Holy Cross Lutheran Church Of Kansas City

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Marissa Castelletto, Kimberly McCoy, Christy Purl, Emma Williams within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-500.052 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: 8/4/2026

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Bayli Middleton within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-500.052 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 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: The walls located in whales bathroom was/were not in good condition as evidenced by chipping paint and holes present from paper towel holder being removed.

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

Violation: The ceilings located in whales room, hallway leading to bathroom, and movie room was/were not clean as evidenced by stained ceiling tiles.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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 25-500.082 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 rail road ties splintering and tilting .

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

Violation: Hazardous items as follows were accessible to children: Styrofoam covering. The item(s) was/were located under rocking chair in infant 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: Submit Documentation

Compliance Date: 8/4/2026

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Jessica Begley and Isaac Schaunaman

Rule Reference: 5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--

Correction Required: The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

Correction Verification: Submit Documentation

Compliance Date: 8/4/2026

5 CSR 25-500.102 Personnel

Violation: A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Jessica Begley.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number from the department.

Correction Required: All caregivers shall obtain a MOPD ID.

Correction Verification: Submit Documentation

Compliance Date: 8/4/2026

5 CSR 25-500.102 Personnel

Violation: Safe sleep training was not completed within the past 3 years for the following staff Bayli Middleton and Jessica Begley.

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 25-500.102 Personnel

Violation: A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Bayli Middleton.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number from the department.

Correction Required: All caregivers shall obtain a MOPD ID.

Correction Verification: Submit Documentation

5 CSR 25-500.112 Staff/Child Ratios

Violation: Staff/child ratio requirements were not met as evidenced by twelve children , ages 3-to-10-years, were cared for by one 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: Corrected on Site

Compliance Date: 8/4/2026

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Jessica Begley 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: Jessica Begley.

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 25-500.122 Medical Examination Reports

Violation: Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 8/13/2025 & 5/26/2023.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is 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. This rule does not incorporate any subsequent amendments or additions.

Correction Required: Child medical requirements shall be completed and on file as required.

Correction Verification: Submit Documentation

5 CSR 25-500.192 Health Care

Violation: Requirements for immunization reports on file were not met as evidenced by 2 immunization record(s) was/were not on file.

Rule Reference: 5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.

Correction Required: Child immunization requirements shall be on file as required.

Correction Verification: Submit Documentation

Compliance Date: 8/4/2026

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Jessica Begley and Josilyn Farro (8/4/2026).

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 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Marissa Castelletto, Kimberly McCoy, Christy Purl, Emma Williams within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-500.052 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 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: Hazardous items as follows were accessible to children: glitter & acrylic paint. The item(s) was/were located on low shelf.

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: 7/27/2026

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

Violation: The ceilings located in whales room, hallway leading to bathroom, and movie room was/were not clean as evidenced by stained ceiling tiles.

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

Violation: There was evidence of spiders/webs in both hallway bathrooms.

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: Corrected on Site

Compliance Date: 7/27/2026

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 rail road ties splintering and tilting .

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

Violation: The walls located in whales bathroom was/were not in good condition as evidenced by chipping paint and holes present from paper towel holder being removed.

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

Violation: Hazardous items as follows were accessible to children: Styrofoam covering. The item(s) was/were located under rocking chair in infant 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: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Jessica Begley and Isaac Schaunaman

Rule Reference: 5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--

Correction Required: The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Jessica Begley.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number from the department.

Correction Required: All caregivers shall obtain a MOPD ID.

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Jessica Begley 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: Jessica Begley.

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 25-500.122 Medical Examination Reports

Violation: Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 8/13/2025 & 5/26/2023.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is 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. This rule does not incorporate any subsequent amendments or additions.

Correction Required: Child medical requirements shall be completed and on file as required.

Correction Verification: Submit Documentation

5 CSR 25-500.182 Child Care Program

Violation: A child was left without competent supervision as evidenced by a 10-year-old child (staff's child) was in the cafeteria with no caregiver present.

Rule Reference: 5 CSR 25-500.182 Child Care Program (1) (A) 1. states: Caregivers shall not leave any child without competent supervision.

Correction Required: The facility shall provide competent supervision for each child as required.

Correction Verification: Corrected on Site

Compliance Date: 7/27/2026

5 CSR 25-500.192 Health Care

Violation: Requirements for immunization reports on file were not met as evidenced by 2 immunization record(s) was/were not on file.

Rule Reference: 5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.

Correction Required: Child immunization requirements shall be on file as required.

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Jessica Begley and Josilyn Farro.

