Complaint·May 15, 2026

It was alleged that the subject child experienced recurring diaper rash allegedly associated with care provided at the facility, that physician feeding instructions were not consistently followed, that the facility imposed disputed diaper and enrollment-related fees, and that updated admission agreements and policy documentation were delayed or inadequately provided. Medical documentation reflected concerns regarding diaper rash severity, physician involvement, formula preparation instructions, and dietary restrictions. It was also alleged that diaper rash symptoms appeared to worsen during daycare attendance and improve during periods when the subject child was absent from care. It was also alleged that physician-directed feeding and formula preparation instructions were not consistently followed by facility staff. Facility staff stated that physician and parental feeding instructions were reviewed, documented, and implemented to the extent permitted under licensing regulations. Facility staff stated that bottles, formula, and approved food were consistently offered in accordance with documented care plans; however, staff could not force the infant child to consume food or formula when refused. Facility staff stated that feeding attempts, refusals, and intake were documented through SproutAbout and internal care logs. Conflicting information was obtained regarding whether feeding difficulties were the result of staff noncompliance or the infant child’s personal feeding tolerance, developmental needs, and adjustment to care. Facility staff interviews consistently disclosed that the subject child often arrived at the facility with diaper rash or soiled diapers already present. Facility staff stated that diaper changes were routinely performed, documented through the SproutAbout application, and increased in frequency when diaper rash was present. Facility staff further stated that infant diapers were checked regularly and that all parents/authorized representatives were notified of diaper rash concerns, including completion of incident reports and unusual incident documentation when symptoms were severe. Continued on LIC 9099-C. Facility staff additionally stated that the family supplied their own diapers, wipes, creams, and formula, and that physician dietary instructions were documented and followed according to parent/authorized representative and physician directives. Documentation reviewed included physician notes directing formula preparation requirements, parental formula substitution forms, and feeding logs reflecting bottle offerings, refusals, solid food intake, and formula tracking. Facility staff stated that disputed fees were consistent with updated pricing structures and standard policy, including diaper-related fees, and that all families were subject to revised admission agreements and pricing changes. Facility staff stated that admission and enrollment agreements were provided, maintained, and updated throughout enrollment. Documentation reviewed confirmed the presence of recurring diaper rash concerns, physician dietary instructions, updated fee policies, and enrollment records; however, conflicting information remained regarding the source of diaper rash, adequacy of dietary implementation, and timing of agreement communication. Due to conflicting information, it is determined there was not sufficient information evident to support the allegation that facility staff neglected the infant child resulting in diaper rash, failed to follow physician-modified dietary instructions, charged fees not listed in the admission agreement, or failed to provide an admission agreement to the authorized representative in a timely manner. Based on information obtained during interviews and records reviewed, it is determined that the allegation could not be substantiated or dismissed. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is UNSUBSTANTIATED. An exit interview was conducted and report was reviewed with Director Claudia Gonzalez. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.