M And P Daycare, Llc

5 CSR 25-500.087 Fire Safety

Violation: Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.

Rule Reference: 5 CSR 25-500.087 Fire Safety (2) (F) 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

Compliance Date: 3/9/2026

5 CSR 25-500.087 Fire Safety

Violation: Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by the disaster and tornado drill was not held at least one time every three months.

Rule Reference: 5 CSR 25-500.087 Fire Safety (2) (F) 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

Compliance Date: 3/9/2026

5 CSR 25-500.090 Disaster and Emergency Preparedness

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 3/9/2026

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 sleeping infant was observed wearing a bib and covered by a blanket.

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: Return Inspection

Compliance Date: 3/9/2026

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: An infant was observed sleeping in a/an motorized swing.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. I states: Sitting devices such as car safety seats, strollers, swings, infant carriers, infant slings, and other sitting devices shall not be used for sleep/nap time. Infants who fall asleep anywhere other than a crib, portable crib, or playpen shall be placed in the crib or playpen for the remainder of their sleep or nap time.

Correction Required: Infants shall only sleep in a crib, portable crib, or playpen.

Correction Verification: Return Inspection

Compliance Date: 3/9/2026

5 CSR 25-500.087 Fire Safety

Violation: Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by the disaster and tornado drill was not held at least one time every three months.

Rule Reference: 5 CSR 25-500.087 Fire Safety (2) (F) 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 25-500.087 Fire Safety

Violation: Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.

Rule Reference: 5 CSR 25-500.087 Fire Safety (2) (F) 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 25-500.090 Disaster and Emergency Preparedness

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: The passage to an exit located in the I/T unit office was not clear as evidenced by a baby swing was blocking the means of egress.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 2. states: Furniture and equipment shall be arranged to provide a clear passage to all exits.

Correction Required: Caregivers shall keep passageways to all exits clear.

Correction Verification: Corrected on Site

Compliance Date: 3/3/2026

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 sleeping infant was observed wearing a bib and covered by a blanket.

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: Return Inspection

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: An infant was observed sleeping in a/an motorized swing.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. I states: Sitting devices such as car safety seats, strollers, swings, infant carriers, infant slings, and other sitting devices shall not be used for sleep/nap time. Infants who fall asleep anywhere other than a crib, portable crib, or playpen shall be placed in the crib or playpen for the remainder of their sleep or nap time.

Correction Required: Infants shall only sleep in a crib, portable crib, or playpen.

Correction Verification: Return Inspection

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

Violation: The premises were not safe and suitable as evidenced by 4 cords were hanging from a powerstrip behind the swings in the I/T unit and accessible to children's reach .

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.

Correction Required: The premises shall be safe and suitable for the care of children.

Correction Verification: Submit Documentation

Compliance Date: 12/8/2025

5 CSR 25-500.192 Health Care

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 12/8/2025

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include child's full name, address, date of birth and date care begins and ends.

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;

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

Correction Verification: Submit Documentation

Compliance Date: 12/8/2025

5 CSR 25-500.222 Records and Reports

Violation: An individual file was not kept for 1 child(ren).

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) . states: An individual file shall be kept to identify each child and enable the provider to communicate with the parent(s), guardian or legal custodian of the child in an emergency.

Correction Required: Accurate records shall be maintained.

Correction Verification: Submit Documentation

Compliance Date: 12/8/2025

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include field trip and transportation authorization.

Rule Reference: 5 CSR 25-500.222 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: Submit Documentation

Compliance Date: 12/8/2025

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include name of individual authorized to take the child from the facility.

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) (E) states: Name of the individual(s) authorized to take the child from the facility;

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

Correction Verification: Submit Documentation

Compliance Date: 12/8/2025

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include telephone number of family physician or hospital.

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;

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

Correction Verification: Submit Documentation

Compliance Date: 12/8/2025

5 CSR 25-500.222 Records and Reports

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

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;

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

Correction Verification: Submit Documentation

Compliance Date: 12/8/2025

5 CSR 25-500.222 Records and Reports

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

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;

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

Correction Verification: Submit Documentation

Compliance Date: 12/8/2025

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

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by resilient material was not uniformly spread over the fall-zone area.

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

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

Correction Verification: Corrected on Site

Compliance Date: 10/16/2025

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

Violation: Staff or older children used the infant/toddler areas as passageway to other parts of the building as evidenced by two staff were seen leaving the staff break room/office and walking through the I/T unit when leaving.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (B) 2. B. (VIII) states: Infant/toddler areas may not be used by staff or older children as passageways to other areas of the building.