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 25-500.052 Annual Requirements

Violation: The annual fire safety inspection was not approved.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

Correction Required: The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification: Submit Documentation

Compliance Date: 5/15/2026

5 CSR 25-500.102 Personnel

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

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: 3/18/2026

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Alexandria Espino, Brooklyn Glassburner, Payton McDaniels, Rebekah Meissner, Bayli Middleton, Ella Purl, Raylee Whitaker, Karmen White, Karmen Gonzalez, Kayla Hernandez, Mykel Dupree (all previous corrected-1/29/2026), and McKenzie Newsom 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: 4/13/2026

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Payton McDaniels, Rebekah Meissner(1/29/2026), Karmen Gonzalez(1/29/2026) and Craig Meissner(1/29/2026).

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: 3/18/2026

5 CSR 25-500.052 Annual Requirements

Violation: The staff sheet was not submitted.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (1) (D) states: A current staff sheet.

Correction Required: The facility shall submit a current staff sheet as required.

Correction Verification: Submit Documentation

Compliance Date: 1/29/2026

5 CSR 25-500.052 Annual Requirements

Violation: The annual fire safety inspection was not approved.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

Correction Required: The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Kimberly McCoy, Payton McDaniels, Christy Purl, Emma Williams, and Craig Meissner within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-500.052 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: 9/15/2025

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

Violation: The ceilings located in Lions and boys bathroom was/were not clean as evidenced by missing/stained ceiling tiles and dusty vent.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 1/29/2025

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

Violation: The walls located in Crusaders, Lambs and Angels was/were not clean as evidenced by tape residue on window and dirt/residue on window sill and chipping paint.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 1/29/2025

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

Violation: The floors located in Preschool/Pre-K room was/were not clean as evidenced by sticky residue.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 8/4/2025

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

Violation: There was evidence of dirt/debris in that there was sticky residue on crib in toddler .

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: 8/4/2025

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

Violation: The requirements for toilet and handwashing facilities were not met as evidenced by the toilet was not convenient for children's use.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 3. states: Toilet and hand washing facilities shall be in working order and convenient for the children's use.

Correction Required: Bathroom fixtures shall be functional and convenient.

Correction Verification: Submit Documentation

Compliance Date: 8/4/2025

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 black ground covering exposed in preschool play ground, and chipping paint on deck outside Angels room.

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: 9/15/2025

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

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 resilient material was not uniformly spread over the fall-zone area.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

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

Correction Verification: Submit Documentation

Compliance Date: 9/15/2025

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

Violation: Animal excrement was observed in an indoor area used by children; the location of the excrement was in chinchilla cage accessible to the children.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (8) (E) states: Areas used by children shall be free of animal excrement.

Correction Required: No animal excrement shall be in areas used by children.

Correction Verification: Submit Documentation

Compliance Date: 1/29/2026

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: A child was on a cot; no parental permission was on file.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. B. states: With written parental consent on file, cots may be used for napping or sleeping for toddlers twelve (12) months and older.

Correction Required: The facility shall use cots for toddlers only with written parental permission.

Correction Verification: Submit Documentation

Compliance Date: 1/29/2026

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Requirements for feeding equipment for infants and toddlers who are unable to sit at a table were not met as evidenced by the restraints were not available.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (C) 2. states: Infants and toddlers. Infants and toddlers who are unable to sit at a table shall have one (1) piece of mealtime feeding equipment for every four (4) infant/toddlers which may include feeding tables, high chairs, infant seats or other safely designed infant seating equipment. Equipment shall be provided which will allow the child to sit comfortably and securely while being fed. Appropriate restraints shall be used.

Correction Required: Safe and secure feeding equipment shall be provided as required.

Correction Verification: Corrected on Site

Compliance Date: 1/29/2026

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Payton McDaniels, Rebekah Meissner, Ella Purl, Kayla Hernandez,

Rule Reference: 5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--

Correction Required: The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

Correction Verification: Submit Documentation

Compliance Date: 8/4/2025

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: Karmen Gonzalez-needs 1 hour.

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: 1/29/2026

5 CSR 25-500.102 Personnel

Violation: A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: , Karmen White, Karmen Gonzalez, Piper Handcock Kayla Hernandez, Mykel Dupree, and McKenzie Newsom.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number from the department.

Correction Required: All caregivers shall obtain a MOPD ID.

