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On January 14, 2026, the Office of Childhood (OOC) received a report alleging that Child A (11 years old) has an allergy to nuts and has an EpiPen to be used if needed. Yesterday, she was given a snack with nuts while at LINC. At 4:45 p.m., they called mom and said they did not give her the EpiPen, but she may have had nuts. When mom picked her up, she gave her Benadryl and then took her to her grandma's house. While there, she was given more Benadryl but became sicker, itching and swelling. The ambulance was called, and she was taken to Children's Mercy where they administered the shots. After conducting the investigation, Compliance Inspector (CI) Curtis West finds the allegation is substantiated. This conclusion is based on the following evidence of a licensing rule violation that occurred at the facility:
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."
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5 CSR 25-500.102(1)(F), which states "Caregivers shall be capable of handling emergencies promptly and intelligently."
On January 14, 2026, Compliance Inspector (CI) Curtis West interviewed Parent A (Parent of Child A) and Child A (11 years old). Parent A stated that when she enrolled Child A into the after-school program, she advised Director Bryan Geddes about Child A's allergy to nuts. Bryan insisted that an EpiPen be left on site and that she provided an action plan for Child A, in case of an emergency. On January 13, 2026, around 4:58 p.m., she received a call from the after-school program advising her that Child A may have been exposed to nuts. She was advised that Child A didn't eat actual nuts. Child A had eaten granola that was made with cashew nut oil. She advised the after-school program that since Child A didn't eat actual nuts, then Benadryl should work and that she was on her way. She arrived at the facility around 5:15 p.m. and gave Child A some Benadryl. She took Child A to Grandparent A's (Grandparent of Child A) house and Child A was given another dose of Benadryl. At 5:45 p.m. on January 13, 2026, Child A broke out into hives. She called for an ambulance and Child A was taken to Children's Mercy, where they administered an Epi-Pen shot.
Child A stated that on January 13, 2026, the after-school program provided yogurt and several toppings so that they could have a yogurt social. All the ingredients were placed into bowls. The children were able to form lines and make their own yogurt bowls. She made a yogurt bowl for herself, and she used some granola as a topping. She didn't think there were any nuts in the granola. She only ate about half of her yogurt when she felt her throat become itchy. She asked one of the teachers if there were nuts in the granola. She asked them to call Parent A because her throat had become itchy. One of the teachers checked the ingredients in the granola and found that it was made with cashew oil. Bryan called Parent A. Bryan told her to wait by the door because Parent A was coming to get her. She took some Benadryl and left with Parent A. Later that evening, she broke out into hives and had to go to the hospital by ambulance to get an EpiPen shot.
On January 14, 2026, CI West conducted an unannounced inspection and interviewed Director Bryan Geddes, Caregiver Asma Abdullah, and Caregiver LaVera Prewitt. Brian stated that he was aware that Child A had an allergy to nuts and shellfish. He didn't advise Child A's primary caregivers about her allergy to nuts. On January 13, 2026, shortly after 4:30 p.m., he was called on the radio from LaVera, who stated that Child A had reported that her throat was itchy. He called Parent A again, and he advised her that Child A reported her throat was itchy after eating a yogurt parfait with granola made with cashew oil. Parent A stated that she was on her way and that since Child A hadn't eaten actual nuts, Benadryl should ease her itchy throat. Asma and LaVera provided consistent information. They stated that on January 13, 2026, Child A reported that her throat was itchy after eating her parfait and that the granola Child A had eaten was made with cashew oil. No one had ever mentioned that Child A was allergic to nuts to them. They had never seen Child A's Food/Anaphylaxis Action Plan or her School-Age Child Health Report. Asma stated that she read on Child A's emergency contact card that Child A was restricted from eating nuts, tree nuts, and shellfish.
On January 15, 2026, CI West received an email communication from Bryan with the food/anaphylaxis action plan prepared by a registered nurse. Child A is allergic to shellfish and all nuts. Mild reactions include runny nose, sneezing, itchy nose, itching, tingling, or mild swelling of lips, tongue, or mouth. Give antihistamine and observe. If symptoms worsen, give epinephrine. Moderate to severe reaction includes tightening of throat, hoarseness, cough, labored breathing, and wheezing. Use epinephrine and give antihistamine. Call 911, and tell dispatcher may need epinephrine. Antihistamine: Benadryl (diphenhydramine) 10ml OR Cetirizine 10ml. Epinephrine: Inject into muscle of the thigh: Epinephrine 0.3mg. May repeat epinephrine dose in 10 minutes if symptoms have not resolved.
The director knew about Child A's allergy. The caregivers were not notified of Child A's allergy; however, this information was on the emergency contact card, which was accessible to the caregivers. The facility did not follow the anaphylaxis action plan when they failed to give Child A an antihistamine when she had symptoms.
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5 CSR 25-500.122(2)(D), which states "The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child's health history, any current health problems, and any restrictions necessary for the child's care."
On January 14, 2026, Compliance Inspector (CI) Curtis West interviewed Parent A (Parent of Child A) and Child A (11 years old). Parent A stated that she doesn't recall providing a School-Age Child Health Report to the program.
On January 14, 2026, CI West conducted an unannounced inspection and interviewed Director Bryan Geddes. He was unable to locate the School-Age Child Health Report for Child A.
On January 20, 2026, CI West received an email communication from Bryan with the School-Age Child Health Report, which was dated January 16, 2026.
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