Itsy Bitsy Hearts Llc

5 CSR 25-400.055 Annual Requirements

Violation: The equipment list was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The Annual Declaration was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for July Abdeen, Hyejin Choi, Katie Gavali, Jinee Jaouni, and Maimuna Sayba within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

Compliance Date: 11/26/2025

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that corner of the wooden fence located by the back gate was detached at the top exposing rusty nails.

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

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

Correction Verification: Submit Documentation

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

Violation: The 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 no resilient material was present.

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

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

Correction Verification: Submit Documentation

Compliance Date: 5/5/2026

5 CSR 25-400.086 Fire Safety

Violation: Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.090 Disaster and Emergency Preparedness

Violation: The facility's disaster and emergency plan was not available in each room used for child care as evidenced by the living room did not have a copy available.

Rule Reference: 5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster emergency plan is readily available in the office area and in each room used for care of children.

Correction Required: The facilities disaster and emergency plan must be available in required locations.

Correction Verification: Submit Documentation

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

Violation: The provider was not present 40 hours a week during the hours of highest attendance as evidenced by lack of provider attendance records.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (A) states: The provider routinely shall be present during the hours of highest attendance a minimum of forty (40) hours per week.

Correction Required: The provider shall be routinely on duty as required.

Correction Verification: Submit Documentation

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

Violation: A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Hyesjin Choi, Maimuna Sayba, and Katie Gavali.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (J) . 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 child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:

Correction Required: The provider shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification: Submit Documentation

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

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2024, the staff listed need the following information: July Abdeen, Katie Gavali, and Jinee Jaouni need 12 hours.

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

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

Correction Verification: Submit Documentation

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

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 5/5/2026

5 CSR 25-400.125 Medical Examination Reports

Violation: A medical examination report was not on file for volunteer(s): Maimuna Sayba.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (1) (D) states: Assistants who are employed or volunteer more than five (5) hours per week shall have a medical examination report on file within thirty (30) days of beginning work in the home.

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

Correction Verification: Submit Documentation

Compliance Date: 5/5/2026

5 CSR 25-400.125 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: Maimuna Sayba.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (1) (E) . 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 tuberulin skin test (TST) as required.

Correction Verification: Submit Documentation

Compliance Date: 5/5/2026

5 CSR 25-400.185 Health Care

Violation: Facility did not submit the 2026 annual summary report showing immunization status of each child enrolled by January 15.

Rule Reference: 5 CSR 25-400.185 Health Care (4) (D) states: The administrator of each day care facility shall prepare a record of immunization of each child enrolled in or attending the facility. An annual summary report shall be made by January 15 showing the immunization status of each child enrolled, using forms provided by the department. The immunization records shall be available for review by department personnel upon request.

Correction Required: Facility shall submit an annual summary report by January 15 showing the immunization status of each child enrolled.

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The equipment list was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The Annual Declaration was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for July Abdeen, Hyejin Choi, Katie Gavali, Jinee Jaouni, and Maimuna Sayba within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that corner of the wooden fence located by the back gate was detached at the top exposing rusty nails.

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

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

Correction Verification: Submit Documentation

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

Violation: The 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 no resilient material was present.

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

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

Correction Verification: Submit Documentation

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

Violation: Hazardous items as follows were accessible to children: one bottle of hand sanitizer and one container of sanitizing wipes. The item(s) was/were located on the shelf in the living room.

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

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Corrected on Site

Compliance Date: 11/17/2025

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

Violation: Hazardous items as follows were accessible to children: four containers of sanitizing wipes. The item(s) was/were located in the restroom on the bottom of the diapering table.

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

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Corrected on Site

Compliance Date: 11/17/2025

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

Violation: Hazardous items as follows were accessible to children: one lighter, one bottle of isopropyl alcohol, one bottle of yard treatment spray, and one bottle of bug spray. The item(s) was/were located on the outdoor table.

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

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Corrected on Site

Compliance Date: 11/17/2025

5 CSR 25-400.086 Fire Safety

Violation: Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.086 Fire Safety

Violation: The requirements for protective outlet covers were not met as evidenced by two outlets missing protective covers.

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

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

Correction Verification: Corrected on Site

Compliance Date: 11/17/2025

5 CSR 25-400.090 Disaster and Emergency Preparedness

Violation: The facility's disaster and emergency plan was not available in each room used for child care as evidenced by the living room did not have a copy available.

Rule Reference: 5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster emergency plan is readily available in the office area and in each room used for care of children.

Correction Required: The facilities disaster and emergency plan must be available in required locations.