Correction Verification: Submit Documentation

Compliance Date: 1/29/2026

5 CSR 25-500.102 Personnel

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

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 25-500.102 Personnel

Violation: Payton McDaniels, Bayli Middleton, Ella Purl, Karmen White, Karmen Gonzalez, Kayla Hernandez, Mykel Dupree, McKenzie Newsom, and Josie Paul 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: 1/29/2026

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Alexandria Espino, Brooklyn Glassburner, Payton McDaniels, Rebekah Meissner, Bayli Middleton, Ella Purl, Raylee Whitaker, Karmen White, Karmen Gonzalez, Kayla Hernandez, Mykel Dupree (all previous corrected-1/29/2026), and McKenzie Newsom 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: Alexandria Espino, Brooklyn Glassburner, Payton McDaniels, Rebekah Meissner, Bayli Middleton, Ella Purl, Raylee Whitaker, Karmen White, Karmen Gonzalez, Kayla Hernandez, Mykel Dupree, and McKenzie Newsom.

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: 1/29/2026

5 CSR 25-500.192 Health Care

Violation: Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file.

Rule Reference: 5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.

Correction Required: Child immunization requirements shall be on file as required.

Correction Verification: Submit Documentation

Compliance Date: 1/29/2026

5 CSR 25-500.202 Nutrition and Food Service

Violation: The provider did not meet requirements for a written diet plan for each infant and toddler as evidenced by the written diet plan was not updated for a child in that No feeding plan on file for child (admission date: 1/2/2024).

Rule Reference: 5 CSR 25-500.202 Nutrition and Food Service (2) (B) states: The written diet plan for each infant/toddler shall be followed. The parent(s) shall update the plan according to the individual needs of the child until they grant permission in writing for the child to eat table foods.

Correction Required: A written diet plan shall be on file for each infant/toddler, updated as needed and followed by caregivers.

Correction Verification: Submit Documentation

Compliance Date: 1/29/2026

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Payton McDaniels, Rebekah Meissner(1/29/2026), Karmen Gonzalez(1/29/2026) and Craig Meissner(1/29/2026).

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 25-500.052 Annual Requirements

Violation: The staff sheet was not submitted.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (1) (D) states: A current staff sheet.

Correction Required: The facility shall submit a current staff sheet as required.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Annual Declaration was not submitted.

Rule Reference: 5 CSR 25-500.052 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 group child care home or child care center and agreement to comply with all statutes and department licensing rules.

Correction Required: The facility shall submit the Annual Declaration as required.

Correction Verification: Corrected on Site

Compliance Date: 7/9/2025

5 CSR 25-500.052 Annual Requirements

Violation: The annual fire safety inspection was not approved.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

Correction Required: The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Kimberly McCoy, Payton McDaniels, Christy Purl, Emma Williams, and Craig Meissner within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-500.052 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 25-500.082 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 missing outlet cover in eagles room.

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: 7/9/2025

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: scissors and bleach spray solution. The item(s) was/were located on low shelves.

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: 7/9/2025

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

Violation: The floors located in Preschool/Pre-K room was/were not clean as evidenced by sticky residue.

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

Violation: There was evidence of dirt/debris in that there was sticky residue on crib in toddler .

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

Violation: The requirements for toilet and handwashing facilities were not met as evidenced by the toilet was not convenient for children's use.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 3. states: Toilet and hand washing facilities shall be in working order and convenient for the children's use.

Correction Required: Bathroom fixtures shall be functional and convenient.

Correction Verification: Submit Documentation

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 black ground covering exposed in preschool play ground, and chipping paint on deck outside Angels room.

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

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 resilient material was not uniformly spread over the fall-zone area.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

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

Correction Verification: Submit Documentation

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

Violation: Animal excrement was observed in an indoor area used by children; the location of the excrement was in chinchilla cage accessible to the children.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (8) (E) states: Areas used by children shall be free of animal excrement.

Correction Required: No animal excrement shall be in areas used by children.

Correction Verification: Submit Documentation

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

Violation: The ceilings located in Lions and boys bathroom was/were not clean as evidenced by missing/stained ceiling tiles and dusty vent.

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

Violation: The walls located in Crusaders, Lambs and Angels was/were not clean as evidenced by tape residue on window and dirt/residue on window sill and chipping paint.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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 25-500.092 Furniture, Equipment and Materials

Violation: A child was on a cot; no parental permission was on file.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. B. states: With written parental consent on file, cots may be used for napping or sleeping for toddlers twelve (12) months and older.

Correction Required: The facility shall use cots for toddlers only with written parental permission.

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Outdoor equipment, ball , in infant/toddler play area was not in good condition as evidenced by flat.

Rule Reference: 5 CSR 25-500.092 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 play equipment shall be safe and in good repair.

