Keith, Candice

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence had openings that were between 3.5 and 9 inches and allow entrapment - the openings measured 6 feet by 3 1/2 feet along the north east side of the fence where the fence is not secure to the ground.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 1. states: An outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water or other hazards. For family day care homes initially licensed after the effective date of these rules, or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard and provide a safe fence around the outdoor play area as required.

Correction Verification: Submit Documentation

Compliance Date: 6/16/2026

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: Hazardous items as follows were accessible to children: buckets of paint and drill. The item(s) was/were located in the back room on the right.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Submit Documentation

Compliance Date: 5/27/2026

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The floors located in the area off the kitchen was/were not in good condition as evidenced by several areas were chipped .

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

Compliance Date: 5/11/2026

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: There was evidence of dirt/debris in the kitchen area as the kitchen counters were observed to be full with dishes and other items. Very little works space.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 9. states: The home shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.

Correction Required: The facility shall be clean and pest free.

Correction Verification: Submit Documentation

Compliance Date: 5/27/2026

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Outdoor equipment, caterpillar, in the outdoor play area was not in good condition as evidenced by yellow plastic cracking on top of caterpillar exposing sharp areas.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: Outdoor equipment shall have no exposed hazards.

Correction Verification: Submit Documentation

Compliance Date: 5/11/2026

5 CSR 25-400.055 Annual Requirements

Violation: The equipment list was not submitted.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (1) (B) states: A current list of available equipment.

Correction Required: The child care provider shall submit an equipment list as required.

Correction Verification: Corrected on Site

Compliance Date: 4/21/2026

5 CSR 25-400.055 Annual Requirements

Violation: The listing of household members and assistants was not submitted.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (1) (C) states: A listing of household members and assistant(s).

Correction Required: The child care provider shall submit a listing of all household members and assistants.

Correction Verification: Corrected on Site

Compliance Date: 4/21/2026

5 CSR 25-400.055 Annual Requirements

Violation: The Annual Declaration was not submitted.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed family child care home and agreement to comply with all statutes and department licensing rules;

Correction Required: The child care provider shall submit the Annual Declaration as required.

Correction Verification: Corrected on Site

Compliance Date: 4/21/2026

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence had openings that were between 3.5 and 9 inches and allow entrapment - the openings measured 6 feet by 3 1/2 feet along the north east side of the fence where the fence is not secure to the ground.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 1. states: An outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water or other hazards. For family day care homes initially licensed after the effective date of these rules, or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard and provide a safe fence around the outdoor play area as required.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: Hazardous items as follows were accessible to children: buckets of paint and drill. The item(s) was/were located in the back room on the right.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The floors located in the area off the kitchen was/were not in good condition as evidenced by several areas were chipped .

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: There was evidence of dirt/debris in the kitchen area as the kitchen counters were observed to be full with dishes and other items. Very little works space.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 9. states: The home shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.

Correction Required: The facility shall be clean and pest free.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: There was evidence of dirt/debris in kitchen as the trash can was observed full and needed to be disposed.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 9. states: The home shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.

Correction Required: The facility shall be clean and pest free.

Correction Verification: Corrected on Site

Compliance Date: 4/21/2026

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: There was evidence of dirt/debris in the entryway to the bathroom. Several throw rugs were in front of the bathroom doorway that pose a tripping hazard.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 9. states: The home shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.

Correction Required: The facility shall be clean and pest free.

Correction Verification: Corrected on Site

Compliance Date: 4/21/2026

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Outdoor equipment, caterpillar, in the outdoor play area was not in good condition as evidenced by yellow plastic cracking on top of caterpillar exposing sharp areas.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: Outdoor equipment shall have no exposed hazards.

Correction Verification: Submit Documentation

5 CSR 25-400.210 Records and Reports

Violation: One child(ren) records did not include employers' name of parent(s), guardian or legal custodian.

Rule Reference: 5 CSR 25-400.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.

Correction Required: Child enrollment information shall be completed and on file as required.

