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On March 18, 2024 the Office of Childhood received a report alleging "Child A (12 years old) is not receiving insulin at daycare. Insulin and needles are not being removed from Child A's bag." After conducting an investigation, Compliance Inspector (CI) Caylin Mertz has found these allegations to be substantiated based on the following evidence and rule violations:
5 CSR 25-500.192(3)(E) which states "All medication shall be stored out of reach of children or in a locked container."
On March 25, 2024 CI Caylin Mertz conducted an unannounced inspection at the facility and interviewed Director Kellee Fiscus, Caregiver Liz Andrews and Parent A. Director Fiscus stated Child A kept her insulin and needles in her bag; it was not stored in the refrigerator. Child A carried her bag with her. Caregiver Andrews believed Child A's insulin was left in her bag which was set on the counter in the facility. Parent A indicated she observed Child A to be allowed to carry her pack with insulin and needles throughout the facility.
AND
5 CSR 25-500.102(1)(E) which states "Caregivers shall have knowledge of the needs of children and shall be sensitive to the capabilities, interests, and problems of children in care."
On March 25, 2024 CI Caylin Mertz conducted an unannounced inspection at the facility and interviewed Director Kellee Fiscus, Caregiver Liz Andrews, and Parent A. Director Fiscus indicated she told Child A to check her blood sugar every two hours. She did not have any documentation about how to dose insulin or check sugars. She did not log when insulin was administered or how much. She did not know anything about diabetes or administering insulin so she would not have been able to give Child A guidance with dosing insulin.
Caregiver Andrews said there was no paperwork regarding Child A's diabetes, when to check blood sugars, or how much insulin should be given. She did not document when Child A's sugar was checked or if insulin was administered and how much.
CI Mertz interviewed Parent A. She indicated she counted the needles in Child A's pack before dropping her off and after picking her up on two occasions and no needles were missing, indicating Child A had not been given insulin.
AND
5 CSR 25-500.132(6) which states "A child who has a special physical, developmental, or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source."
On March 25, 2024 CI Caylin Mertz conducted an unannounced inspection at the facility and interviewed Director Kellee Fiscus and Caregiver Liz Andrews. Director Fiscus said she did not have any documentation about how to dose insulin or check sugars. Caregiver Andrews said there was no paperwork regarding Child A's diabetes, when to check blood sugars, or how much insulin should be given.
CI Mertz observed Child A's file, which did not contain an individualized plan for specialized care detailing Child A's diagnosis and how to handle her diagnosis and medication.
AND
5 CSR 25-500.192(4)(A) which states "No child shall be permitted to enroll in or attend any day care facility caring for ten or more children unless the child has been immunized adequately against vaccine-preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP) . The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration."
On March 25, 2024 Compliance Inspector (CI) Caylin Mertz conducted an unannounced inspection at the facility and interviewed Director Kellee Fiscus, who stated she did not receive immunization records for Child A. CI Mertz observed Child A's file, which did not contain a copy of Child A's immunizations.
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