Correction Verification: Corrected on Site

Compliance Date: 7/9/2025

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Payton McDaniels, Rebekah Meissner, Ella Purl, Kayla Hernandez,

Rule Reference: 5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--

Correction Required: The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

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: Karmen Gonzalez-needs 1 hour.

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: A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: , Karmen White, Karmen Gonzalez, Piper Handcock Kayla Hernandez, Mykel Dupree, and McKenzie Newsom.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number from the department.

Correction Required: All caregivers shall obtain a MOPD ID.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

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

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 25-500.102 Personnel

Violation: Payton McDaniels, Bayli Middleton, Ella Purl, Karmen White, Karmen Gonzalez, Kayla Hernandez, Mykel Dupree, McKenzie Newsom, and Josie Paul 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 Alexandria Espino, Brooklyn Glassburner, Payton McDaniels, Rebekah Meissner, Bayli Middleton, Ella Purl, Raylee Whitaker, Karmen White, Karmen Gonzalez, Kayla Hernandez, Mykel Dupree, and McKenzie Newsom 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: Alexandria Espino, Brooklyn Glassburner, Payton McDaniels, Rebekah Meissner, Bayli Middleton, Ella Purl, Raylee Whitaker, Karmen White, Karmen Gonzalez, Kayla Hernandez, Mykel Dupree, and McKenzie Newsom.

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 25-500.192 Health Care

Violation: Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file.

Rule Reference: 5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.

Correction Required: Child immunization requirements shall be on file as required.

Correction Verification: Submit Documentation

5 CSR 25-500.202 Nutrition and Food Service

Violation: The provider did not meet requirements for a written diet plan for each infant and toddler as evidenced by the written diet plan was not updated for a child in that No feeding plan on file for child (admission date: 1/2/2024.

Rule Reference: 5 CSR 25-500.202 Nutrition and Food Service (2) (B) states: The written diet plan for each infant/toddler shall be followed. The parent(s) shall update the plan according to the individual needs of the child until they grant permission in writing for the child to eat table foods.

Correction Required: A written diet plan shall be on file for each infant/toddler, updated as needed and followed by caregivers.

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Payton McDaniels, Rebekah Meissner, Karmen Gonzalez and Craig Meissner.

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

Violation: The walls located in whales room was/were not in good condition as evidenced by chipping paint.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 2/4/2025

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

Violation: The ceilings located in the lions room was/were not clean as evidenced by stained tile near back door.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 2/19/2025

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

Violation: There was evidence of dirt/debris in that cabinets in cafeteria and whales room dirty/sticky residue.

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: 2/4/2025

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

Violation: Food and water dishes used by animals were accessible to children as evidenced by no lock on storage door that has the chinchilla cage in it. The food and water is accessible through the cage.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (8) (G) states: Food and water dishes used by animals shall not be accessible to the children.

Correction Required: Food and water dishes used by animals shall not be accessible to children.

Correction Verification: Submit Documentation

Compliance Date: 2/4/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, cabinet under the sink, in lions room was not in good condition as evidenced by broken.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

Compliance Date: 2/19/2025

5 CSR 25-500.052 Annual Requirements

Violation: The annual fire safety inspection was not conducted.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

Correction Required: The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification: Submit Documentation

Compliance Date: 10/28/2024

5 CSR 25-500.052 Annual Requirements

Violation: The annual sanitation inspection was not approved.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

Correction Required: The facility shall submit evidence of compliance with annual sanitation requirements.

Correction Verification: Submit Documentation

Compliance Date: 1/2/2025

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: scissors. The item(s) was/were located on a low counter in the cafeteria area.

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: 1/30/2025

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

Violation: The walls located in lions (room and bathroom) was/were not in good condition as evidenced by exposed putty/chipping paint.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 10/22/2024

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

Violation: There was evidence of dirt/debris in that cabinets in cafeteria and whales room dirty/sticky residue.

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

Violation: Food and water dishes used by animals were accessible to children as evidenced by no lock on storage door that has the chinchilla cage in it. The food and water is accessible through the cage.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (8) (G) states: Food and water dishes used by animals shall not be accessible to the children.

Correction Required: Food and water dishes used by animals shall not be accessible to children.

Correction Verification: Submit Documentation

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

Violation: The ceilings located in the lions room was/were not clean as evidenced by stained tile near back door.

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

Violation: The walls located in whales room was/were not in good condition as evidenced by chipping paint.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, cabinet under the sink, in lions room was not in good condition as evidenced by broken.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: A child was on a cot; no parental permission was on file.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. B. states: With written parental consent on file, cots may be used for napping or sleeping for toddlers twelve (12) months and older.