Correction Verification: Submit Documentation

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

Violation: The provider was not present 40 hours a week during the hours of highest attendance as evidenced by lack of provider attendance records.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (A) states: The provider routinely shall be present during the hours of highest attendance a minimum of forty (40) hours per week.

Correction Required: The provider shall be routinely on duty as required.

Correction Verification: Submit Documentation

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

Violation: A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Hyesjin Choi, Maimuna Sayba, and Katie Gavali.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (J) . 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 child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:

Correction Required: The provider shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification: Submit Documentation

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

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2024, the staff listed need the following information: July Abdeen, Katie Gavali, and Jinee Jaouni need 12 hours.

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

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

Correction Verification: Submit Documentation

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

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.125 Medical Examination Reports

Violation: A medical examination report was not on file for volunteer(s): Maimuna Sayba.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (1) (D) states: Assistants who are employed or volunteer more than five (5) hours per week shall have a medical examination report on file within thirty (30) days of beginning work in the home.

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

Correction Verification: Submit Documentation

5 CSR 25-400.125 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: Maimuna Sayba.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (1) (E) . 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 tuberulin skin test (TST) as required.

Correction Verification: Submit Documentation

5 CSR 25-400.210 Records and Reports

Violation: Daily attendance records were not maintained on file as required as evidenced by there was no caregiver/volunteer attendance record for the following staff: Katie Gavali.

Rule Reference: 5 CSR 25-400.210 Records and Reports (6) states: Daily attendance records for all caregivers shall be maintained and kept on file a minimum of one (1) year.

Correction Required: Caregiver/Volunteer attendance records shall be maintained and retained as required.

Correction Verification: Submit Documentation

Compliance Date: 11/17/2025

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

Violation: The provider was not present 40 hours a week during the hours of highest attendance as evidenced by lack of provider attendance records.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (A) states: The provider routinely shall be present during the hours of highest attendance a minimum of forty (40) hours per week.

Correction Required: The provider shall be routinely on duty as required.

Correction Verification: Submit Documentation

5 CSR 25-400.210 Records and Reports

Violation: Daily attendance records were not maintained on file as required as evidenced by there was no caregiver/volunteer attendance record for the following staff: Katie Gavali.

Rule Reference: 5 CSR 25-400.210 Records and Reports (6) states: Daily attendance records for all caregivers shall be maintained and kept on file a minimum of one (1) year.

Correction Required: Caregiver/Volunteer attendance records shall be maintained and retained as required.

Correction Verification: Submit Documentation

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

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by the resilient material used is unapproved as evidenced by one Little Tykes slide in the backyard is on very sparse grass.

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

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

Correction Verification: Return Inspection

Compliance Date: 5/27/2025

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that on the right side of the backyards chain-link fence it is bent and curved, leaning inward.

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

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

Correction Verification: Submit Documentation

Compliance Date: 5/27/2025

5 CSR 25-400.090 Disaster and Emergency Preparedness

Violation: Requirements of facility's 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 25-400.090 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, or other disaster drills shall be completed and recorded as required.

Correction Verification: Submit Documentation

Compliance Date: 5/27/2025

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that on the right side of the backyards chain-link fence it is bent and curved, leaning inward.

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

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

Correction Verification: Submit Documentation

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

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by the resilient material used is unapproved as evidenced by one Little Tykes slide in the backyard.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.090 Disaster and Emergency Preparedness

Violation: Requirements of facility's 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 25-400.090 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, or other disaster drills shall be completed and recorded as required.

Correction Verification: Submit Documentation

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that on the right side of the backyards chain-link fence it is bent and curved, leaning inward.

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

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

Correction Verification: Submit Documentation

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

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by the resilient material used is unapproved as evidenced by one Little Tykes slide in the backyard.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.086 Fire Safety

Violation: The requirements for protective outlet covers were not met as evidenced by three outlets did not have protective coverings in two of the child care spaces.

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

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

Correction Verification: Corrected on Site

Compliance Date: 1/27/2025

5 CSR 25-400.090 Disaster and Emergency Preparedness

Violation: Requirements of facility's 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 25-400.090 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, or other disaster drills shall be completed and recorded as required.

Correction Verification: Submit Documentation

5 CSR 25-400.210 Records and Reports

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

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

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

Correction Verification: Corrected on Site

Compliance Date: 1/27/2025

5 CSR 25-400.210 Records and Reports

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

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

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

Correction Verification: Corrected on Site

Compliance Date: 1/27/2025

5 CSR 25-400.210 Records and Reports

Violation: One child(ren) records did not include name and phone number of the family physician or hospital.

