Daisy's Imagination Station

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that one of the wooden board is broken creating a opening that measured 12"x6".

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard.

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 fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence had openings that were between 3.5 and 9 inches and allow entrapment - the openings measured 5 inches.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard.

Correction Verification: Submit Documentation

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

Violation: The facility's outdoor space was not safe for children's activities as evidenced by one of the gates sectioning the play yards has a latch that is sharp within children's reach.

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

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

Correction Verification: Submit Documentation

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

Violation: The facility's outdoor space was not safe for children's activities as evidenced by a section on the wooden board on the ramp is cracked and lifting up.

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

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

Correction Verification: Submit Documentation

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

Violation: The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that One electrical plate in the school age classroom is loose and has a gap between the wall and the electrical plate.

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: Submit Documentation

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

Violation: The walls located in the school age bathroom was/were not in good condition as evidenced by presence of a hole in the wall.

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

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

Correction Required: Bathroom fixtures shall be functional and convenient.

Correction Verification: Submit Documentation

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

Violation: The kitchen was not in compliance with state and local rules governing food service sanitation.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (5) (D) states: Kitchens shall be maintained in compliance with state or local rules, or both, governing food service sanitation.

Correction Required: Kitchens/food service shall be approved.

Correction Verification: Corrected on Site

Compliance Date: 7/23/2026

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Outdoor equipment, the yellow and red table, in play yard was not in good condition as evidenced by has section that is separated creating a pinching factor.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: Outdoor play equipment shall be safe and in good repair.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Chloe Coughenour and Michaela Miner.

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

Correction Required: All caregivers shall obtain a MOPD ID.

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: 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: Molly Brim, Chloe Coughenour, Rachelle Smith and Michaela Miner.

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 Molly Brim, Chloe Coughenour and Michaela Miner 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: Medication was not stored out of children's reach.

Rule Reference: 5 CSR 25-500.192 Health Care (3) (E) states: All medication shall be stored out of reach of children or in a locked container.

Correction Required: Medication shall be inaccessible to children and handled as required.

Correction Verification: Corrected on Site

Compliance Date: 7/23/2026

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that one wooden board is detached from the top exposing the sharp side off 8 nails.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard.

Correction Verification: Submit Documentation

Compliance Date: 2/13/2026

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

Violation: The walls located the Flying Eagle was/were not in good condition as evidenced by presence of chipping paint.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

Compliance Date: 2/13/2026

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's disaster and emergency plan was not available in the office.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster and emergency plan is readily available in the office area and in each room used for care of children;

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

Correction Verification: Submit Documentation

Compliance Date: 2/9/2026

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: Molly Brim 2, Iris Burton 6.25, Cindy Castro 1, Kim Hutton 5.25, Britany Kincanon 8, Danielle Lindsey .75, Kiersten Manes 1, Pipper McGuire 4.75, Julia McMahon 1.5, Jewls Parker 3.75, Chloe Parker 9.25 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: 2/9/2026

5 CSR 25-500.102 Personnel

Violation: Safe sleep training was not completed within the past 3 years for the following staff Molly Brim, Allison Linton and Lauren Tyau.

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: 2/9/2026

5 CSR 25-500.122 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 2/25/2026

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: 1/16/2026

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that one wooden board is detached from the top exposing the sharp side off 8 nails.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard.

Correction Verification: Submit Documentation

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

Violation: Children were not restricted to approved space as evidenced by the furnace room was not locked.

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

Correction Required: Caregivers shall restrict children to approved space.

Correction Verification: Submit Documentation

Compliance Date: 8/8/2025

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that there is a broken board with sharp edges in the big play yard.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard.

Correction Verification: Submit Documentation

Compliance Date: 9/9/2025

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

Violation: The walls located the Flying Eagle was/were not in good condition as evidenced by presence of chipping paint.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

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

Violation: The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that an electrical outlet did not have a protective cover.

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

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

Correction Verification: Submit Documentation

Compliance Date: 8/8/2025

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's disaster and emergency plan was not available in the office.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster and emergency plan is readily available in the office area and in each room used for care of children;

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 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: Chloe Coughenour.