Correction Required: The facility shall use cots for toddlers only with written parental permission.

Correction Verification: Submit Documentation

Compliance Date: 1/30/2025

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: Hazel Speer-needs 11 hrs; Karmen Gonzales needs-1hr.

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: 1/28/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Alexus Davis, Karmen Gonzales, Jenna Monroe, Harmonee Rodriguez 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: 1/30/2025

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: Alexus Davis, Karmen Gonzales, Jenna Monroe, Harmonee Rodriguez.

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: 1/30/2025

5 CSR 25-500.202 Nutrition and Food Service

Violation: The provider did not meet requirements for a written diet plan for each infant and toddler as evidenced by the written diet plan was not followed for a child in that missing and non-updated feeding plans .

Rule Reference: 5 CSR 25-500.202 Nutrition and Food Service (2) (B) states: The written diet plan for each infant/toddler shall be followed. The parent(s) shall update the plan according to the individual needs of the child until they grant permission in writing for the child to eat table foods.

Correction Required: A written diet plan shall be on file for each infant/toddler, updated as needed and followed by caregivers.

Correction Verification: Submit Documentation

Compliance Date: 1/30/2025

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Susan Forson, Alesia Kendall, Sandra Ledford, Patty Mael, Kim McCoy, Christy Purl, Brandi Schaunaman, Tracy Watson, Stacy Williams.

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: 10/29/2024

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Alexus Davis, Karmin, Gonzales, Jenna Monroe, Carter Schaunaman, Hazel Speer.

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: 1/30/2025

5 CSR 25-500.052 Annual Requirements

Violation: The annual fire safety inspection was not conducted.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

Correction Required: The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The annual sanitation inspection was not approved.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

Correction Required: The facility shall submit evidence of compliance with annual sanitation requirements.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Alexus Davis within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-500.052 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: 9/16/2024

5 CSR 25-500.052 Annual Requirements

Violation: The equipment list did not contain a list of equipment as required in 5 CSR 25-500.092.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (1) (C) states: A current list of available equipment.

Correction Required: The facility shall submit an equipment list as required.

Correction Verification: Submit Documentation

Compliance Date: 9/16/2024

5 CSR 25-500.052 Annual Requirements

Violation: The Annual Declaration was not completed as evidenced by not signed by Board president-no designee on file.

Rule Reference: 5 CSR 25-500.052 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 group child care home or child care center and agreement to comply with all statutes and department licensing rules.

Correction Required: The facility shall submit the Annual Declaration as required.

Correction Verification: Submit Documentation

Compliance Date: 7/31/2024

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

Violation: Children were not restricted to approved space as evidenced by lock on furnace room not working.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.

Correction Required: Caregivers shall restrict children to approved space.

Correction Verification: Submit Documentation

Compliance Date: 9/16/2024

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

Violation: The walls located in lions (room and bathroom) was/were not in good condition as evidenced by exposed putty/chipping paint.

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

Violation: The ceilings located in lions was/were not clean as evidenced by dusty vents.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 9/16/2024

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 paint chipping and exposed rust on wall outside of Angels room.

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: 9/16/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, cribs, in Noah's ark was not in good condition as evidenced by sticky redisdue.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

Compliance Date: 9/16/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: A child was on a cot; no parental permission was on file.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. B. states: With written parental consent on file, cots may be used for napping or sleeping for toddlers twelve (12) months and older.

Correction Required: The facility shall use cots for toddlers only with written parental permission.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: Alexus Davis, Jenna Monroe, Harmonee Rodriguez, Lydia Tabke, Karmen Gonzales 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: 9/26/2024

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Alaina Foster, Karmen Gonzales, Lydia Tabke

Rule Reference: 5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--

Correction Required: The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

Correction Verification: Submit Documentation

Compliance Date: 9/16/2024

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: Hazel Speer-needs 11 hrs; Karmen Gonzales needs-1hr.

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 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Alexus Davis, Karmen Gonzales, Jenna Monroe, Harmonee Rodriguez 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: Alexus Davis, Karmen Gonzales, Jenna Monroe, Harmonee Rodriguez.

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 25-500.122 Medical Examination Reports

Violation: Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 5/25/2023 & 2/22/2022.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is 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. This rule does not incorporate any subsequent amendments or additions.

Correction Required: Child medical requirements shall be completed and on file as required.

Correction Verification: Submit Documentation

Compliance Date: 9/16/2024

5 CSR 25-500.192 Health Care

Violation: Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file.

Rule Reference: 5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.

Correction Required: Child immunization requirements shall be on file as required.

