Little Bulldogs Learning Center Llc

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

Violation: The walls located in the dramatic play room was/were not in good condition as evidenced by a chunk of drywall missing from the blue wall, close to the floor by the cubby unit.

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: 8/6/2026

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

Violation: The facility did not have a telephone in working order for incoming and outgoing calls as evidenced by the telephone was not working.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 10. states: A telephone in working order shall be available for incoming and outgoing calls. If a telephone answering machine is used, it must be turned on so incoming messages can be heard and parents' calls can be returned promptly.

Correction Required: A working telephone and answering machine shall be used as required.

Correction Verification: Return Inspection

Compliance Date: 8/6/2026

5 CSR 25-500.102 Personnel

Violation: The facility did not conduct a Family Care Safety Registry screening for Vivian Eaton, who was hired on 06-01-2026 .

Rule Reference: 5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

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

Correction Verification: Submit Documentation

Compliance Date: 8/3/2026

5 CSR 25-500.102 Personnel

Violation: Vivian Eaton (rechecked 08.06.2026-not corrected) 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: The facility did not conduct a Family Care Safety Registry screening for Lena Crutchfield, who was hired on 08.03.2026.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Vivian Eaton (rechecked 08.06.2026-not corrected) 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: Vivian Eaton (rechecked 08.06.2026-not corrected).

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 25-500.132 Admission Policies and Procedures

Violation: A diet plan for each infant/toddler was not on file.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 3. states: A diet plan for each infant/toddler signed by the parent(s);

Correction Required: Each infant and toddler's diet plan shall be completed and on file as required.

Correction Verification: Submit Documentation

Compliance Date: 7/31/2026

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Vivian Eaton (rechecked 08.06.2026-not corrected).

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 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Lena Crutchfield.

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 the dramatic play room was/were not in good condition as evidenced by a chunk of drywall missing from the blue wall, close to the floor by the cubby unit.

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 did not have a telephone in working order for incoming and outgoing calls as evidenced by the telephone was not working.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 10. states: A telephone in working order shall be available for incoming and outgoing calls. If a telephone answering machine is used, it must be turned on so incoming messages can be heard and parents' calls can be returned promptly.

Correction Required: A working telephone and answering machine shall be used as required.

Correction Verification: Return Inspection

5 CSR 25-500.102 Personnel

Violation: The facility did not conduct a Family Care Safety Registry screening for Vivian Eaton, who was hired on 06-01-2026.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: Vivian Eaton 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 Vivian Eaton 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: Vivian Eaton.

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 25-500.132 Admission Policies and Procedures

Violation: A diet plan for each infant/toddler was not on file.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 3. states: A diet plan for each infant/toddler signed by the parent(s);

Correction Required: Each infant and toddler's diet plan shall be completed and 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 Vivian Eaton.

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 25-500.102 Personnel

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2025, the staff listed need the following information: Lydia Eaton needs 12 clock hours.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.

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

Correction Verification: Submit Documentation

Compliance Date: 7/21/2026

5 CSR 25-500.102 Personnel

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2025, the staff listed need the following information: Lydia Eaton needs 12 clock hours.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. 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 25-500.182 Child Care Program

Violation: The diapering table or other approved area was not cleaned thoroughly with a disinfectant after each use.

Rule Reference: 5 CSR 25-500.182 Child Care Program (1) (E) 2. states: The diapering table shall be cleaned thoroughly with a disinfectant after each use.

Correction Required: The facility shall provide a safe diapering table and cleaned as required.

Correction Verification: Return Inspection

Compliance Date: 5/21/2026

5 CSR 25-500.202 Nutrition and Food Service

Violation: The provider did not supply and serve food according to the Meal and Snack Food Chart as evidenced by 1/2 slice lunch meat, 1/2 slice cheese, 1/2 slice of bread, 1/2 banana, and handfuls of potato chips with milk..

Rule Reference: 5 CSR 25-500.202 Nutrition and Food Service (1) (A) states: The provider shall supply and serve nourishing food according to the Meal and Snack Food Chart provided in this rule.

