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Compliance Inspector (CI) Jessica Graham investigated the allegation that Child A was served juice when the facility was notified that Child A shall not be served juice. As a result, Child A had diarrhea. Parent A was not required to fill out any paperwork. Child B has a sensitivity to milk and was served regular milk when the facility was aware that they should only have almond milk. Due to the facility serving Child B regular milk, Child B had ongoing stomach issues. The facility told the parent that they must provide the almond milk. Parent was not asked to provide or fill out any other documents regarding Child B's milk intolerance. This allegation is substantiated based on the following rule violations:
5 CSR 25-500.222(1)., which states: "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."
AND
5 CSR 25-500.222(2)., which states: "An individual file shall be kept to identify each child and enable the provider to communicate with the parent(s) , guardian or legal custodian of the child in an emergency. Records shall include:"
AND
5 CSR 25-500.132 (8)(E)., which states: "Completion by the parent(s) of the following written information which shall be on file before the child is accepted for care:"
AND
5 CSR 25-500.132 (8)(E)3., which states: "A diet plan for each infant/toddler signed by the parent(s)."
AND
5 CSR 25-500.122(2)(A)., which states: "The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department's medical assessment form or the provider may use its own form if it contains all the information on the department's form. The Child Medical Examination Report (Infant/Toddler/Pre-School) form, revised 2021, is incorporated by reference in this rule, as published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms. This rule does not incorporate any subsequent amendments or additions."
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 January 23, 2025, Nicole Hassell, director, stated that Child B (age 22-months-old), did not have any documents on file stating that she had lactose intolerance and should be served almond milk. Child B also did not have a physical or immunization record on file. Parent B was told to bring in almond milk for Child B if needed. Child A (age 2-years-old), did not have an enrollment form, physical or immunization record on file. She did not have any written information on her feeding plan for not serving juice.
On January 30, 2025 Starla Francis, caregiver, said via phone that she never knew of Child A being served any juice. Parent A had told her not to serve Child A any juice but there was no paperwork indicating that she should not have it that she was aware of. She made a note of it on her clipboard.
On January 30, 2025, Hailey Peters, caregiver, said via phone that she got a text message from Parent A asking if Child A was served juice because she had diarrhea. Hailey was not aware that Child A was not supposed to be given juice until she received that text message.
On January 30, 2025, Lori Wolfe, caregiver, said via phone that she was the caregiver for Child B. Parent B did not bring in almond milk for Child B when she started so she was served regular milk. She did not have any feeding form on file for Child B. After Parent B started brining in almond milk, that is all that was served.
Parent B was called but no contact was made.
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