she is not at the facility for her required forty hours a week due to her obligations at other centers and that she does not keep attendance on herself.
CI Fyfe also observed the facility's playground. CI Fyfe was able to identify the playground equipment involved in the reported concerns. One larger playground structure was observed with a blue roof. Child A was on top of the blue roof on this structure the first time that staff member Traci Williams observed Child A. A smaller structure was observed closer to the edge of the black padding. This is the playground structure that Child A climbed on top of the second and third time that Ms. Williams observed Child A and the structure that Child A jumped from and fell and broke his arm.
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