Correction Verification: Submit Documentation

Compliance Date: 9/16/2024

5 CSR 25-500.202 Nutrition and Food Service

Violation: The provider did not meet requirements for a written diet plan for each infant and toddler as evidenced by the written diet plan was not followed for a child in that missing and non-updated feeding plans .

Rule Reference: 5 CSR 25-500.202 Nutrition and Food Service (2) (B) states: The written diet plan for each infant/toddler shall be followed. The parent(s) shall update the plan according to the individual needs of the child until they grant permission in writing for the child to eat table foods.

Correction Required: A written diet plan shall be on file for each infant/toddler, updated as needed and followed by caregivers.

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Susan Forson, Alesia Kendall, Sandra Ledford, Patty Mael, Kim McCoy, Christy Purl, Brandi Schaunaman, Tracy Watson, Stacy Williams.

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 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Alexus Davis, Karmin, Gonzales, Jenna Monroe, Carter Schaunaman, Hazel Speer.

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 25-500.042 Licensing Process

Violation: The name, address and telephone number of the owner(s) was not prominently posted near the license.

Rule Reference: 5 CSR 25-500.042 Licensing Process (13) (B) states: Facility owner(s);

Correction Required: The name, address, and phone number of the owner shall be posted near the license.

Correction Verification: Corrected on Site

Compliance Date: 7/17/2024

5 CSR 25-500.042 Licensing Process

Violation: The name, address and telephone number of the board president was not prominently posted near the license.

Rule Reference: 5 CSR 25-500.042 Licensing Process (13) (C) states: Board president or chairperson;

Correction Required: The name, address, and board president or chairperson shall be posted near the license.

Correction Verification: Corrected on Site

Compliance Date: 7/17/2024

5 CSR 25-500.052 Annual Requirements

Violation: The equipment list did not contain a list of equipment as required in 5 CSR 25-500.092.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (1) (C) states: A current list of available equipment.

Correction Required: The facility shall submit an equipment list as required.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Annual Declaration was not completed as evidenced by not signed by Board president-no designee on file.

Rule Reference: 5 CSR 25-500.052 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 group child care home or child care center and agreement to comply with all statutes and department licensing rules.

Correction Required: The facility shall submit the Annual Declaration as required.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The annual fire safety inspection was not conducted.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

Correction Required: The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The annual sanitation inspection was not approved.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

Correction Required: The facility shall submit evidence of compliance with annual sanitation requirements.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Alexus Davis within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-500.052 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 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers

Violation: The walls located in lions (room and bathroom) was/were not in good condition as evidenced by exposed putty/chipping paint.

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

Violation: Children were not restricted to approved space as evidenced by lock on furnace room not working.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.

Correction Required: Caregivers shall restrict children to approved space.

Correction Verification: Submit Documentation

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 missing outlet cover.

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: 7/17/2024

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: Suave conditioner, Arm and Hammer Simple Saline, Modge Podge glue and sealer, glass cleaner, Goo Gone, bleach spray. The item(s) was/were located in unlocked cabinets and on low shelf.

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: 7/17/2024

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

Violation: The ceilings located in lions was/were not clean as evidenced by dusty vents.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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 25-500.082 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 paint chipping and exposed rust on wall outside of Angels room.

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 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, cribs, in Noah's ark was not in good condition as evidenced by sticky redisdue.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: The requirements for sleeping materials were not met as evidenced by 5 children 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: Corrected on Site

Compliance Date: 7/17/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Sleeping equipment was not arranged to provide required spacing as evidenced by the aisle on the long side of the napping equipment was too narrow - the space measured 1'.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 1. D. states: Sleeping equipment shall be arranged to provide at least a two foot (2') aisle on one (1) long side of the equipment.

Correction Required: Caregivers shall provide a two foot (2') aisle on one long side of the napping equipment.

Correction Verification: Corrected on Site

Compliance Date: 7/17/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: A child was on a cot; no parental permission was on file.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. B. states: With written parental consent on file, cots may be used for napping or sleeping for toddlers twelve (12) months and older.

Correction Required: The facility shall use cots for toddlers only with written parental permission.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: Alexus Davis, Jenna Monroe, Harmonee Rodriguez, Lydia Tabke, Karmen Gonzales 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 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Alaina Foster, Karmen Gonzales, Lydia Tabke

Rule Reference: 5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--

Correction Required: The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

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: Hazel Speer-needs 11 hrs; Karmen Gonzales needs-1hr.

