Developmental Center Of The Ozarks

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that outlets in 3 classrooms were not covered.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.

Correction Required: The facility shall use outlet covers or twist-lock outlets as required.

Correction Verification: Corrected on Site

Compliance Date: 7/24/2026

5 CSR 25-500.102 Personnel

Violation: Safe sleep training was not completed within the past 3 years for the following staff Stephanie Ballard.

Rule Reference: 5 CSR 25-500.102 Personnel (4) (A) . states: Every three (3) years, the child care provider, group child care home provider, child care staff members, and volunteers in a group child care home or child care center 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/deseadministrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Correction Required: The director, group home provider, other caregivers, and those volunteers counted in staff/child ratio, shall complete department-approved safe sleep training as required.

Correction Verification: Submit Documentation

Compliance Date: 3/10/2026

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Malichi Shull and Danielle Roeder as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.

Correction Required: Medical reports shall be on file as required.

Correction Verification: Submit Documentation

Compliance Date: 2/18/2026

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.

Rule Reference: 5 CSR 25-500.222 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: Submit Documentation

Compliance Date: 2/18/2026

5 CSR 25-500.222 Records and Reports

Violation: 2 child(ren) records did not include address of another individual who might be reached in an emergency.

Rule Reference: 5 CSR 25-500.222 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: 2/18/2026

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: Hazardous items as follows were accessible to children: bleach. The item(s) was/were located in a cabinet with a broken safety lock.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) 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: 2/9/2026

5 CSR 25-500.102 Personnel

Violation: Safe sleep training was not completed within the past 3 years for the following staff Stephanie Ballard.

Rule Reference: 5 CSR 25-500.102 Personnel (4) (A) . states: Every three (3) years, the child care provider, group child care home provider, child care staff members, and volunteers in a group child care home or child care center 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/deseadministrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Correction Required: The director, group home provider, other caregivers, and those volunteers counted in staff/child ratio, shall complete department-approved safe sleep training as required.

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Malichi Shull and Danielle Roeder as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.

Correction Required: Medical reports shall be on file as required.

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.

Rule Reference: 5 CSR 25-500.222 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: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: 2 child(ren) records did not include address of another individual who might be reached in an emergency.

Rule Reference: 5 CSR 25-500.222 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 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: There was evidence of dirt/debris in the fans in the classrooms.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 9. states: The facility 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: 9/17/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: The requirements for sleeping materials were not met as evidenced by 6 child(ren) 12 months or older, who nap or sleep, did not have a sheet.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 1. A. states: An individual cot or bed 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: 9/16/2025

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: Hazardous items as follows were accessible to children: cleaning products. The item(s) was/were located in an unlocked closet in the activities room.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) 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: 8/13/2025

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: There was evidence of dirt/debris in the fans in the classrooms.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 9. states: The facility 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 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's list of emergency numbers are not posted in each room used for child care, specifically the list in the 2 year old room was not visible as it was on the other side of the facility numbers.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;

Correction Required: The facility must post all emergency numbers as required.

Correction Verification: Corrected on Site

Compliance Date: 8/13/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: The requirements for sleeping materials were not met as evidenced by 6 child(ren) 12 months or older, who nap or sleep, did not have a sheet.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 1. A. states: An individual cot or bed 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 25-500.102 Personnel

Violation: A caregiver did not obtain one clock hour of training for each month of employment. The staff listed need the following information: Gabriela Rogers needs 3 hours for 2024.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (C) states: Caregivers who were employed after the first of the year shall obtain one (1) clock of hour training for each one (1) month of employment, regardless of the date employment began.

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

Correction Verification: Submit Documentation

Compliance Date: 2/22/2025

5 CSR 25-500.102 Personnel

Violation: Terrontayia Reeves and Gabriela Rogers did not complete safe sleep training within 30 days of employment or volunteering at the facility.

Rule Reference: 5 CSR 25-500.102 Personnel (4) (A) 3. states: The child care provider, group child care home provider, child care staff members, and volunteers shall complete safe sleep training described in subsection (4)(A) of this rule within thirty (30) days of employment or volunteering at the facility.

Correction Required: The department-approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification: Submit Documentation

Compliance Date: 2/25/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Tyrese Wells and Makydria Harper as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.

Correction Required: Medical reports shall be on file as required.

Correction Verification: Submit Documentation

Compliance Date: 4/9/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Alexa Webb, Autum Jones and Terrontayia Reeves.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

Correction Required: Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberculin skin test (TST) as required.

Correction Verification: Submit Documentation

Compliance Date: 3/6/2025

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's list of emergency numbers are not posted in each room used for child care, specifically numbers not posted in rooms 7, 12 & the activity room.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;

Correction Required: The facility must post all emergency numbers as required.