Correction Required: Infant/toddler areas shall not be used as a passageway by other staff or children.

Correction Verification: Corrected on Site

Compliance Date: 10/16/2025

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

Violation: Children were not restricted to approved space as evidenced by a 10 year old child was in the staff break room.

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

Correction Required: Caregivers shall restrict children to approved space.

Correction Verification: Corrected on Site

Compliance Date: 10/16/2025

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

Violation: The premises were not safe and suitable as evidenced by 4 cords were hanging from a powerstrip behind the swings in the I/T unit and accessible to children's reach .

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.

Correction Required: The premises shall be safe and suitable for the care of children.

Correction Verification: Submit Documentation

5 CSR 25-500.182 Child Care Program

Violation: A child was left without competent supervision as evidenced by an unattended child was in the staff break 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: 10/16/2025

5 CSR 25-500.192 Health Care

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include child's full name, address, date of birth and date care begins and ends.

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;

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

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

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

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;

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

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

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

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;

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

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: An individual file was not kept for 1 child(ren).

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) . states: An individual file shall be kept to identify each child and enable the provider to communicate with the parent(s), guardian or legal custodian of the child in an emergency.

Correction Required: Accurate records shall be maintained.

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include field trip and transportation authorization.

Rule Reference: 5 CSR 25-500.222 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: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include name of individual authorized to take the child from the facility.

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) (E) states: Name of the individual(s) authorized to take the child from the facility;

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

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include telephone number of family physician or hospital.

Rule Reference: 5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Amanda Amelunke, Shelly Whitener, Ally Whitener, Mallorie Miller, & Autumn Underwood within thirty (30) days prior to the anniversary date.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.

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

Correction Verification: Submit Documentation

Compliance Date: 8/6/2025

5 CSR 25-500.102 Personnel

Violation: Kylie Botbyl & Abbigail Crowder 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: 8/6/2025

5 CSR 25-500.102 Personnel

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

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: 8/6/2025

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: Abbigael Crowder, Kylie Botbyl, Victoria Wheeling, & Mallorie Miller.

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: 8/6/2025

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Kylie Botbyl, Victoria Wheeling, Josie Whitnener.

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: Return Inspection

Compliance Date: 8/6/2025

5 CSR 25-500.042 Licensing Process

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

Rule Reference: 5 CSR 25-500.042 Licensing Process (13) (A) states: The child care provider(s);

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

Correction Verification: Return Inspection

Compliance Date: 4/9/2025

5 CSR 25-500.042 Licensing Process

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

Rule Reference: 5 CSR 25-500.042 Licensing Process (12) states: Once granted, the license shall be posted near the entrance of the facility where it may be seen easily by parents or others who visit.

Correction Required: The official license shall be posted.

Correction Verification: Return Inspection

Compliance Date: 4/9/2025

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Amanda Amelunke, Shelly Whitener, Ally Whitener, Mallorie Miller, & Autumn Underwood 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 25-500.102 Personnel

Violation: Kylie Botbyl & Abbigail Crowder 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 Autumn Whitener.

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: Aranda Amelunke needs 2.5 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: Return Inspection

Compliance Date: 4/8/2025

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Victoria Wheeling & Mallorie Miller

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

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

Correction Verification: Return Inspection

Compliance Date: 4/9/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Victoria Wheeling, Abbigail Crowder &, Kylie Botbyl 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: Return Inspection

Compliance Date: 4/9/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Abbigael Crowder, Kylie Botbyl, Victoria Wheeling, & Mallorie Miller.

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 25-500.222 Records and Reports

Violation: Daily attendance records were not maintained on file as evidenced by there was no staff/volunteer attendance record for the following staff: Karen Whitener & Josie Whitener.

Rule Reference: 5 CSR 25-500.222 Records and Reports (6) states: Daily staff and volunteer attendance records shall be maintained and kept on file a minimum of one (1) year.

Correction Required: Staff/volunteer attendance records shall be maintained and retained as required.

Correction Verification: Return Inspection

Compliance Date: 4/9/2025

5 CSR 25-600.020 General Requirements

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

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: Return Inspection

Compliance Date: 4/9/2025

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Kylie Botbyl, Victoria Wheeling, Josie Whitnener.

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: Return Inspection

5 CSR 25-500.042 Licensing Process

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

Rule Reference: 5 CSR 25-500.042 Licensing Process (13) (A) states: The child care provider(s);

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

Correction Verification: Return Inspection

5 CSR 25-500.042 Licensing Process

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

Rule Reference: 5 CSR 25-500.042 Licensing Process (12) states: Once granted, the license shall be posted near the entrance of the facility where it may be seen easily by parents or others who visit.

