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On November 24, 2025, the Office of Childhood (OOC) received an allegation that Parent A (parent of Child A) noticed a large bump on the right side of Child A's (17-months-old) head during bath time. Parent A took Child A to St. Mary's Hospital in Jefferson City, where tests and images were taken of Child A's head. There was concern for a traumatic brain injury. Parent A was contacted later by St. Mary's personnel and advised to take Child A to Cardinal Glennon Children's Hospital for a skull fracture. The hospital personnel at St. Louis stated that the injury is not typical for running into a wall and it is being considered a non-accidental trauma. Parent A was informed by Rhodes to Wiser Childcare Center LLC staff that Child A ran into a wall. After conducting an investigation, Compliance Inspector (CI) Patrick O'Malley has found this allegation to be substantiated based on the following evidence:
5 CSR 25-500.102(1)(A), which states that: "Child care personnel shall be of good character and intent and shall be qualified to provide care conducive to the welfare of children."
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5 CSR 25-500.102(1)(F), which states that: "Caregivers shall be capable of handling emergencies promptly and intelligently."
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5 CSR 25-500.192(5)(A), which states that: "In case of accident or injury to a child, the provider shall notify the parent(s) immediately. If the child requires emergency medical care, the provider shall follow the parent's(s') written instructions."
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5 CSR 25-500.192(5)(B), which states that: "Information regarding the date and circumstance of any accident or injury shall be noted in the child's record."
On November 24, 2025, CI O'Malley conducted a visit to Parent A's home. CI O'Malley observed a knot to the right side of Child A's head. The knot measured four inches across with no discoloration. CI O'Malley observed an after-visit summary from St. Mary's Hospital in Jefferson City, dated November 21, 2025, which shows that a CT scan of the head without contrast was performed, and Child A was diagnosed with swelling of the scalp. CI O'Malley observed an after-visit summary from Cardinal Glennon Children's Hospital in St. Louis, dated November 22, 2025, which shows that an x-ray scan was performed, and Child A was diagnosed with a closed fracture of the parietal bone.
CI O'Malley conducted an interview with Parent A, who stated that on Friday, November 21, 2025, she picked up Child A from Rhodes to Wiser Childcare Center LLC at about 4:30 p.m. Parent A took Child A grocery shopping and out to dinner. Nothing occurred during the evening that would have caused swelling to Child A's head. Parent A gave Child A a bath at about 7:30 p.m., during which she noticed a large, squishy knot to the right side of Child A's head, under Child A's hair. Parent A texted director Monica Wiser, asking what had happened to Child A's head. Parent A took Child A to St. Mary's Hospital in Jefferson City, where a computed tomography (CT) scan was performed. Child A was diagnosed with non-specific swelling to the head and sent home. On Saturday, November 22, 2025, Monica responded via text that staff Mercedes "Sadie" Mitchell reported that Child A had run into a wall while playing. Also on November 22, 2025, she received a phone call from a doctor at St. Mary's Hospital who reported that Child A's CT scan had been reviewed again and Child A had been diagnosed with a skull fracture without depression. The doctor also recommended taking Child A to Cardinal Glennon Hospital in St. Louis, which Parent A did that day. Child A received an x-ray scan and was diagnosed with a closed fracture of the parietal bone. The doctor at Cardinal Glennon reported that the injury was inconsistent with running into a wall. Parent A has not had any contact with the facility since November 22, 2025. Parent A was disenrolling Child A from the facility.
On November 24, 2025, CI O'Malley conducted an unannounced inspection of the facility and conducted interviews with director Monica Wiser, staff Heaven Werdehausen, and Mercedes "Sadie" Mitchell. Director Monica Wiser stated that she was contacted by Parent A via text on November 22, 2025; Parent A wanted to know if Child A had received a head injury the previous day. Monica forwarded Parent A's question to the facility's staff text chain. Sadie responded that Child A had been spinning in place and then ran into a wall. Monica asked if Sadie had completed an incident report, which Sadie denied doing. All staff would be retrained in reporting and responding to accidents and injuries.
Staff Heaven Werdehausen stated that she and Sadie worked in the toddler room with Child A on November 21, 2025. Heaven did not witness any injuries to Child A. At about 4:30 p.m., she was getting ready to leave. Heaven heard a thump and Child A started crying. Sadie said that Child A had gotten dizzy and run into a wall.
Staff Mercedes "Sadie" Mitchell stated that she was playing with Child A at the end of the day on November 21, 2025. Sadie was picking up Child A, throwing Child A onto her shoulder, then leaning forward to let Child A fall off her shoulder, then catching Child A as Child A fell. Sadie missed catching Child A and Child A fell to the floor, striking her head. Sadie picked Child A up off the floor and checked her for injuries. Sadie did not see any marks, bruises, or injuries to Child A's head. Parent A arrived a few minutes after the accident to take Child A. Sadie did not inform Parent A of the accident. Sadie also stated that she did not inform administration of the accident or complete an incident report. Sadie stated that she initially lied to both Heaven and Monica about what had happened. Sadie was afraid of getting into trouble and being fired.
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