Correction Verification: Corrected on Site

Compliance Date: 4/21/2026

5 CSR 25-400.210 Records and Reports

Violation: One child(ren) records did not include work schedule of parent(s), guardian or legal custodian.

Rule Reference: 5 CSR 25-400.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.

Correction Required: Child enrollment information shall be completed and on file as required.

Correction Verification: Corrected on Site

Compliance Date: 4/21/2026

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The use of potty chairs/junior commode/adaptor seat did not meet requirements as evidenced by the potty chair was not cleaned.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (C) 2. states: Infants and toddlers. At least one (1) potty chair, junior commode or toilet with an adaptor seat shall be provided. Potty chairs shall be located in the bathroom and shall be emptied, cleaned and disinfected after each use.

Correction Required: The facility shall provide and clean/sanitize potty training equipment as required.

Correction Verification: Submit Documentation

Compliance Date: 10/14/2025

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The walls located in the front room, south wall next to the door was/were not in good condition as evidenced by a hole approximately 2 inches in diameter was observed in the wall..

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

Compliance Date: 10/21/2025

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence had openings that were between 3.5 and 9 inches and allow entrapment - the openings measured 4 1/2 inches and were located on the far northside corner of the fence and the northeast corner of the fence.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 1. states: An outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water or other hazards. For family day care homes initially licensed after the effective date of these rules, or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard and provide a safe fence around the outdoor play area as required.

Correction Verification: Submit Documentation

Compliance Date: 1/12/2026

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Outdoor equipment, caterpiller, in the outdoor play area was not in good condition as evidenced by several places that were broken on the top exposing sharp areas that could harm children..

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: Outdoor equipment shall have no exposed hazards.

Correction Verification: Submit Documentation

Compliance Date: 11/11/2025

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence had openings that were between 3.5 and 9 inches and allow entrapment - the openings measured 4 1/2 inches and were located on the far northside corner of the fence and the northeast corner of the fence.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 1. states: An outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water or other hazards. For family day care homes initially licensed after the effective date of these rules, or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard and provide a safe fence around the outdoor play area as required.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: Hazardous items as follows were accessible to children: potting soil. The item(s) was/were located the front room near the entrance.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Corrected on Site

Compliance Date: 10/14/2025

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The walls located in the front room, south wall next to the door was/were not in good condition as evidenced by a hole approximately 2 inches in diameter was observed in the wall..

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The use of potty chairs/junior commode/adaptor seat did not meet requirements as evidenced by the potty chair was not cleaned.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (C) 2. states: Infants and toddlers. At least one (1) potty chair, junior commode or toilet with an adaptor seat shall be provided. Potty chairs shall be located in the bathroom and shall be emptied, cleaned and disinfected after each use.

Correction Required: The facility shall provide and clean/sanitize potty training equipment as required.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The bathroom was not clean and odor free as evidenced by trash can next to the changing table was overflowing and lid unable to close.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (C) 1. E. states: Bathrooms shall be clean and odor free.

Correction Required: Bathrooms shall be clean and odor free.

Correction Verification: Corrected on Site

Compliance Date: 10/14/2025

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Outdoor equipment, caterpiller, in the outdoor play area was not in good condition as evidenced by several places that were broken on the top exposing sharp areas that could harm children..

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: Outdoor equipment shall have no exposed hazards.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by the resilient material used is unapproved as evidenced by rubber interlocking mats observed in the fall zone of the dome climber, these are not manufactured as resilient surfacing.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 6. states: The fall-zone area under and around outdoor equipment where children might fall and be injured shall be covered with impact absorbing materials which effectively cushions the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material. Grass may be an approved resilient material, but if grass becomes worn or sparse, the area must be covered with another approved resilient material.

Correction Required: The facility shall maintain approved resilient material in all fall-zone areas.

Correction Verification: Submit Documentation

Compliance Date: 6/30/2025

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by bare ground observed in the fall zone of the slides, and all climbers.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 9. states: Concrete, asphalt, carpet or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.

Correction Required: The facility shall maintain approved resilient material in all fall-zone areas.

