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On May 30, 2025, the Office of Childhood (OOC) received a report alleging "Child A (15 months old) began attending Mother's Touch on May 27. Upon enrollment, Parent A informed Meagan of Child A's severe allergies to dairy, peanuts, and cat hair. Parent A provided Zyrtec, two EpiPens, and an inhaler, along with written action plans from both her pediatrician and allergist. Despite these precautions, when Parent A picked her up that same day, Child A was experiencing an allergic reaction. On May 28, Cristy was not present at drop-off but later called at 3:00 p.m. to inform Parent A that Child A was again experiencing an allergic reaction. She asked if Parent A could provide Benadryl, and Parent A reminded her she had already supplied Zyrtec with the necessary forms. Parent A asked what food Child A was given that day, as she'd had reactions two days in a row. Parent A was told Child A had fruit, cereal, soy milk, pizza, and an English muffin. When Parent A pressed for the pizza brand since she is allergic to dairy, no clear answer was provided. Cristy contradicted herself regarding the meal, first claiming she wasn't there that day, and then saying Child A didn't have cheese. The center did not follow the action plans Parent A provided and Parent A believes Child A was given cheese on May 28. The child is currently hospitalized due to retractions and labored breathing as a result of the allergic exposures. On May 27, Parent A picked Child A up at 4:40 p.m. and was told the child woke up from her nap with the allergic symptoms." After conducting an investigation, Compliance Inspector (CI) Caylin Mertz has found this allegation to be substantiated based on the following evidence:
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 June 5, 2025 and June 13, 2025, CI Caylin Mertz conducted unannounced inspections and walkthroughs at the facility. Over the course of this investigation, CI Mertz interviewed LLC Member Heather Penrod, Director Cristy Best, Caregiver Megan Oveido, Caregiver Heaven Peugh, Caregiver Haiden "Serena" Smith, and Parent A (Child A's Mother). Parent A indicated she provided the facility with information regarding Child A's allergies upon enrollment, including an allergy/anaphylaxis plan. CI Mertz observed the allergy/anaphylaxis plan in Child A's file, which states Child has an allergy to cow's milk and peanuts, along with instructions written on a medical by Parent A: "Allergic to dairy, peanuts and cat hair. If hives break out please give 2.5 ml of Zyrtec but if its a severe reaction please inject 0.15mg of the epinephrine and call me. Has severe asthma and will provide spacer with inhaler. If she starts coughing repeatedly or wheezing please give her 2 puffs. If still coughing or wheezing please give another 2 puffs and if not better after 3 treatments please call me." Caregiver Megan indicated she looked over the paperwork but did not notice Child A was allergic to peanuts and cat hair. When she later observed symptoms of an allergic reaction, including hives and breathing concerns, she indicated she did not look at the allergy/anaphylaxis plan, which articulates specific steps to take based on the severity of the reaction. Caregiver Heaven indicated she had no idea Child A had allergies until the child was already having an allergic reaction. Caregiver Serena indicated she knew Child A had allergies but did not know if Child A had medication at the facility or what medication the child needed. Heaven, Megan and Serena provided care for Child A; however, none were knowledgeable of all of Child A's allergy needs and allergy/anaphylaxis plan.
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5 CSR 25-500.192(2)(F) which states "Parental contact and the decision made shall be recorded and filed in the child's record."
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5 CSR 25-500.192(3)(B) which states "All medication shall be given to a child only with the dated, written permission of the parent(s) stating the length of time medication may be given."
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5 CSR 25-500.192(3)(I) which states "The date and time(s) of administration, the name of the individual giving the medication and the quantity of any medication given shall be recorded promptly after administration. This information shall be filed in the child's record after the medication is no longer necessary."
On June 5, 2025, CI Mertz observed the facility file for Child A. CI Mertz observed an enrollment form, a medical examination form that is not signed by a physician, and an allergy/anaphylaxis plan for Child A. CI Mertz did not observe any medication authorization forms, documentation that medication was administered or documentation that Parent A was contacted to pick up Child A due to health concerns. Director Cristy indicated Caregiver Heaven administered medication. Heaven provided corroborating statements. She indicated she did not observe the medication authorization form but assumed everything had been signed as Cristy directed her to administer the medication. She indicated she did not document this anywhere; she believed Cristy did. Cristy and Heather both looked for documentation regarding medication administration and authorization during inspections but were unable to locate any documentation. Cristy also stated she contacted Parent A on Thursday regarding Child A possibly having an allergic reaction. CI Mertz did not observe any documentation regarding this parental contact nor was the decision for Child A to be picked up documented.
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5 CSR 25-600.020 (1) which states "Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department."
While interviewing LLC Member Heather on June 5, 2025, Mickey came in and asked Heather if her fingerprints came back yet. Heather indicated they had not. When Mickey exited, CI Mertz asked if she had an eligibility letter for Mickey. Heather indicated she only had the Family Care Safety Registry (FCSR).
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