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On September 15, 2025, the Office of Childhood (OOC) received an allegation that Child A (9-months-old) was given medication at All Aboard Learning Center without parental acknowledgement on two occasions, March 27, and September 10, 2025. Parent A (parent of Child A) did not provide the medication for Child A and did not authorize the medication to be administered. After conducting an investigation, Compliance Inspector (CI) Patrick O'Malley has found this allegation to be substantiated based on the following evidence:
5 CSR 25-500.192(3)(B), which states the following: "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."
AND
5 CSR 25-500.192(3)(D), which states the following: "All nonprescription medication shall be in the original container and labeled by the parent(s) with the child's name, and instructions for administration, including the times and amounts for dosages."
On September 16, 2025, Compliance Inspector (CI) Patrick O'Malley conducted a phone interview with Parent A, who stated that on March 27, 2025, she was contacted by facility staff, who requested permission to give Child A Tylenol due to fussiness. Parent A provided the facility with the medication that same day but was not asked to sign a permission slip. Parent A did not recall if she received the bottle back. On September 10, 2025, she was again contacted by facility staff, who asked that she provide Tylenol due to fussiness. When she arrived at the facility, she was told that Child A had already received 2.5 mL of Tylenol. Parent A was not told where the second bottle of Tylenol came from but she did not provide it. Parent A was not asked to sign a permission slip after the second dose either.
On September 19, 2025, CI O'Malley conducted an unannounced inspection of the facility and observed a medication authorization form for Child A. The form shows that 2.5 mL of Tylenol was administered to Child A by caregiver Sophia Horsefield on September 10 at 1:20 p.m. The form does not show a parent signature. Facility staff could not produce the bottle of Tylenol that was given to Child A on September 10, 2025 and there were no bottles of Tylenol at the facility labeled with Child A's name on them.
Staff Sophia Horsefield stated that she contacted Parent A on September 10, 2025, and received verbal permission to administer liquid Tylenol to Child A. Sophia then provided 2.5 mL of Tylenol to Child A. Sophia was not sure if the bottle was marked with Child A's name but assumed it was his from a previous use. Sophia was not employed by the facility in March 2025.
Lead staff Erica Helderly stated that Child A received liquid Tylenol on September 10, 2025. Staff were always supposed to contact parents before administering as needed medication. Erica was not sure if Child A received Tylenol on March 27, 2025. Erica did not know why it was not documented if Child A received Tylenol on March 27, 2025. Erica did not know why Parent A did not give written permission for Child A to receive Tylenol.
On October 6, 2025, CI O'Malley conducted a phone interview with director Teresa Switzer, who stated that she was not sure if Child A received Tylenol on March 27, 2025. None of the employees currently working in the infant room were working at the facility in March 2025. Teresa stated that Tylenol was administered to Child A on September 10, 2025, without receiving prior written permission from Parent A.
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