Correction Verification: Submit Documentation

Compliance Date: 6/30/2025

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The floors located kitchen was/were not in good condition as evidenced by small hole in floor.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

Compliance Date: 4/12/2025

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: The outdoor play equipment, plastic rock climbing piece, from which a child might fall was more than six feet in height. The height was 6' 9".

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials (3) (E) states: For family day care homes initially licensed after the effective date of these rules or for homes installing new equipment, any part of the equipment from which children might fall shall not be more than six feet (6') in height.

Correction Required: The maximum height of any part of equipment, from which children might fall, shall not be more than six feet in height.

Correction Verification: Submit Documentation

Compliance Date: 6/30/2025

5 CSR 25-400.185 Health Care

Violation: Requirements for handwashing were not met as evidenced by snack served to the children during the inspection, no child was instructed to wash their hands.

Rule Reference: 5 CSR 25-400.185 Health Care (6) (B) states: Caregivers shall teach children to wash their hands before eating and after toileting.

Correction Required: Staff/children shall wash hands as required.

Correction Verification: Submit Documentation

Compliance Date: 4/3/2025

5 CSR 25-400.185 Health Care

Violation: Requirements for handwashing were not met as evidenced by caregiver did not wash her had prior to preparing and serving snack.

Rule Reference: 5 CSR 25-400.185 Health Care (6) (A) states: Caregivers shall wash their hands with soap and running water after toileting or assisting a child with toileting, after diapering a child, before food preparation or serving of food and at other times as needed.

Correction Required: Staff/children shall wash hands as required.

Correction Verification: Submit Documentation

Compliance Date: 4/3/2025

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Candice Keith.

Rule Reference: 5 CSR 25-600.020 General Requirements (5) states: Criminal background checks shall be completed for each child care staff member every five (5) years.

Correction Required: Required results of criminal background checks shall be on file.

Correction Verification: Submit Documentation

Compliance Date: 4/15/2025

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by the resilient material used is unapproved as evidenced by rubber interlocking mats observed in the fall zone of the dome climber, these are not manufactured as resilient surfacing.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 6. states: The fall-zone area under and around outdoor equipment where children might fall and be injured shall be covered with impact absorbing materials which effectively cushions the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material. Grass may be an approved resilient material, but if grass becomes worn or sparse, the area must be covered with another approved resilient material.

Correction Required: The facility shall maintain approved resilient material in all fall-zone areas.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by bare ground observed in the fall zone of the slides, and all climbers.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 9. states: Concrete, asphalt, carpet or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.

Correction Required: The facility shall maintain approved resilient material in all fall-zone areas.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The floors located kitchen was/were not in good condition as evidenced by small hole in floor.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Outdoor equipment, little tykes, in play yard was not free of sharp parts as evidenced by the latter rungs are broken and sharp.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: Outdoor equipment shall have no exposed hazards.

Correction Verification: Corrected on Site

Compliance Date: 4/3/2025

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Outdoor equipment, caterpillar , in play yard was not free of sharp parts as evidenced by one of the plastic feet is broken and sharp.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: Outdoor equipment shall have no exposed hazards.

Correction Verification: Corrected on Site

Compliance Date: 4/3/2025

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: The outdoor play equipment, plastic rock climbing piece, from which a child might fall was more than six feet in height. The height was 6' 9".

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials (3) (E) states: For family day care homes initially licensed after the effective date of these rules or for homes installing new equipment, any part of the equipment from which children might fall shall not be more than six feet (6') in height.

Correction Required: The maximum height of any part of equipment, from which children might fall, shall not be more than six feet in height.

Correction Verification: Submit Documentation

5 CSR 25-400.185 Health Care

Violation: Requirements for handwashing were not met as evidenced by caregiver did not wash her had prior to preparing and serving snack.

Rule Reference: 5 CSR 25-400.185 Health Care (6) (A) states: Caregivers shall wash their hands with soap and running water after toileting or assisting a child with toileting, after diapering a child, before food preparation or serving of food and at other times as needed.

Correction Required: Staff/children shall wash hands as required.

