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On April 2, 2025, the Office of Childhood (OOC) received a complaint alleging that on March 28, 2025, Child A (1.5 years old) was given milk, and he is allergic to milk. Child A was having a hard time breathing and was given an EpiPen. When the paramedics got there, his oxygen level was below 50%, and he was taken to the emergency room. The daycare was told and knew he was allergic to milk. Compliance Inspector (CI) Heather Radney conducted an investigation of the allegation and found it to be substantiated based on the following information:
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.
On April 2, 2025, Compliance Inspector (CI) Heather Radney conducted an interview with Julie Furrow, who reported the incident occurred as described in the complaint. Child A was given cow's milk by accident by Joyce Turner. Joyce poured the milk and didn't realize she poured cow's milk for Child A. Joyce and Shelby Fairman were present in the classroom when the incident occurred. They called for her to come to the classroom. When she arrived, they told her that Child A had thrown up. She observed Child A and he was mucousy, coughing, and couldn't catch his breath. He had hives from his chin to his collarbone. They observed the food Child A had eaten and then realized he was given cow's milk. The oat milk is kept in the kitchen and the cook sets it along with cow's milk in the window as needed for teachers to fill cups. The teachers are responsible for filling cups with milk.
On April 2, 2025, CI Radney received and reviewed Child A's Medical Examination Report, Individualized Plan for Specialized Care and Incident Report. The Child Medical Examination Report, Physician's Instructions for Specialized Care reads "Multiple food allergies- Egg, diary, mango, peach, peanuts, tree nuts, sesame, soy and wheat. Well Child." The report is signed by a medical doctor and dated 12/20/24. The Report of Accident, Injury and/or Emergency Medical Care is dated 3/27/25 at 11:30. The Description of Incident reads "When we sat Child A down for lunch in his highchair, he began coughing and his face was progressively getting flush. I began monitoring him, when he then puked. I took him out of his seat and began patting his back." Noted to the side is written "He was accidentally given whole milk instead of oat milk." The report is signed by Julie Furrow and Shelby Fairman. The Individual Plan For Specialized Care form under Area of Concern reads "Multiple food allergies- egg, diary, mango, peach, peanut, tree nuts, sesame, soy and wheat." Under Adaptive Equipment or Supplies Needed at Day Care it reads "Please allow mother to bring in oat milk and allergy safe meals and foods." Under Medication/Treatment Child is to Receive at Facility During Child Care Hours, it reads "Epipen Jr 0.15mg/.3mL- Administer as needed for anaphylaxis." Under Symptoms/Indicators/Possible Problems Related to Child's Condition/Treatment/Health Problems that Can Result in an Emergency, it reads "Facial swelling, hives and vomiting, difficulty breathing." The form is signed and dated 12/20/24.
On May 19, 2025, CI Radney conducted an interview with Shelby Fairman. She reported that she and Joyce were working in the classroom with Child A. Joyce had worked there more than a year. She assumed Joyce knew of the milk allergy because Joyce had worked there longer than she had. A co-worker told her of Child A's allergens soon after she started while she was working in Child A's classroom. Joyce prepared Child A's milk. Child A began coughing. She got Julie. At first Julie thought he was fine but having sinus issues. Julie said give him milk and see if that helps. She gave him more milk from his cup. He continued coughing and gagging. She called for Maria to get Julie again and tell her it is an emergency. She had him on the changing table and was undressing him, and she turned him over and started patting him on his back because he was choking. Child A was coughing, crying and puking and was red in the face. Julie grabbed him off the changing table and put him on the floor. Julie observed hives and said he's having an allergic reaction. She smelled his milk and told them it was definitely cow's milk. Allergens are listed in the kitchen where the milk is. Allergens are also posted by the diapering area, not where the food is served.
On May 19, 2025, CI Radney conducted an interview with Parent A. She was at work. She wasn't sure what happened. She heard someone gave him cow's milk accidentally instead of the oat milk. Everybody should have known of his allergy. They have the doctor's notes of his allergy.
On May 20, 2025, CI Radney conducted an interview with Maria Penn. She was in the neighboring classroom, which shares a half wall. Shelby and Joyce were in the room with Child A. Joyce gave him milk on accident. Child A's first symptom was projectile vomiting about five minutes after ingesting the milk. Child A began to cry. Shelby went to get Julie. Julie realized Child A had been given cow's milk when she opened his cup and took a sip. The allergies are posted in the room but she thinks Joyce didn't see the sign that was posted. She's been there since March 2024 and Joyce has been there the entire time she has been there. Child A started in her classroom when he first started. Parent A told them about his allergy and showed them the documentation from the doctor.
On May 27, 2025, CI Radney conducted an interview with Joyce Turner. She and Shelby were in the classroom with Child A. It was lunch time, and they were filling the children's plates and cups. It slipped her mind that Child A was allergic to milk. Angela sat the gallon of milk on the counter and she was filling the cups and she filled Child A's cup from the gallon milk. She just forgot about Child A's allergy because she is not normally in that room. She was informed of Child A's allergies by them being written down and posted on the wall in the classrooms and in the kitchen.
The allegations in the report are substantiated as Caregiver Joyce Turner accidentally gave Child A an allergen (cow's milk), which caused Child A to have an anaphylactic reaction and require emergency medical care.
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