Correction Required: Nourishing food shall be provided as required.

Correction Verification: Return Inspection

Compliance Date: 5/21/2026

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Sleeping equipment was not arranged to provide required spacing as evidenced by there was no aisle on the long side of the napping equipment.

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: 5/13/2026

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Infant sleeping requirements were not met as evidenced by blankets or other soft or loose bedding was observed on the side of the crib.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. H states: Blankets or other soft or loose bedding shall not be hung on the sides of cribs or put under the fitted sheet. Only sleep clothing that is designed to keep an infant warm without the possible hazard of covering the head or face may be used during sleep or nap time.

Correction Required: Infant sleeping requirements shall be met.

Correction Verification: Corrected on Site

Compliance Date: 5/13/2026

5 CSR 25-500.182 Child Care Program

Violation: A child was left without competent supervision as evidenced by 10-month-old child left alone in the I/T room.

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: 5/13/2026

5 CSR 25-500.182 Child Care Program

Violation: The diapering table or other approved area was not cleaned thoroughly with a disinfectant after each use.

Rule Reference: 5 CSR 25-500.182 Child Care Program (1) (E) 2. states: The diapering table shall be cleaned thoroughly with a disinfectant after each use.

Correction Required: The facility shall provide a safe diapering table and cleaned as required.

Correction Verification: Return Inspection

5 CSR 25-500.182 Child Care Program

Violation: Handwashing requirements were not met as evidenced by a caregiver did not wash his/her hands with soap and water after changing a child's diaper.

Rule Reference: 5 CSR 25-500.182 Child Care Program (1) (E) 6. states: Caregivers changing diapers shall wash their hands with soap and running water each time after changing a child's diaper.

Correction Required: Caregivers shall wash their hands after each diaper change.

Correction Verification: Corrected on Site

Compliance Date: 5/13/2026

5 CSR 25-500.202 Nutrition and Food Service

Violation: The provider did not supply and serve food according to the Meal and Snack Food Chart as evidenced by 1/2 slice lunch meat, 1/2 slice cheese, 1/2 slice of bread, 1/2 banana, and handfuls of potato chips with milk..

Rule Reference: 5 CSR 25-500.202 Nutrition and Food Service (1) (A) states: The provider shall supply and serve nourishing food according to the Meal and Snack Food Chart provided in this rule.

Correction Required: Nourishing food shall be provided as required.

Correction Verification: Return Inspection

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

Violation: The walls located on the half door dividing the dining area from the preschool purple cubby room was/were not in good condition as evidenced by a large area of peeling white paint was present.

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: 2/26/2026

5 CSR 25-500.102 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: Chanda Winn needs 1.75 hours and Lydia Eaton needs 8.0 hours (01/02/2025-Lydia Eaton needs 7.00 hours and Chanda Winn has compleed clock hours for 2024).

Rule Reference: 5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.

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

Correction Verification: Submit Documentation

Compliance Date: 2/26/2026

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Mary Winn and Lydia Eaton.

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: 1/7/2026

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

Compliance Date: 9/2/2025

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: 7/12/2025

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

Violation: The walls located on the half door dividing the dining area from the preschool purple cubby room was/were not in good condition as evidenced by a large area of peeling white paint was present.

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, the white and blue toy shelf, in the playroom (called cubby room) was not in good condition as evidenced by the blue surface on the right and front side was chipped and did not have a smooth washable surface.

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: 7/21/2025

5 CSR 25-500.102 Personnel

Violation: Documentation of caregiver completion of the facility orientation was not on file for the following staff: Mary Winn.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (L) states: The child care provider shall ensure that documentation of caregiver completion of the facility orientation is maintained and on file for review by the department.

Correction Required: Documentation of caregiver completion of the facility orientation shall be maintained and on file for review by the department as required.

Correction Verification: Submit Documentation

Compliance Date: 12/18/2025

5 CSR 25-500.102 Personnel

Violation: The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate first aid was not on site.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.