Correction Verification: Submit Documentation

5 CSR 25-400.185 Health Care

Violation: Requirements for handwashing were not met as evidenced by snack served to the children during the inspection, no child was instructed to wash their hands.

Rule Reference: 5 CSR 25-400.185 Health Care (6) (B) states: Caregivers shall teach children to wash their hands before eating and after toileting.

Correction Required: Staff/children shall wash hands as required.

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Candice Keith.

Rule Reference: 5 CSR 25-600.020 General Requirements (5) states: Criminal background checks shall be completed for each child care staff member every five (5) years.

Correction Required: Required results of criminal background checks shall be on file.

Correction Verification: Submit Documentation

5 CSR 25-400.045 Licensing Process

Violation: Posting requirements were not met as evidenced by the posted license was outdated.

Rule Reference: 5 CSR 25-400.045 Licensing Process (12) states: Once granted, the license shall be posted near the entrance of the home where it may be seen easily by parents or others who visit.

Correction Required: The official license shall be posted.

Correction Verification: Submit Documentation

Compliance Date: 5/28/2024

5 CSR 25-400.055 Annual Requirements

Violation: The equipment list was not submitted.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (1) (B) states: A current list of available equipment.

Correction Required: The child care provider shall submit an equipment list as required.

Correction Verification: Submit Documentation

Compliance Date: 4/18/2024

5 CSR 25-400.055 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Candie Keith, and Gina Miller-Lile within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.

Correction Required: Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification: Submit Documentation

Compliance Date: 5/28/2024

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence had openings that were between 3.5 and 9 inches and allow entrapment - the openings measured 5 inches at the bottom of the fence on the northeast corner of the play yard.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 1. states: An outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water or other hazards. For family day care homes initially licensed after the effective date of these rules, or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard and provide a safe fence around the outdoor play area as required.

Correction Verification: Submit Documentation

Compliance Date: 5/28/2024

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by small broken metal pipe with sharp edges was observed in the dome climber which is the fall zone of the play piece.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 5. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

Correction Required: The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification: Submit Documentation

Compliance Date: 5/28/2024

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by bare ground inside of the dome climber.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 9. states: Concrete, asphalt, carpet or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.

Correction Required: The facility shall maintain approved resilient material in all fall-zone areas.

Correction Verification: Submit Documentation

Compliance Date: 5/28/2024

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: Children were observed in the kitchen napping.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (D) 5. states: Kitchens shall not be used for napping.

Correction Required: Children shall not be in the kitchen except for supervised activities.

Correction Verification: Submit Documentation

Compliance Date: 5/28/2024

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Outdoor equipment, alligator-teetertotter, in play yard was not in good condition as evidenced by missing handle bars.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: Outdoor equipment shall have no exposed hazards.

Correction Verification: Submit Documentation

Compliance Date: 5/28/2024

5 CSR 25-400.210 Records and Reports

Violation: 1 child(ren) records did not include address of another individual who might be reached in an emergency.

Rule Reference: 5 CSR 25-400.210 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached.

Correction Required: Child enrollment information shall be completed and on file as required.

Correction Verification: Submit Documentation

Compliance Date: 5/28/2024

5 CSR 25-400.045 Licensing Process

Violation: Posting requirements were not met as evidenced by the posted license was outdated.

Rule Reference: 5 CSR 25-400.045 Licensing Process (12) states: Once granted, the license shall be posted near the entrance of the home where it may be seen easily by parents or others who visit.

Correction Required: The official license shall be posted.

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The equipment list was not submitted.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (1) (B) states: A current list of available equipment.

Correction Required: The child care provider shall submit an equipment list as required.

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The listing of household members and assistants was not submitted.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (1) (C) states: A listing of household members and assistant(s).

Correction Required: The child care provider shall submit a listing of all household members and assistants.

Correction Verification: Corrected on Site

Compliance Date: 4/17/2024

5 CSR 25-400.055 Annual Requirements

Violation: The Annual Declaration was not submitted.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed family child care home and agreement to comply with all statutes and department licensing rules;

Correction Required: The child care provider shall submit the Annual Declaration as required.