Correction Verification: Corrected on Site

Compliance Date: 2/14/2025

5 CSR 25-500.102 Personnel

Violation: A caregiver did not obtain one clock hour of training for each month of employment. The staff listed need the following information: Gabriela Rogers needs 3 hours for 2024.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (C) states: Caregivers who were employed after the first of the year shall obtain one (1) clock of hour training for each one (1) month of employment, regardless of the date employment began.

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: Terrontayia Reeves and Gabriela Rogers did not complete safe sleep training within 30 days of employment or volunteering at the facility.

Rule Reference: 5 CSR 25-500.102 Personnel (4) (A) 3. states: The child care provider, group child care home provider, child care staff members, and volunteers shall complete safe sleep training described in subsection (4)(A) of this rule within thirty (30) days of employment or volunteering at the facility.

Correction Required: The department-approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Tyrese Wells and Makydria Harper as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.

Correction Required: Medical reports shall be on file as required.

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Alexa Webb, Autum Jones and Terrontayia Reeves.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

Correction Required: Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberculin skin test (TST) as required.

Correction Verification: Submit Documentation

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's list of emergency numbers are not posted in each room used for child care, specifically classroom 8.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;

Correction Required: The facility must post all emergency numbers as required.

Correction Verification: Corrected on Site

Compliance Date: 8/9/2024

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: The facility's outdoor space was not safe for children's activities as evidenced by on the preschool play yard the corner of the concrete pad with a basket ball hoop is broken and the soil is eroding under this section creating a gap and exposed embedded sharp rocks in this area and also on the toddler play yard and the large preschool play yard. On the preschool play yard there is a putting green, the holes for the balls have standing water. On the preschool play yard there is a storage shed, there are gaps measuring over 3 1/2 inches on the east and west side of the shed.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. 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: 2/15/2024

5 CSR 25-500.112 Staff/Child Ratios

Violation: Group size requirements were not met as evidenced by 21 children, ages 4-years-old to 5-years-old, were cared for by 4 adult caregiver(s).

Rule Reference: 5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: The staff/child ratio and group size shall be followed as outlined in the below chart unless it meets an exception in subparagraphs (1)(B)-(G) below: Infants, toddlers, and 2-year-olds shall have one caregiver for every four children with no more than eight children per group; Groups composed solely of children 24 to 36 months shall have one caregiver for every eight children with no more than 16 children per group; Groups composed solely of children 3 to 4 years shall have one caregiver for every 10 children with no more than 20 children per group; Groups composed solely of children 5 years or older shall have one caregiver for every 16 children with no more than 32 children per group; A mixed group of children consisting of no more than four children age 2 years, and at least one child older than 3 years shall have one caregiver for every 10 children with no more than 20 children per group; A mixed group of children consisting of more than four children ages 24 to 36 months, and at least one child older than 36 months shall have one caregiver for every eight children with no more than 16 children per group.

Correction Required: Staff/child ratios and group sizes shall be maintained at all times.

Correction Verification: Return Inspection

Compliance Date: 2/15/2024

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that one electrical outlet not covered in classroom 1.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.

Correction Required: The facility shall use outlet covers or twist-lock outlets as required.

Correction Verification: Corrected on Site

Compliance Date: 2/6/2024

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: The facility's outdoor space was not safe for children's activities as evidenced by on the preschool play yard the corner of the concrete pad with a basket ball hoop is broken and the soil is eroding under this section creating a gap and exposed embedded sharp rocks in this area and also on the toddler play yard and the large preschool play yard. On the preschool play yard there is a putting green, the holes for the balls have standing water. On the preschool play yard there is a storage shed, there are gaps measuring over 3 1/2 inches on the east and west side of the shed.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. 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 25-500.112 Staff/Child Ratios

Violation: Group size requirements were not met as evidenced by 21 children, ages 4-years-old to 5-years-old, were cared for by 4 adult caregiver(s).

Rule Reference: 5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: The staff/child ratio and group size shall be followed as outlined in the below chart unless it meets an exception in subparagraphs (1)(B)-(G) below: Infants, toddlers, and 2-year-olds shall have one caregiver for every four children with no more than eight children per group; Groups composed solely of children 24 to 36 months shall have one caregiver for every eight children with no more than 16 children per group; Groups composed solely of children 3 to 4 years shall have one caregiver for every 10 children with no more than 20 children per group; Groups composed solely of children 5 years or older shall have one caregiver for every 16 children with no more than 32 children per group; A mixed group of children consisting of no more than four children age 2 years, and at least one child older than 3 years shall have one caregiver for every 10 children with no more than 20 children per group; A mixed group of children consisting of more than four children ages 24 to 36 months, and at least one child older than 36 months shall have one caregiver for every eight children with no more than 16 children per group.

Correction Required: Staff/child ratios and group sizes shall be maintained at all times.

Correction Verification: Return Inspection