Lacey Petersen

13A.15.11.04E(1)(c)

“At the time of inspection, a child's EpiPen was expired as of 03/09/2026. Provider should discard or return to the parent and obtain a new EpiPen for the child.”

13A.15.11.04A(1)(a)

“At the time of inspection, a child's medication administration authorization form was not signed by the child's parent. Provider must submit evidence that the form has been completed and signed.”

13A.15.03.04C

“At the time of inspection, LS observed the following: one child missing emergency form, health inventory, immunizations and lead testing; two children missing evidence of age-appropriate lead testing, one child's medication authorization form missing parent authorization and signature, and two emergency forms were missing annual updates.”

13A.15.03.04A(3)

“At the time of inspection, LS observed two emergency forms that had not been updated since June of 2024 and January of 2025 respectively. Provider to submit evidence that the emergency forms have been updated.”

13A.15.11.04E(1)(c)

“At the time of inspection, one EpiPen observed by LS was expired as of 2022. Provider is to obtain a new EpiPen for the child.”

13A.15.03.04C

“At the time of inspection, LS could not observe the following: age appropriate lead testing for 4 children; part I of the health inventory for two children; part II of the health inventory for one child. LS requests that provider submit required documentation for all children.”