Correction Required: The official license shall be posted.

Correction Verification: Return Inspection

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Amanda Amelunke, Shelly Whitener, Ally Whitener, Mallorie Miller, & Autumn Underwood 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: Return Inspection

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

Violation: Staff or older children used the infant/toddler areas as passageway to other parts of the building as evidenced by the office they being used is through the infant/toddler unit. Staff have to pass through the infant/toddler unit to access computer, files, paperwork and timeclock.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (B) 2. B. (VIII) states: Infant/toddler areas may not be used by staff or older children as passageways to other areas of the building.

Correction Required: Infant/toddler areas shall not be used as a passageway by other staff or children.

Correction Verification: Return Inspection

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 6 month old was observed sleeping covered in a blanket.

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: 3/24/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Infant sleeping requirements were not met as evidenced by soft materials or objects were placed under a sleeping infant in that a 6 month old was observed sleeping propped on a boppy pillow.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. F. states: Soft materials or objects such as pillows, quilts, comforters, or sheepskins, even if covered by a sheet, shall not be placed under a sleeping infant. If a mattress cover to protect against wetness is used, it shall be tightly fitting and thin.

Correction Required: Infant sleeping requirements shall be met.

Correction Verification: Corrected on Site

Compliance Date: 3/24/2025

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Victoria Wheeling & Mallorie Miller

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

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

Correction Verification: Return Inspection

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: Aranda Amelunke needs 2.5 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: Return Inspection

5 CSR 25-500.102 Personnel

Violation: Kylie Botbyl & Abbigail Crowder 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: Return Inspection

5 CSR 25-500.102 Personnel

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

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: Return Inspection

5 CSR 25-500.112 Staff/Child Ratios

Violation: Staff/child ratio requirements were not met as evidenced by 6 children , ages 1-2 years, were cared for by 1 adult caregiver(s).

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

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

Correction Verification: Corrected on Site

Compliance Date: 3/24/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Victoria Wheeling, Abbigail Crowder &, Kylie Botbyl 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: Return Inspection

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: Abbigael Crowder, Kylie Botbyl, Victoria Wheeling, & Mallorie Miller.

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: Return Inspection

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: 3/24/2025

5 CSR 25-500.222 Records and Reports

Violation: Daily attendance records were not maintained on file as evidenced by there was no staff/volunteer attendance record for the following staff: Karen Whitener & Josie Whitener.

Rule Reference: 5 CSR 25-500.222 Records and Reports (6) states: Daily staff and volunteer attendance records shall be maintained and kept on file a minimum of one (1) year.

Correction Required: Staff/volunteer attendance records shall be maintained and retained as required.

Correction Verification: Return Inspection

5 CSR 25-600.020 General Requirements

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

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: Return Inspection

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Kylie Botbyl, Victoria Wheeling, Josie Whitnener.

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: Return Inspection

5 CSR 25-500.052 Annual Requirements

Violation: The Annual Declaration was not submitted.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.

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

Correction Verification: Submit Documentation

Compliance Date: 7/16/2024

5 CSR 25-500.052 Annual Requirements

Violation: The staff sheet was not submitted.

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

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

Correction Verification: Submit Documentation

Compliance Date: 7/16/2024

5 CSR 25-500.052 Annual Requirements

Violation: The equipment list was not submitted.

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

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

Correction Verification: Submit Documentation

Compliance Date: 7/16/2024

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Victoria Botbyl, Kimberly Patterson, Cathy Stallard and Autumn Whitener 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: 7/16/2024

5 CSR 25-500.192 Health Care

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 7/16/2024

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Mallorie Miller and Victoria Botbyl .

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: 7/16/2024

5 CSR 25-500.052 Annual Requirements

Violation: The Annual Declaration was not submitted.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The staff sheet was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The equipment list was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Victoria Botbyl, Kimberly Patterson, Cathy Stallard and Autumn Whitener 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 25-500.192 Health Care

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Mallorie Miller and Victoria Botbyl .

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Annual Declaration was not submitted.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The staff sheet was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The equipment list was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Victoria Botbyl, Kimberly Patterson, Cathy Stallard and Autumn Whitener 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 25-500.192 Health Care

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Mallorie Miller and Victoria Botbyl .