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

Correction Verification: Submit Documentation

Compliance Date: 7/28/2025

5 CSR 25-500.102 Personnel

Violation: The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate CPR was not on site.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.

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

Correction Verification: Submit Documentation

Compliance Date: 7/28/2025

5 CSR 25-500.102 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: Chanda Winn needs 1.75 hours and Lydia Eaton needs 8.0 hours (01/02/2025-Lydia Eaton needs 7.00 hours and Chanda Winn has compleed clock hours for 2024).

Rule Reference: 5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. 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 25-500.102 Personnel

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

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: 1/2/2026

5 CSR 25-500.102 Personnel

Violation: Mary Winn 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: 1/2/2026

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Mary Winn and Lydia Eaton.

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 number of children was/were exceeded as evidenced by 23 children were present at the time of inspection.

Rule Reference: 5 CSR 25-500.042 Licensing Process (18) states: The number and ages of children a group child care home or child care center is authorized to have in care at any one time shall be specified on the license and shall not be exceeded except as permitted within these rules.

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

Correction Verification: Return Inspection

Compliance Date: 7/17/2025

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 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 Chanda Winn, Lydia Eaton, Bryanna Griggs, and Kimberly Eaton 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: 7/17/2025

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

Violation: Emergency numbers for the police, fire department, and ambulance were not posted.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 11. states: Telephone numbers for the police, fire department, ambulance and other emergency telephone numbers shall be posted near the telephone.

Correction Required: Emergency numbers shall be posted near the telephone.

Correction Verification: Submit Documentation

Compliance Date: 7/9/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, the white and blue toy shelf, in the playroom (called cubby room) was not in good condition as evidenced by the blue surface on the right and front side was chipped and did not have a smooth washable surface.

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 25-500.102 Personnel

Violation: Documentation of caregiver completion of the facility orientation was not on file for the following staff: Mary Winn.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (L) states: The child care provider shall ensure that documentation of caregiver completion of the facility orientation is maintained and on file for review by the department.

Correction Required: Documentation of caregiver completion of the facility orientation shall be maintained and on file for review by the department as required.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The facility did not conduct a Family Care Safety Registry screening for Mary Winn, who was hired on 05.09.2025.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

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

Correction Verification: Submit Documentation

Compliance Date: 7/17/2025

5 CSR 25-500.102 Personnel

Violation: The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate first aid was not on site.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate CPR was not on site.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 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: Chanda Winn needs 1.75 hours and Lydia Eaton needs 8.0 hours.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. 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 25-500.102 Personnel

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

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: Mary Winn 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 25-500.112 Staff/Child Ratios

Violation: Staff/child ratio requirements were not met as evidenced by 23 children , ages 16 months through 8 years old (including (7) 2-year-olds and (4) under age 2 years old), were cared for by 3 adult caregiver(s).

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

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

Correction Verification: Return Inspection

Compliance Date: 7/17/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Mary Winn 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: 7/16/2025

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: Mary Winn.

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: 7/16/2025

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 06.04.2025.

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: 7/16/2025

5 CSR 25-500.132 Admission Policies and Procedures

Violation: An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.

Correction Required: An individualized plan from a professional source shall be on file as required.

Correction Verification: Submit Documentation

Compliance Date: 7/14/2025

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Mary Winn and Lydia Eaton.

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 number of children was/were exceeded as evidenced by 23 children were present at the time of inspection.

Rule Reference: 5 CSR 25-500.042 Licensing Process (18) states: The number and ages of children a group child care home or child care center is authorized to have in care at any one time shall be specified on the license and shall not be exceeded except as permitted within these rules.

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

Correction Verification: Return Inspection

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Chanda Winn, Lydia Eaton, Bryanna Griggs, and Kimberly Eaton 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 25-500.052 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 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 25-500.082 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 would not flush.

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: Corrected on Site

Compliance Date: 7/8/2025

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

Violation: Emergency numbers for the police, fire department, and ambulance were not posted.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 11. states: Telephone numbers for the police, fire department, ambulance and other emergency telephone numbers shall be posted near the telephone.

