Amanda Cooke v. Iowa Department of Health and Human Services

CourtSupreme Court of Iowa
DecidedFebruary 13, 2026
Docket24-2031
StatusPublished

This text of Amanda Cooke v. Iowa Department of Health and Human Services (Amanda Cooke v. Iowa Department of Health and Human Services) is published on Counsel Stack Legal Research, covering Supreme Court of Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Amanda Cooke v. Iowa Department of Health and Human Services, (iowa 2026).

Opinion

In the Iowa Supreme Court

No. 24–2031

Submitted December 17, 2025—Filed February 13, 2026

Amanda Cooke,

Appellee,

vs.

Iowa Department of Health and Human Services,

Appellant.

Appeal from the Iowa District Court for Polk County, Jeanie K. Vaudt,

judge.

Iowa Department of Health and Human Services appeals a judicial review

order reversing a founded child abuse assessment under Iowa Code section

232.68(2)(a)(4)(b). Reversed.

Oxley, J., delivered the opinion of the court, in which all justices joined.

Brenna Bird, Attorney General, and Tabitha J. Gardner (argued), Assistant

Attorney General, for appellant.

Eric S. Mail (argued) and Eric D. Puryear of Puryear Law, P.C., Davenport,

for appellee. 2

Oxley, Justice.

A five-month-old child died from anoxic brain injury after she was found

with her face in a blanket. She had been placed down for a nap by Amanda

Cooke, a state-registered childcare provider. To become a category “B” registered

childcare provider, Cooke was required to comply with certain protocols,

including specific “safe sleep” regulations and facility requirements. The Iowa

Department of Health and Human Services (HHS) issued a founded child abuse

assessment for denying the infant critical care by failing to provide proper

supervision. Proper supervision is statutorily defined as the supervision “that a

reasonable and prudent person would exercise under similar facts and

circumstances.” Iowa Code § 232.68(2)(a)(4)(b) (2023).

On judicial review, the district court reversed the founded child abuse

assessment on the basis that “a reasonable and prudent person” is an objective

“generic person” standard that does not consider the training or knowledge of

the particular person at issue. The district court remanded the case to HHS to

reconsider the assessment under this revised standard.

HHS appealed. On our review, we agree with HHS’s application of Iowa law

when it found that Cooke denied the child critical care under section

232.68(2)(a)(4)(b). We therefore reverse the district court.

I. Factual Background and Proceedings.

Cooke has been a category “B” registered childcare provider in Manchester

since 2020. See Iowa Code § 237A.3A. She provided child daycare services in her

home for families, some of whom received childcare assistance benefits from

HHS. See id. § 237A.13. As a registered childcare provider, Cooke was required

to follow HHS regulations. 3

For instance, Cooke was required—and agreed—to “follow safe sleep

practices as recommended by the American Academy of Pediatrics for infants

under the age of one.” Iowa Admin. Code r. 441—110.8(5)(a). The infant must be

placed on their back to sleep on a firm mattress with a tight-fitted sheet. Id.

r. 441—110.8(5)(a)(1)–(2). “No toys, soft objects, stuffed animals, pillows, bumper

pads, blankets, or loose bedding shall be allowed in the sleeping area with the

infant.” Id. r. 441—110.8(5)(a)(4). The registered childcare provider must actively

monitor the sleeping infant by sight and sound. Id. r. 441—110.8(5)(a)(6). HHS

conducts annual compliance visits at registered childcare providers’ homes to

ensure that they know of and abide by these regulations.

One of the children in Cooke’s care, five-month-old Q.S., was dropped off

by her mother at Cooke’s home around 6:00 a.m. on October 9, 2023—as was

her customary drop-off time most days. Cooke played with Q.S. for about half an

hour and then took Q.S. to the basement to put her down for her morning nap

in a Pack ‘n Play. Typically, the Pack ‘n Play where Q.S. slept was placed in

Cooke’s bedroom on the main floor. But Cooke’s husband was using a wheelchair

while recovering from an injury at the time, and there was not enough room for

the Pack ‘n Play in the bedroom. So Cooke temporarily used the basement for

Q.S.’s naps, even though the basement was only supposed to be used for

emergency tornado drills because it did not have the necessary exits to be used

as part of the daycare. Cooke did not use any type of baby monitor in the

basement and could not observe Q.S. by sight or by sound. Cooke could only

check on Q.S. by going down to the basement.

Around 7:00 a.m., Cooke checked on Q.S. in the Pack ‘n Play. Q.S. was

sleeping but fussed a bit when Cooke looked after her. Cooke returned to the

basement around 8:30 a.m. to wake Q.S. up and feed her breakfast, but Q.S. did 4

not respond when Cooke rubbed her back. There was a large blanket in the Pack

‘n Play with Q.S., and Q.S. was rolled over on her stomach with her face up

against the blanket. Cooke claimed that she left the blanket draped over the side

of the Pack ‘n Play, with half of it hanging inside and the other half hanging

outside. The blanket ultimately ended up inside the Pack ‘n Play covering Q.S.’s

face.

Q.S. was limp and pale when Cooke turned her over. Cooke immediately

started to perform CPR on Q.S. while her husband called 911. First responders

and emergency medical personnel continued resuscitation efforts and

transported Q.S. to Regional Medical Center in Manchester. She regained a

heartbeat and was transferred to the University of Iowa Hospitals and Clinics,

but she died the next day. Her cause of death was listed as “[a]noxic brain injury

due to resuscitated cardiopulmonary arrest due to combined effects of positional

asphyxia and smothering.”

HHS issued Cooke a notice of founded child abuse assessment on

November 6 for denying critical care to Q.S. by failing to provide adequate

supervision. HHS concluded that Cooke was required to be placed on the central

child abuse registry because the risk to the child’s health and welfare was neither

minor nor isolated and not unlikely to reoccur. Iowa Code § 232.71D(2), (3)(a)(2).

HHS also revoked Cooke’s child care registration and her child care assistance

provider agreement. Cooke timely appealed.

An administrative law judge (ALJ) issued a proposed decision upholding

HHS’s determination to revoke Cooke’s childcare registration due to her failure

to follow HHS’s safe sleep regulations. But it reversed the agency’s

determinations that Cooke (1) denied critical care to Q.S. by failing to provide

proper supervision; (2) failed her record check evaluation as a result of the denial 5

of critical care; and (3) needed to have her childcare assistance provider

agreement revoked. With respect to the denial of critical care finding, the ALJ

noted that Cooke’s actions must be measured against an objective “reasonable

and prudent person” standard that did not consider her “greater training by

virtue of her status as a registered day care provider.” The ALJ did not believe

that a parent would be found to have denied critical care by leaving a blanket in

their five-month-old child’s sleeping area. Reasoning that Cooke should be

judged by the same objective standard, the ALJ concluded that Cooke likewise

did not deny critical care.

The case proceeded to the HHS Director, who issued a final agency

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