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 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Alexus Davis, Karmen Gonzales, Jenna Monroe, Harmonee Rodriguez 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: Alexus Davis, Karmen Gonzales, Jenna Monroe, Harmonee Rodriguez.

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 25-500.122 Medical Examination Reports

Violation: Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 5/25/2023 & 2/22/2022.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is 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. This rule does not incorporate any subsequent amendments or additions.

Correction Required: Child medical requirements shall be completed and on file as required.

Correction Verification: Submit Documentation

5 CSR 25-500.192 Health Care

Violation: Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file.

Rule Reference: 5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.

Correction Required: Child immunization requirements shall be on file as required.

Correction Verification: Submit Documentation

5 CSR 25-500.202 Nutrition and Food Service

Violation: The provider did not meet requirements for a written diet plan for each infant and toddler as evidenced by the written diet plan was not followed for a child in that missing and non-updated feeding plans .

Rule Reference: 5 CSR 25-500.202 Nutrition and Food Service (2) (B) states: The written diet plan for each infant/toddler shall be followed. The parent(s) shall update the plan according to the individual needs of the child until they grant permission in writing for the child to eat table foods.

Correction Required: A written diet plan shall be on file for each infant/toddler, updated as needed and followed by caregivers.

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Susan Forson, Alesia Kendall, Sandra Ledford, Patty Mael, Kim McCoy, Christy Purl, Brandi Schaunaman, Tracy Watson, Stacy Williams.

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 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Alexus Davis, Karmin, Gonzales, Jenna Monroe, Carter Schaunaman, Hazel Speer.

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

Violation: Children were not restricted to approved space as evidenced by lock on storage door broken.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.

Correction Required: Caregivers shall restrict children to approved space.

Correction Verification: Submit Documentation

Compliance Date: 4/25/2024

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

Violation: The walls located in Lambs was/were not clean as evidenced by sticky residue on back door.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 4/25/2024

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

Violation: The ceilings located in Lions and Whales was/were not in good condition as evidenced by stained/missing/holes in ceiling tiles.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 5/29/2024

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 black ground covering exposed near tree on infant/toddler playground.

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: 5/1/2024

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

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 resilient material was not uniformly spread over the fall-zone area.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

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

Correction Verification: Submit Documentation

Compliance Date: 4/25/2024

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

Violation: Animal excrement was observed in an indoor area used by children; the location of the excrement was guinea pig cage low and excrement accessible to children.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (8) (E) states: Areas used by children shall be free of animal excrement.

Correction Required: No animal excrement shall be in areas used by children.

Correction Verification: Submit Documentation

Compliance Date: 4/25/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, table, in Lions was not in good condition as evidenced by Tape peeling off bottom.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

Compliance Date: 4/25/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, shelves and changing table, in Angels, Lions and Whales was not in good condition as evidenced by sticky residue.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

Compliance Date: 5/1/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Outdoor equipment, toy spaceship, in preschool playground was not in good condition as evidenced by chipping paint/exposed rust spots.

Rule Reference: 5 CSR 25-500.092 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 play equipment shall be safe and in good repair.

Correction Verification: Submit Documentation

Compliance Date: 4/25/2024

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

Violation: Children were not restricted to approved space as evidenced by lock on storage door broken.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.

Correction Required: Caregivers shall restrict children to approved space.

Correction Verification: Submit Documentation

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: batteries, screwdriver, Windex, Triple S absorbent powder, bleach spray, Borax, Stay-Flo, Funkaway air freshner. The item(s) was/were located in unlocked cabinets and on low shelf.

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: 2/29/2024

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

Violation: The ceilings located in Lions and Whales was/were not in good condition as evidenced by stained/missing/holes in ceiling tiles.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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 25-500.082 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 black ground covering exposed near tree on infant/toddler playground.

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

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 resilient material was not uniformly spread over the fall-zone area.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

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

Correction Verification: Submit Documentation

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

Violation: Animal excrement was observed in an indoor area used by children; the location of the excrement was guinea pig cage low and excrement accessible to children.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (8) (E) states: Areas used by children shall be free of animal excrement.

Correction Required: No animal excrement shall be in areas used by children.

Correction Verification: Submit Documentation

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

Violation: The walls located in Lambs was/were not clean as evidenced by sticky residue on back door.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, shelves and changing table, in Angels, Lions and Whales was not in good condition as evidenced by sticky residue.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Requirements for feeding equipment for infants and toddlers who are unable to sit at a table were not met as evidenced by the restraints were not available.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (C) 2. states: Infants and toddlers. Infants and toddlers who are unable to sit at a table shall have one (1) piece of mealtime feeding equipment for every four (4) infant/toddlers which may include feeding tables, high chairs, infant seats or other safely designed infant seating equipment. Equipment shall be provided which will allow the child to sit comfortably and securely while being fed. Appropriate restraints shall be used.