Correction Required: Emergency numbers shall be posted near the telephone.

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, the white and blue toy shelf, in the playroom (called cubby room) was not in good condition as evidenced by the blue surface on the right and front side was chipped and did not have a smooth washable surface.

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 25-500.102 Personnel

Violation: Mary Winn 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: Safe sleep training was not completed within the past 3 years for the following staff Lydia Eaton.

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: 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: Chanda Winn needs 1.75 hours and Lydia Eaton needs 8.0 hours.

Rule Reference: 5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. 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 25-500.102 Personnel

Violation: The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate first aid was not on site.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.

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

Correction Verification: Return Inspection

5 CSR 25-500.102 Personnel

Violation: The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate CPR was not on site.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.

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

Correction Verification: Return Inspection

5 CSR 25-500.102 Personnel

Violation: The facility did not conduct a Family Care Safety Registry screening for Mary Winn, who was hired on 05.09.2025.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: Documentation of caregiver completion of the facility orientation was not on file for the following staff: Mary Winn.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (L) states: The child care provider shall ensure that documentation of caregiver completion of the facility orientation is maintained and on file for review by the department.

Correction Required: Documentation of caregiver completion of the facility orientation shall be maintained and on file for review by the department as required.

Correction Verification: Submit Documentation

5 CSR 25-500.112 Staff/Child Ratios

Violation: Staff/child ratio requirements were not met as evidenced by 23 children , ages 16 months through 8 years old (including (7) 2-year-olds and (4) under age 2 years old), were cared for by 3 adult caregiver(s).

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

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

Correction Verification: Return Inspection

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 06.04.2025.

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 25-500.122 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: Mary Winn.

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: Medical examination report(s) was/were not on file for Mary Winn 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 25-500.132 Admission Policies and Procedures

Violation: An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.

Correction Required: An individualized plan from a professional source 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 Mary Winn and Lydia Eaton.

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 25-500.102 Personnel

Violation: The director is not routinely on duty, as evidenced by director Chanda Winn was not present and staff indicated that the director is off on Fridays.

Rule Reference: 5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.

Correction Required: The director/group home provider shall be routinely on duty, as required.

Correction Verification: Return Inspection

Compliance Date: 12/20/2024

5 CSR 25-500.112 Staff/Child Ratios

Violation: Staff/child ratio requirements were not met as evidenced by eleven children , ages 2-4-years-old, were cared for by Lydia Eaton adult caregiver(s).

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

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

Correction Verification: Return Inspection

Compliance Date: 12/20/2024

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

Violation: The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that two plug protectors were missing from an outlet in the first childcare room on the right.

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: 12/6/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by a blanket was covering an 8 month old female infant (D.O.B. 3/29.24) while sleeping in a pack-n-play in the Infant/Toddler room. .

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. G states: Cribs, portable cribs and playpens shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation. Examples include bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, pillow-like toys, wedges, infant positioners, special mattresses, special sleep surfaces, and other similar items.

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

Correction Verification: Corrected on Site

Compliance Date: 12/6/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Infant sleeping requirements were not met as evidenced by blankets or other soft or loose bedding was observed on the side of the crib.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. H states: Blankets or other soft or loose bedding shall not be hung on the sides of cribs or put under the fitted sheet. Only sleep clothing that is designed to keep an infant warm without the possible hazard of covering the head or face may be used during sleep or nap time.

Correction Required: Infant sleeping requirements shall be met.

Correction Verification: Corrected on Site

Compliance Date: 12/6/2024

5 CSR 25-500.102 Personnel

Violation: The director is not routinely on duty, as evidenced by director Chanda Winn was not present and staff indicated that the director is off on Fridays.

Rule Reference: 5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.

Correction Required: The director/group home provider shall be routinely on duty, as required.

Correction Verification: Return Inspection

5 CSR 25-500.112 Staff/Child Ratios

Violation: Staff/child ratio requirements were not met as evidenced by eleven children , ages 2-4-years-old, were cared for by Lydia Eaton adult caregiver(s).

