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Compliance Inspector (CI) Heather Radney conducted an investigation of the allegation that Child A (2 years old) has been given milk, which he is allergic to, three times this week and six times in the past two months. Child A's parent was only told about one incident. It is unknown if Child A had any type of reaction. The allegation is substantiated based on the following information:
5 CSR 25-500.202(1)(A) - The provider shall supply and serve nourishing food according to the Meal and Snack Food Chart provided in this rule.
On August 1, 2023, CI Radney conducted interviews with Director Stephanie Crone and Caregivers Hailey Jones and Madison Rocha. They reported Child A had been given dairy on different occasions for different reasons. Director Stephanie reported Child A received dairy from Caregiver Mayra Santini who told her she thought that what Parent A was providing for a substitute was not enough for Child A. Caregiver Hailey Jones reported she knew Child A had an allergy to dairy but forgot. She thought the bean burrito provided only contained beans until Caregiver Madison told her it also had cheese. Caregiver Madison Rocha reported she once gave Child A an egg omelet and she just forgot there was cheese in the omelet. On November 13, 2023, CI Radney conducted a telephone interview with Caregiver Mayra Santini who reported she gave Child A a mozzarella stick on accident on accident because she was new to that classroom and it was a little hectic. She didn't realize until later when Child A had a loose bowel movement and she contacted Parent A. Parent A then looked on Luvnotes and saw the picture she had posted of Child A eating a mozzarella stick.
On August 1, 2023, CI Radney received Child A's enrollment form, Child Medical Examination Report and Medical Statement to Request Special Meals and/or Accommodations. Child A's enrollment form shows Child A's birthday at 12/22/21. The Child Medical Examination states Physician's Instructions for Specialized Care as "Cows Milk Allergy Avoid All Dairy" and is signed by Roberta Boyd, CPNP on 6/27/22. The Medical Statement to Request Special Meals and/or Accommodations lists "cow's milk protein allergy" under Disability or medical condition requiring a special meal or accommodation. It also lists "milk, butter, casein, whey, anything with cow's milk protein" under Foods to be Omitted. This form is signed by Roberta Boyd, CPNP on 6/27/22.
On November 13, 2023, CI Radney conducted a telephone interview with Parent A. She reported that she was called a few of the times that Child A was given dairy but not all of the times. She learned of the additional time Child A was given dairy by looking at the pictures of Child A eating in Luvnotes and seeing dairy on his plate. Parent A asked Little Sunshine's Playhouse and Preschool, Inc. if they were going to provide substitutions for the foods and drinks that have dairy. She was told they would provide soy milk as a milk substitute but that she would have to provide a food substitute for foods containing dairy. She did begin sending food substitutions when she saw on the menu that a food with dairy was being served.
5 CSR 25-500.102(1)(E) - Caregivers shall have knowledge of the needs of children and shall be sensitive to the capabilities, interests, and problems of children in care.
Caregivers were not knowledgeable of the needs of Child A or sensitive to the capabilities, interests, and problems for Child A when they provided him with an allergen. Director Stephanie Crone and Caregivers Hailey Jones and Madison Rocha reported Child A had been given dairy on different occasions for different reasons. Director Stephanie reported Child A received dairy from Caregiver Mayra Santini who told her she thought that what Parent A was providing for a substitute was not enough for Child A. Caregiver Hailey Jones reported she knew Child A had an allergy to dairy but forgot. She thought the bean burrito provided only contained beans until Caregiver Madison told her it also had cheese. Caregiver Madison Rocha reported she once gave Child A an egg omelet and she just forgot there was cheese in the omelet. On November 13, 2023, CI Radney conducted a telephone interview with Caregiver Mayra Santini who reported she gave Child A a mozzarella stick on accident on accident because she was new to that classroom and it was a little hectic.
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