Follow-up on corrections·October 28, 2025

On 10/28/2025 at approximately 9:45AM, Licensing Program Analyst (LPA) Jung conducted an unannounced case management inspection to follow up on an unusual incident that was reported by the facility to the Department. Upon arrival, LPA met with Director, Stephanie Strand. LPA disclosed the purpose of the inspection and was led on a tour of the facility. There were 37 infant children, 10 infant staff, 24 preschool children, and 4 preschool staff members present. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. An Unusual Incident Report (UIR) was submitted to the Department on 10/23/2025 reporting that Child 1 (C1) was fed the wrong bottle by Staff 1 (S1) on the morning of 10/23/2025. During the visit, LPA conducted interviews with staff and reviewed documents pertinent to the investigation. According to staff interviewed, S1 had entered the classroom to give Staff 3 (S3) their morning break. Before S3 left for their break, they had put two infant bottles in the bottle warmer. Without following the facility’s Feeding Log policy, S1 grabbed one of the bottles from the bottle warmer and began feeding C1. Staff 2 (S2), who was also in the room, noticed that S1 was feeding C1 from the wrong bottle. S2 communicated the mistake to S1, but C1 had already ingested one ounce from the wrong bottle. Staff involved communicated the incident to the Director, and Director spoke with families of both children involved. (Go to Page 2) (Page 2) Director stated that they will retrain staff on Feeding Log policy and implement additional measures to the feeding procedure to ensure that staff do not feed the wrong bottle to infants going forward. Director provided LPA with copies of C1 and C2's daily report detailing their feeding times from the day of the incident, as well as facility roster, Child Supervision Record (CSR), and Bottle Feeding Log from the day of the incident. Facility staff reported the incident to the Department in a timely manner. Based on the information obtained and interviews conducted, one Type B citation for Infant Care Food Service is being cited; see LIC 809D for deficiency. Facility was cited for the same deficiency on 1/23/2025 and 5/28/2025. As this is a repeat citation, civil penalty was issued; see LIC 421FC for civil penalty. Report was reviewed with Director, Stephanie Strand, and Notice of Site Visit was given which must remain posted for 30 days. End of report.