Correction Required: Safe and secure feeding equipment shall be provided as required.

Correction Verification: Corrected on Site

Compliance Date: 2/29/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Outdoor equipment, toy spaceship, in preschool playground was not in good condition as evidenced by chipping paint/exposed rust spots.

Rule Reference: 5 CSR 25-500.092 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 play equipment shall be safe and in good repair.

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, table, in Lions was not in good condition as evidenced by Tape peeling off bottom.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The staff sheet was not fully completed as evidenced by missing signature.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (1) (D) states: A current staff sheet.

Correction Required: The facility shall submit a current staff sheet as required.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023

5 CSR 25-500.052 Annual Requirements

Violation: The annual fire safety inspection was not approved.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

Correction Required: The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification: Submit Documentation

Compliance Date: 7/12/2023

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Kim McCoy, Christine Purl, Carol Wilson, Randall Wilson, within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-500.052 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: 10/10/2023

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

Violation: The walls located in crusaders room, preschool room, was/were not clean as evidenced by sticky residue on chalk board walls, dusty window frame.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 10/17/2023

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

Violation: The floors located in toddler room and whales room was/were not clean as evidenced by dirty mats and tape peeling off floors.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 10/10/2023

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

Violation: The floors located in crusaders and eagles was/were not clean as evidenced by debris in corners and window sill dirty.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 10/10/2023

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

Violation: The walls located in eagles room and hallway was/were not in good condition as evidenced by paint chipping on poles and wood wearing on door.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 10/10/2023

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

Violation: The ceilings located infant room was/were not in good condition as evidenced by vent cover missing.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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: 10/3/2023

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

Violation: The bathroom was not clean and odor free as evidenced by the wall was soiled.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 7. states: Bathrooms shall be clean and odor free.

Correction Required: Bathrooms shall be clean and odor free.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023

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

Violation: The bathroom was not clean and odor free as evidenced by the floor was soiled.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 7. states: Bathrooms shall be clean and odor free.

Correction Required: Bathrooms shall be clean and odor free.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023

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

Violation: Animal excrement was observed in an indoor area used by children; the location of the excrement was in hallway; cages accessible to children.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (8) (E) states: Areas used by children shall be free of animal excrement.

Correction Required: No animal excrement shall be in areas used by children.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: Requirements of facilities participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.

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

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, shelves, cabinets, trash can, toy kitchen, in crusaders, whales, and lions rooms was not in good condition as evidenced by sticky residue and contact paper peeling, dirty, broken trash can, dust in crevices of kitchen.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, changing tables, in toddler room and whales rooms was not in good condition as evidenced by sticky residue.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Outdoor equipment, toy boat, in toddler playground was not in good condition as evidenced by broken.

Rule Reference: 5 CSR 25-500.092 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 play equipment shall be safe and in good repair.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023

5 CSR 25-500.102 Personnel

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

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: 10/10/2023

5 CSR 25-500.102 Personnel

Violation: Jessica Begley, Josie Biggs, Meagan Barnett, Brooklyn Glassbrenner 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: 10/10/2023

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Jessica Begley, Josie Barnett, Brooklyn Glassbrenner, Tracy Watson, Emma Wilson

Rule Reference: 5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include:

Correction Required: The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Meagan Barnett, Brooklyn Glassbrenner, Emma Williams 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: 10/10/2023

5 CSR 25-500.122 Medical Examination Reports

Violation: A medical examination report included either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) which was completed more than 12 months before beginning work in the facility for the following staff: Meagan Barnett, Brooklyn Glassbrenner.

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: 10/10/2023

5 CSR 25-500.122 Medical Examination Reports

Violation: Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 11/15/2021.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is 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. This rule does not incorporate any subsequent amendments or additions.

Correction Required: Child medical requirements shall be completed and on file as required.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023

5 CSR 25-500.202 Nutrition and Food Service

Violation: The provider did not meet requirements for a written diet plan for each infant and toddler as evidenced by the written diet plan was not updated for a child in that no toddler feeding plan on file.

Rule Reference: 5 CSR 25-500.202 Nutrition and Food Service (2) (B) states: The written diet plan for each infant/toddler shall be followed. The parent(s) shall update the plan according to the individual needs of the child until they grant permission in writing for the child to eat table foods.

Correction Required: A written diet plan shall be on file for each infant/toddler, updated as needed and followed by caregivers.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2023