Correction Verification: Corrected on Site

Compliance Date: 4/17/2024

5 CSR 25-400.055 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Candie Keith, and Gina Miller-Lile within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.

Correction Required: Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence had openings that were between 3.5 and 9 inches and allow entrapment - the openings measured 5 inches at the bottom of the fence on the northeast corner of the play yard.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 1. states: An outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water or other hazards. For family day care homes initially licensed after the effective date of these rules, or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard and provide a safe fence around the outdoor play area as required.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by small broken metal pipe with sharp edges was observed in the dome climber which is the fall zone of the play piece.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 5. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

Correction Required: The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by bare ground inside of the dome climber.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 9. states: Concrete, asphalt, carpet or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.

Correction Required: The facility shall maintain approved resilient material in all fall-zone areas.

Correction Verification: Submit Documentation

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Violation: Children were observed in the kitchen napping.

Rule Reference: 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (D) 5. states: Kitchens shall not be used for napping.

Correction Required: Children shall not be in the kitchen except for supervised activities.

Correction Verification: Submit Documentation

5 CSR 25-400.086 Fire Safety

Violation: Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by the disaster and tornado drill was not held at least one time every three months.

Rule Reference: 5 CSR 25-400.086 Fire Safety (2) (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.

Correction Required: Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification: Corrected on Site

Compliance Date: 4/17/2024

5 CSR 25-400.086 Fire Safety

Violation: The house numbers were not plainly visible from the street.

Rule Reference: 5 CSR 25-400.086 Fire Safety (2) (F) states: The house numbers shall be plainly visible from the street in case of emergency.

Correction Required: House numbers shall be plainly visible from the street.

Correction Verification: Corrected on Site

Compliance Date: 4/17/2024

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Outdoor equipment, alligator-teetertotter, in play yard was not in good condition as evidenced by missing handle bars.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: Outdoor equipment shall have no exposed hazards.

Correction Verification: Submit Documentation

5 CSR 25-400.210 Records and Reports

Violation: 1 child(ren) records did not include address of another individual who might be reached in an emergency.

Rule Reference: 5 CSR 25-400.210 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached.

Correction Required: Child enrollment information shall be completed and on file as required.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

Correction Required: Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification: Submit Documentation

Compliance Date: 3/2/2024

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

Correction Required: Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification: Submit Documentation

Compliance Date: 3/2/2024

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: Safe sleep training was not completed within the past 3 years for the assistant(s), Gina Lile.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) (A) . states: Every three (3) years the provider, assistant(s), and volunteers in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs dese-administrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Correction Required: The child care provider and assistant(s) shall complete department-approved safe sleep training as required.

Correction Verification: Submit Documentation

Compliance Date: 3/5/2024

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Gina Lile.

Rule Reference: 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.

Correction Required: Required results of criminal background checks shall be on file.

Correction Verification: Submit Documentation

Compliance Date: 2/21/2024

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

Correction Required: Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

Correction Required: Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: Safe sleep training was not completed within the past 3 years for the assistant(s), Gina Lile.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) (A) . states: Every three (3) years the provider, assistant(s), and volunteers in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs dese-administrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Correction Required: The child care provider and assistant(s) shall complete department-approved safe sleep training as required.

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Gina Lile.

Rule Reference: 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.

Correction Required: Required results of criminal background checks shall be on file.

Correction Verification: Submit Documentation

5 CSR 25-400.086 Fire Safety

Violation: The requirements for protective outlet covers were not met as evidenced by three electrical outlets did not have a cover.

Rule Reference: 5 CSR 25-400.086 Fire Safety (11) (B) states: Protective covers or inserts for electrical receptacles shall be installed in all areas occupied by children.

Correction Required: The facility shall use protective outlet covers as required.

Correction Verification: Corrected on Site

Compliance Date: 1/11/2024

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

Correction Required: Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

Correction Required: Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: Safe sleep training was not completed within the past 3 years for the assistant(s), Gina Lile.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) (A) . states: Every three (3) years the provider, assistant(s), and volunteers in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs dese-administrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Correction Required: The child care provider and assistant(s) shall complete department-approved safe sleep training as required.