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

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

Correction Verification: Return Inspection

5 CSR 25-500.182 Child Care Program

Violation: Requirements for supervision of napping children were not met as evidenced by infants and toddlers did not have constant care and supervision in that an 8-month-old female child was observed sleeping in the Infant/Toddler room with the door shut, and without a caregiver present in the room.

Rule Reference: 5 CSR 25-500.182 Child Care Program (1) (D) 1. states: Infants and toddlers shall have constant care and supervision. Home monitors or commercial devices marketed to reduce the risk of Sudden Infant Death Syndrome (SIDS) shall not be used in place of supervision while children are napping or sleeping.

Correction Required: Caregivers shall provide constant care and supervision of infants/toddlers as required.

Correction Verification: Corrected on Site

Compliance Date: 12/6/2024

5 CSR 25-500.182 Child Care Program

Violation: A pacifier was observed attached to an infant’s clothing while the infant was sleeping.

Rule Reference: 5 CSR 25-500.182 Child Care Program (2) (C) 4. F. states: Pacifiers, if used, shall not be hung around the infant’s neck. Pacifier mechanisms or pacifiers that attach to infant clothing shall not be used with sleeping infants.

Correction Required: Pacifiers shall not be hung around an infant’s neck or attached to clothing while the infant is sleeping.

Correction Verification: Corrected on Site

Compliance Date: 12/6/2024

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

Violation: The walls located in the lunch room on the right side corner by the window was/were not in good condition as evidenced by the gray paint had a large area of peeling 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: 8/5/2024

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

Violation: The walls located in the Dramatic playroom outside of the bathroom and gated stairs was/were not in good condition as evidenced by the lavender paint had large areas of peeling 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: 8/5/2024

5 CSR 25-500.102 Personnel

Violation: Lydia Eaton (start date 1/5/24) 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: 7/12/2024

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Lydia Eaton 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: 8/19/2024

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Bryanna Griggs 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: 9/20/2024

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Chanda Winn (expired 6/13/2019).

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: 9/6/2024

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Kenna Lixey and Lydia Eaton.

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: 9/6/2024

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

Violation: The walls located in the Dramatic playroom outside of the bathroom and gated stairs was/were not in good condition as evidenced by the lavender paint had large areas of peeling 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 walls located in the lunch room on the right side corner by the window was/were not in good condition as evidenced by the gray paint had a large area of peeling 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 25-500.102 Personnel

Violation: The facility did not conduct a Family Care Safety Registry screening for Kimberly Eaton, who was hired on 6/4/2019.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

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

Correction Verification: Corrected on Site

Compliance Date: 7/12/2024

5 CSR 25-500.102 Personnel

Violation: Lydia Eaton (start date 1/5/24) 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: The facility did not conduct a Family Care Safety Registry screening for Chanda Winn, who was hired on 5/13/08.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

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

Correction Verification: Corrected on Site

Compliance Date: 7/12/2024

5 CSR 25-500.102 Personnel

Violation: The facility did not conduct a Family Care Safety Registry screening for Kenna Lixey, who was hired on 1/2/24.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

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

Correction Verification: Corrected on Site

Compliance Date: 7/12/2024

5 CSR 25-500.102 Personnel

Violation: The facility did not conduct a Family Care Safety Registry screening for Bryanna Griggs, who was hired on 1/15/24.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

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

Correction Verification: Corrected on Site

Compliance Date: 7/12/2024

5 CSR 25-500.102 Personnel

Violation: The facility did not conduct a Family Care Safety Registry screening for Lydia Eaton, who was hired on 1/5/24.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

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

Correction Verification: Corrected on Site

Compliance Date: 7/12/2024

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Bryanna Griggs 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: Medical examination report(s) was/were not on file for Lydia Eaton 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 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Chanda Winn (expired 6/13/2019).

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 Kenna Lixey and Lydia Eaton.

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: Hazardous items as follows were accessible to children: A large bottle of Pine Sol. The item(s) was/were located on the floor of the shower/tub floor in the bathroom.

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: 1/23/2024