1 R 400.8158 Incident, accident, injury, illness, death, fire reporting. (3) A licensee, licensee designee, or program director shall report to the department, via phone, fax, or email, within 24 hours of notification by a parent that a child received medical treatment or was hospitalized for an injury, accident, or medical condition that occurred while the child was in care.
On 3/22/21, the program director, Ms. Morse sent me an e mail stating that while she was referring to the licensing rule book, she realized that she had not reported an incident to the department about Child A being taken to the emergency room because of the center serving yogurt. Child A is allergic to dairy. Ms. Morse stated that she was not aware of the rule that she had to report any incident leading to medical treatment (R 400.8158(3)) since Child A had no allergy symptoms while he 2 was at the center. I provided consultation and requested for Ms. Morse to send an incident report for the same. On 3/22/21 I received an incident report stating that on 2/18/21, there was a birthday celebration in the classroom. Child A was served with his own snack due to his allergies. Accidentally he was also served with the birthday treat (yogurt). Just after Child A took one bite of the yogurt, staff member Ms. Brown realized that it was a mistake and administered Benadryl and called the parents. Child A did not have any reactions while he was at the center. The parents took him to the emergency room and on the way administered an Auvi-Q pen shot. On 3/22/21, I interviewed Child A's father who stated that they reached the center as soon as they became aware of the incident. Child A's father said that they drove up to the front door, picked up Child A, and Ms. Brown handed the Benadryl bottle to them and they drove away. Child A's father said that they did not see any allergic reactions or symptoms of Child A. On the way to the emergency room, they administered an Auvi-Q pen shot as a precaution. Child A's father stated that the incident had not occurred, but they were satisfied with the care provided to Child A in this event. Child A continues to be enrolled at the center. On 3/25/21, I conducted an onsite investigation at the center. I conducted interviews with the program director and the staff members involved in the incident. I reviewed the allergy plan and the medication permission forms for Child A. On 3/25/21, I interviewed Ms. Morse who stated that on 2/18/21, she was not at the center and she received a text message from Ms. Brown stating that she had given Benadryl to Child A since he was served yogurt at snack time. Ms. Morse said that she told Ms. Brown to call Child A's parents right away and monitor Child A for any symptoms. Ms. Brown confirmed that she called Child A's parents, Child A was picked up from the center and administered Auvi-Q on the way to the emergency room. Ms. Morse said that she was not clear about how the yogurt was served to Child A, even though he had his own snack every day. On 3/25/21, I interviewed Ms. Brown who said that on 2/18/21, they had a birthday celebration in the morning at about 9 am. The children were served yogurt as a birthday treat. The assistant caregiver, Ms. Arnoldy had opened all the yogurt containers and placed them at the children's tables. Children have their own individual tables for meals and table-top activities. As the snacks were served, Child A came up to her and said that he had a tummy ache. After hearing this, Ms. Brown recalled Ms. Arnoldy telling her a few minutes before that Child A had enjoyed his snack. Ms. Brown said that Ms. Brown realized that Child A had eaten the yogurt and he is allergic to dairy products. She immediately administered Benadryl and called the program director, Ms. Morse, and the parents. Ms. Brown said that she did not see any signs of distress even though Child A said that he had a tummy ache. She did not see any problems with breathing or hives. 3 u t ^. i' a •• • ~• i• f . p '• i .•l i • r- ,v- .Y •i• who .I• . • f. -•' . •IiNsi1 •• H. • ff ! • • f:' is fl• I• • • • f ~f •- •' • f •I . f f f d . f A • • . • J.. . - L d • -,..• • ~• .--_ -• • il l • • . products. i o• • . • t •. took f • l • A I I • I iii f c . .J [S i • •. r • - rrr r- c c — — — `• •• • • — — • •I — .• • liii] ; ! • A • !, 0