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Gina Lile.

Rule Reference: 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.

Correction Required: Required results of criminal background checks shall be on file.

Correction Verification: Submit Documentation

5 CSR 25-400.045 Licensing Process

Violation: The ages of children was/were exceeded as evidenced by one child is 14 years old.

Rule Reference: 5 CSR 25-400.045 Licensing Process (18) states: The number and ages of children a family child care home is authorized to have in care at any one time shall be specified on the license and shall not be exceeded except as permitted within these rules.

Correction Required: The provider shall maintain compliance with the specifications on the license.

Correction Verification: Return Inspection

Compliance Date: 12/21/2023

5 CSR 25-400.045 Licensing Process

Violation: The number of children was/were exceeded as evidenced by eleven children were present at the facility.

Rule Reference: 5 CSR 25-400.045 Licensing Process (18) states: The number and ages of children a family child care home is authorized to have in care at any one time shall be specified on the license and shall not be exceeded except as permitted within these rules.

Correction Required: The provider shall maintain compliance with the specifications on the license.

Correction Verification: Return Inspection

Compliance Date: 12/21/2023

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Requirements for the crib mattress/playpen pad/bedding were not met as evidenced by gaps were observed between the matress/pad and side of the crib or playpen.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 2 C states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used and shall be changed immediately when soiled or wet.

Correction Required: Sleeping equipment shall meet safety and sanitation requirements.

Correction Verification: Return Inspection

Compliance Date: 12/18/2023

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: Safe sleep training was not completed within the past 3 years for the assistant(s), Gina Lile.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) (A) . states: Every three (3) years the provider, assistant(s), and volunteers in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs dese-administrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Correction Required: The child care provider and assistant(s) shall complete department-approved safe sleep training as required.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

Correction Required: Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

Correction Required: Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The provider did not conduct a Family Care Safety Registry screening for Gina Lile, who was hired on 11-10-23.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

Correction Required: Required results of the Family Care Safety Registry screening shall be on file.

Correction Verification: Submit Documentation

Compliance Date: 12/21/2023

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Gina Lile.

Rule Reference: 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.

Correction Required: Required results of criminal background checks shall be on file.

Correction Verification: Submit Documentation

5 CSR 25-400.045 Licensing Process

Violation: The number of children was/were exceeded as evidenced by eleven children were present at the facility.

Rule Reference: 5 CSR 25-400.045 Licensing Process (18) states: The number and ages of children a family child care home is authorized to have in care at any one time shall be specified on the license and shall not be exceeded except as permitted within these rules.

Correction Required: The provider shall maintain compliance with the specifications on the license.

Correction Verification: Return Inspection

5 CSR 25-400.045 Licensing Process

Violation: The ages of children was/were exceeded as evidenced by one child is 14 years old.

Rule Reference: 5 CSR 25-400.045 Licensing Process (18) states: The number and ages of children a family child care home is authorized to have in care at any one time shall be specified on the license and shall not be exceeded except as permitted within these rules.

Correction Required: The provider shall maintain compliance with the specifications on the license.

Correction Verification: Return Inspection

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: The requirements for sleeping materials were not met as evidenced by 1 children 12 months or older was/were sleeping/napping on the floor.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 1 A states: A cot, bed, sofa, padded playpen or crib shall be provided for each child who naps or sleeps. An individually assigned sheet and blanket shall be provided for each child twelve (12) months and older who naps or sleeps. Upper levels of bunk beds shall not be used.

Correction Required: The facility shall provide sleeping equipment and bedding as required.

Correction Verification: Submit Documentation

Compliance Date: 12/13/2023

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Requirements for the crib mattress/playpen pad/bedding were not met as evidenced by gaps were observed between the matress/pad and side of the crib or playpen.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 2 C states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used and shall be changed immediately when soiled or wet.

Correction Required: Sleeping equipment shall meet safety and sanitation requirements.

Correction Verification: Return Inspection

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by a child age 11 months old in a pack and play with a blanket and pacifier clip.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 2 E states: Cribs, portable cribs and playpens shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation. Examples include bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, pillow-like toys, wedges, infant positioners, special mattresses, special sleep surfaces, and other similar items.