Rule Reference: 5 CSR 25-400.210 Records and Reports (2) (D) states: Name and phone number of the family physician, or hospital, or both, to be used in an emergency.

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

Correction Verification: Corrected on Site

Compliance Date: 1/27/2025

5 CSR 25-400.210 Records and Reports

Violation: One child(ren) records did not include field trip and transportation authorization.

Rule Reference: 5 CSR 25-400.210 Records and Reports (2) (F) states: Field trip and transportation authorization.

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

Correction Verification: Corrected on Site

Compliance Date: 1/27/2025

5 CSR 25-400.210 Records and Reports

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

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

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

Correction Verification: Corrected on Site

Compliance Date: 1/27/2025

5 CSR 25-400.210 Records and Reports

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

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

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

Correction Verification: Corrected on Site

Compliance Date: 1/27/2025

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

Violation: A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Jinee Jaouni.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (J) . 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 child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:

Correction Required: The provider shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification: Submit Documentation

Compliance Date: 7/19/2024

5 CSR 25-400.125 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 2/20/2023.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of 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), 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: 7/26/2024

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

Violation: A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Jinee Jaouni.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (J) . 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 child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:

Correction Required: The provider shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification: Submit Documentation

5 CSR 25-400.125 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 2/20/2023.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of 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), 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 25-400.090 Disaster and Emergency Preparedness

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

Rule Reference: 5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station.

Correction Required: Facility must post information as required.

Correction Verification: Submit Documentation

Compliance Date: 2/29/2024

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

Violation: A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Jinee Jaouni.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (J) . 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 child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:

Correction Required: The provider shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification: Submit Documentation

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

Violation: The following information for the assistant(s) was not posted as required: the name, address and telephone number of the assistant(s) was not posted with emergency numbers.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (3) (B) states: The names, addresses, and telephone numbers of all assistants shall be posted with other emergency numbers in the home.

Correction Required: Assistant information shall be posted.

Correction Verification: Submit Documentation

Compliance Date: 2/29/2024

5 CSR 25-400.125 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 2/20/2023.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of 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), 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 25-400.185 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 25-400.185 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 adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of 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 completed and on file as required.

Correction Verification: Submit Documentation

Compliance Date: 5/28/2024

5 CSR 25-400.055 Annual Requirements

Violation: The equipment list was not submitted.

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

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

Correction Verification: Submit Documentation

Compliance Date: 2/28/2024

5 CSR 25-400.055 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 1/8/2024

5 CSR 25-400.055 Annual Requirements

Violation: The Annual Declaration was not submitted.

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

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

Correction Verification: Submit Documentation

Compliance Date: 2/28/2024

5 CSR 25-400.055 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Katie Gavali, July Abdeen and Jinee Jaouni within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

Compliance Date: 1/8/2024

5 CSR 25-400.090 Disaster and Emergency Preparedness

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

Rule Reference: 5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station.

Correction Required: Facility must post information as required.

Correction Verification: Submit Documentation

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

Violation: A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Jinee Jaouni.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (J) . 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 child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:

Correction Required: The provider shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification: Submit Documentation

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

Violation: The following information for the assistant(s) was not posted as required: the name, address and telephone number of the assistant(s) was not posted with emergency numbers.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (3) (B) states: The names, addresses, and telephone numbers of all assistants shall be posted with other emergency numbers in the home.

Correction Required: Assistant information shall be posted.

Correction Verification: Submit Documentation

5 CSR 25-400.125 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 2/20/2023.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of 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), 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 25-400.185 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 25-400.185 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 adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of 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 completed and on file as required.

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The equipment list was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The Annual Declaration was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Katie Gavali, July Abdeen and Jinee Jaouni within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.090 Disaster and Emergency Preparedness

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

Rule Reference: 5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station.

Correction Required: Facility must post information as required.

Correction Verification: Submit Documentation

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

Violation: A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Katie Gavali, July Abdeen and Jinee Jaouni.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (J) . 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 child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:

Correction Required: The provider shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification: Submit Documentation

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

Violation: The following information for the assistant(s) was not posted as required: the name, address and telephone number of the assistant(s) was not posted with emergency numbers.

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (3) (B) states: The names, addresses, and telephone numbers of all assistants shall be posted with other emergency numbers in the home.

Correction Required: Assistant information shall be posted.

Correction Verification: Submit Documentation

5 CSR 25-400.125 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 2/20/2023.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of 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), 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 25-400.185 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 25-400.185 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 adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of 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 completed and on file as required.

Correction Verification: Submit Documentation