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On August 4, 2025, the Office of Childhood (OOC) received a report alleging that on July 29, 2025, a child fell off of a changing table. Teacher Madison Mcquerry stood Child A on the changing table with her right arm out. When she went to reach for something, her arm moved, and Child A fell off the changing table. After conducting the investigation, Compliance Inspector (CI) Cole Eddins finds the allegation is substantiated. This conclusion is based on the following evidence of licensing rule violations which occurred at the facility:
5 CSR 25-500.182(1)(E)3. which states: "The child shall not be left unattended at any time while on the diapering table."
On August 5, 2025, Compliance Inspector (CI) Cole Eddins completed an unannounced inspection and interviewed Director Kymille Hill and Addison McCleery. Kymille stated that on July 29, 2025, she heard from Addison that Child A fell off the changing table at around 10:24 a.m. Addison immediately notified her about the incident, and Parent A (who was also a caregiver) was contacted right away. She heard that Addison stood Child A up on a changing table to pull up her diaper. While Child A was still standing on the changing table, Addison reached for a wipe while her right hand let go of Child A. With nothing to hold Child A up, she fell headfirst on the hardwood floor. Child A was observed with a swollen bruise on her head. Addison stated that she was working in the infant room with Katelyn on July 29, 2025. While changing Child A's diaper, she stood Child A up on the changing table so she could pull up her pants. While Child A was still standing on the changing table, she reached for a wipe, which was located directly to the left of the changing table on the counter. She thought her right hand was still placed on Child A, but she later realized that her hand was hovering away from Child A when he fell off the changing table. Child A fell headfirst and hit her head on the hard floor. Child A cried, and her forehead began to swell.
On August 19, 2025, CI Eddins interviewed Parent A (who is also a caregiver) and Caregiver Katelyn Bell. Parent A stated that on July 29, 2025, she was working in her classroom across the hall from Child A's classroom when Kymille came into her room and told her that Child A had fallen off the changing table. The incident occurred sometime in the morning on July 29, 2025. She was told that Child A fell from a changing table and hit her head. When she went into Child A's classroom, she observed a bruise on Child A's forehead. She also observed a black eye, which formed a day after the incident occurred. She requested to watch the video and observed that Addison did not properly hold Child A when she fell off the changing table. The changing table was about three to four feet off the ground, and the classroom contained hardwood floors. Katelyn stated that Addison was changing Child A's diaper while she was standing a few feet away from the changing table sometime in the morning at around 10:30 a.m. She could not remember if Child A was standing up on the table or not. She thought that Addison had her hands on Child A when the incident occurred. She could not remember for certain, but she thought that Child A dove off the changing table near the end of the diaper change, and Addison did not react quickly enough to catch Child A. She observed a large knot on Child A's forehead.
On August 5, 2025, CI Eddins conducted a walkthrough of the facility and observed the changing table in Child A's classroom, which stood about two feet and eight inches from the ground. CI Eddins observed hardwood floors in Child A's classroom. CI Eddins observed baby wipes within arm's reach of the changing table located on the connecting countertop. CI Eddins also observed the accident report in Procare, which was time-stamped 10:42 a.m. The incident report stated that Child A was on the changing table getting her pants put on. Addison was holding her body when she grabbed a wipe. Child A leaned forward and fell off the table.
On August 5, 2025, CI Eddins received and reviewed footage from July 29, 2025. The video footage contained no audio. The camera angle faced down from the ceiling when the video began at 11:24:45 a.m. on July 29, 2025. Kymille noted that the time stamp on the video was incorrect, and the actual time should have been 10:24:45 a.m. Addison could be observed wearing pink clothing, and Katelyn could be observed wearing a yellow shirt. Katelyn remained on the right side of the video, supervising infants for the majority of the video. As the video began, Addison could immediately be observed standing in front of Child A while she was being changed on the changing table. At 11:24:54 a.m., Addison stands Child A up on her feet while she adjusts her diaper. At 11:25:07 a.m., Addison reaches for a wipe, which was located to the left of the diaper changing table on the counter, a foot or two away from Addison. Addison's arm was in front of Child A, but it was not touching Child A. At 11:25:08 a.m., Child A could be observed leaning forward while Addison was looking toward the counter. Addison took two steps toward the counter and moved her arm from in front of Child A to in front of her own body. Child A fell headfirst over two feet from the changing table and onto the hardwood floor. Child A hit her head at 11:25:08 a.m.
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