Correction Required: Infant napping equipment shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation.

Correction Verification: Return Inspection

Compliance Date: 12/13/2023

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The provider did not conduct a Family Care Safety Registry screening for Gina Lile, who was hired on 11-10-23.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

Correction Required: Required results of the Family Care Safety Registry screening shall be on file.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

Correction Required: Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: Safe sleep training was not completed within the past 3 years for the assistant(s), Gina Lile.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) (A) . states: Every three (3) years the provider, assistant(s), and volunteers in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs dese-administrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Correction Required: The child care provider and assistant(s) shall complete department-approved safe sleep training as required.

Correction Verification: Submit Documentation

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

Correction Required: Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Gina Lile.

Rule Reference: 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.

Correction Required: Required results of criminal background checks shall be on file.

Correction Verification: Submit Documentation

5 CSR 25-400.045 Licensing Process

Violation: The number of children was/were exceeded as evidenced by twelve children were present at the facility.

Rule Reference: 5 CSR 25-400.045 Licensing Process (18) states: The number and ages of children a family child care home is authorized to have in care at any one time shall be specified on the license and shall not be exceeded except as permitted within these rules.

Correction Required: The provider shall maintain compliance with the specifications on the license.

Correction Verification: Return Inspection

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: The requirements for sleeping materials were not met as evidenced by 1 children 12 months or older was/were sleeping/napping on the floor.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 1 A states: A cot, bed, sofa, padded playpen or crib shall be provided for each child who naps or sleeps. An individually assigned sheet and blanket shall be provided for each child twelve (12) months and older who naps or sleeps. Upper levels of bunk beds shall not be used.

Correction Required: The facility shall provide sleeping equipment and bedding as required.

Correction Verification: Submit Documentation

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Requirements for the crib mattress/playpen pad/bedding were not met as evidenced by gaps were observed between the matress/pad and side of the crib or playpen.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 2 C states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used and shall be changed immediately when soiled or wet.

Correction Required: Sleeping equipment shall meet safety and sanitation requirements.

Correction Verification: Return Inspection

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by a child age 11 months old in a pack and play with a blanket and pacifier clip.

Rule Reference: 5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 2 E states: Cribs, portable cribs and playpens shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation. Examples include bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, pillow-like toys, wedges, infant positioners, special mattresses, special sleep surfaces, and other similar items.

Correction Required: Infant napping equipment shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation.

Correction Verification: Return Inspection

5 CSR 25-400.086 Fire Safety

Violation: The house numbers were not plainly visible from the street.

Rule Reference: 5 CSR 25-400.086 Fire Safety 2 (F) states: The house numbers shall be plainly visible from the street in case of emergency.

Correction Required: House numbers shall be plainly visible from the street.

Correction Verification: Submit Documentation

Compliance Date: 8/15/2023

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: Candice Keith needs 4 hours.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (4) (A) states: The provider shall obtain at least twelve (12) clock hours of child care-related training during each calendar year. Any assistant who works or volunteers more than five (5) hours per week shall meet the same training requirements. Clock hour training shall be approved by the department.

Correction Required: Required training hours shall be documented for each caregiver.

Correction Verification: Submit Documentation

Compliance Date: 10/13/2023

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: Safe sleep training was not completed within the past 3 years for the provider, Candice Keith.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) (A) . states: Every three (3) years the provider, assistant(s), and volunteers in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs dese-administrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Correction Required: The child care provider and assistant(s) shall complete department-approved safe sleep training as required.

Correction Verification: Submit Documentation

Compliance Date: 10/13/2023

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Violation: Safe sleep training was not completed within the past 3 years for the assistant(s), Amanda Johnson and Crystal Vickers.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) (A) . states: Every three (3) years the provider, assistant(s), and volunteers in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs dese-administrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Correction Required: The child care provider and assistant(s) shall complete department-approved safe sleep training as required.

Correction Verification: Submit Documentation

Compliance Date: 10/13/2023