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 premises were not safe and suitable as evidenced by there are no barriers or car stops in place in front of the building or along the playground. During the inspection on 3/6/2023, car stops were placed but were not anchored.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.

Correction Required: The premises shall be safe and suitable for the care of children.

Correction Verification: Submit Documentation

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

Violation: The walls located behind the trashcan in the infant/toddler unit was/were not finished with material which can be cleaned easily as evidenced by the chalky substance of the sheetrock was exposed.

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: Return Inspection

Compliance Date: 10/31/2023

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

Violation: The facility's outdoor space was not safe for children's activities as evidenced by there are vines growing in the playground.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

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

Correction Verification: Return Inspection

Compliance Date: 10/31/2023

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by the top of the picnic table on the preschool playground was not on the table.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

Correction Required: Indoor play equipment, clean and in good repair, shall be accessible to children.

Correction Verification: Return Inspection

Compliance Date: 12/29/2023

5 CSR 25-500.052 Annual Requirements

Violation: The annual fire safety inspection was not approved.

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

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

Correction Verification: Submit Documentation

Compliance Date: 6/13/2023

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

Violation: The premises were not safe and suitable as evidenced by there are no barriers or car stops in place in front of the building or along the playground. During the inspection on 3/6/2023, car stops were placed but were not anchored.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.

Correction Required: The premises shall be safe and suitable for the care of children.

Correction Verification: Submit Documentation

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

Violation: The walls located behind the trashcan in the infant/toddler unit was/were not finished with material which can be cleaned easily as evidenced by the chalky substance of the sheetrock was exposed.

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: Return Inspection

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

Violation: The facility's outdoor space was not safe for children's activities as evidenced by there are vines growing in the playground.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

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

Correction Verification: Return Inspection

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by the top of the picnic table on the preschool playground was not on the table.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

Correction Required: Indoor play equipment, clean and in good repair, shall be accessible to children.

Correction Verification: Return Inspection

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: Bathroom supplies were not available and accessible to children as evidenced by there were no paper towels.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 4. states: Paper towels, soap and toilet paper shall be provided and easily accessible so the children can reach them without assistance.

Correction Required: The facility shall provide paper towels, soap and toilet paper, accessible for children's use.

Correction Verification: Corrected on Site

Compliance Date: 9/20/2023

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

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by the resilient material used is unapproved in that the facility did not have documentation showing the new mats being used in the infant/toddler playground were made for resiliency.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 5. 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 will effectively cushion the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.

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

Correction Verification: Submit Documentation

Compliance Date: 9/20/2023

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

Violation: The facility's outdoor space was not safe for children's activities as evidenced by there are vines growing in the playground.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

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

Correction Verification: Return Inspection

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

Violation: Staff or older children used the infant/toddler areas as passageway to other parts of the building as evidenced by Payton Chaffin and a 4 year old child came out of the infant/toddler unit during the inspection. When asked about this, Karen stated the child had been sick and was using the bathroom in the infant/toddler unit.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (B) 2. B. (VIII) states: Infant/toddler areas may not be used by staff or older children as passageways to other areas of the building.

Correction Required: Infant/toddler areas shall not be used as a passageway by other staff or children.

Correction Verification: Corrected on Site

Compliance Date: 9/20/2023

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

Violation: The walls located behind the trashcan in the infant/toddler unit was/were not finished with material which can be cleaned easily as evidenced by the chalky substance of the sheetrock was exposed.

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: Return Inspection

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

Violation: Children were not restricted to approved space as evidenced by the utility room door was open.

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

Correction Required: Caregivers shall restrict children to approved space.

Correction Verification: Corrected on Site

Compliance Date: 9/20/2023

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

Violation: The premises were not safe and suitable as evidenced by there are no barriers or car stops in place in front of the building or along the playground. During the inspection on 3/6/2023, car stops were placed but were not anchored.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.

Correction Required: The premises shall be safe and suitable for the care of children.

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by the top of the picnic table on the preschool playground was not on the table.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

Correction Required: Indoor play equipment, clean and in good repair, shall be accessible to children.

Correction Verification: Return Inspection

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 2022, the staff listed need the following information: Shelly Whitener needs 7.5 hours, Mary Lord needs 9 hours, Kelly Cuerton needs 1.5 hours, Karen Whitener needs 1 hour and Cheyenne Osborn needs 9 hours. As of 6/12/2023, all hours have been corrected except for Shelly Whitener who still needs 1.75 hours for 2022.

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: 9/20/2023

5 CSR 25-500.122 Medical Examination Reports

Violation: Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 6/21/22.

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: 7/26/2023