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

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

Correction Verification: Submit Documentation

Compliance Date: 8/8/2025

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: Susanna Blocker 5.25 hours, Kim Hutton 4.25 hours, Brittany Kincanon 5.25 hours and Chloe Parker 3.75 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: 8/8/2025

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 2025, the staff listed need the following information: Molly Brim 2, Iris Burton 6.25, Cindy Castro 1, Kim Hutton 5.25, Britany Kincanon 8, Danielle Lindsey .75, Kiersten Manes 1, Pipper McGuire 4.75, Julia McMahon 1.5, Jewls Parker 3.75, Chloe Parker 9.25 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 25-500.102 Personnel

Violation: Safe sleep training was not completed within the past 3 years for the following staff Molly Brim, Allison Linton and Lauren Tyau.

Rule Reference: 5 CSR 25-500.102 Personnel (4) (A) . states: Every three (3) years, the child care provider, group child care home provider, child care staff members, and volunteers in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs/deseadministrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Heidi Sheffield 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: Rachelle Smith, Lindsey Danielle, Kayley Miner, Julia McMahon and Heidi Sheffield.

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: 12/26/2025

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 1-6-24.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is incorporated by reference in this rule, as published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms. This rule does not incorporate any subsequent amendments or additions.

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

Correction Verification: Submit Documentation

Compliance Date: 10/15/2025

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

5 CSR 25-500.192 Health Care

Violation: Medication was not stored out of children's reach.

Rule Reference: 5 CSR 25-500.192 Health Care (3) (E) states: All medication shall be stored out of reach of children or in a locked container.

Correction Required: Medication shall be inaccessible to children and handled as required.

Correction Verification: Corrected on Site

Compliance Date: 1/15/2026

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that there is a broken board with sharp edges in the big play yard.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard.

Correction Verification: Submit Documentation

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

Violation: The walls located the Flying Eagle was/were not in good condition as evidenced by presence of chipping paint.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

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

Violation: The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that an electrical outlet did not have a protective cover.

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

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

Correction Verification: Submit Documentation

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

Violation: Children were not restricted to approved space as evidenced by the furnace room was not locked.

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

Correction Required: Caregivers shall restrict children to approved space.

Correction Verification: Submit Documentation

5 CSR 25-500.102 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: Chloe Coughenour.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: 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: Susanna Blocker 5.25 hours, Kim Hutton 4.25 hours, Brittany Kincanon 5.25 hours and Chloe Parker 3.75 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 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Jessica Gregg, Lindsey Danielle, Kayley Miner, Jewels Parker and Heidi Sheffield 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: 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 1-6-24.

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: Rachelle Smith, Lindsey Danielle, Kayley Miner, Julia McMahon and Heidi Sheffield.

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

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

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

Correction Required: Bathrooms shall be clean and odor free.

Correction Verification: Submit Documentation

Compliance Date: 2/6/2025

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

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

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

Correction Required: Bathrooms shall be clean and odor free.

Correction Verification: Submit Documentation

Compliance Date: 2/6/2025

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

Violation: The walls located in the bathroom between the school age room and one year old classroom was/were not in good condition as evidenced by a hole in the wall behind one door at the door knob level and exposed drywall on the wall by the door to the one year old room.

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: 2/6/2025

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

Violation: The walls located in the preschool "Women's" bathroom was/were not finished with material which can be cleaned easily as evidenced by there was no paint over the plaster used to repair the wall.

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: 2/6/2025

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

Violation: The walls located in the preschool room was/were not finished with material which can be cleaned easily as evidenced by the paint had come off the wall by the group time corner, exposing drywall.

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: 2/6/2025

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

Violation: The walls located in the two year old room was/were not in good condition as evidenced by the cove base near the sink had peeled off and the edges at the base of the walls in that corner were dirty.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

Compliance Date: 2/6/2025

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

Violation: Hazardous items as follows were accessible to children: plastic bags. The item(s) was/were located within reach of children in the bathroom between the school age room and the one year old classroom.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Submit Documentation

Compliance Date: 2/6/2025

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

Violation: Hazardous items as follows were accessible to children: ice melt. The item(s) was/were located in an unlocked furnace closet in the kitchen on the infant/toddler side of the facility.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Submit Documentation

Compliance Date: 2/6/2025

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's disaster and emergency plan was not available in each room used for childcare as evidenced by there was no copy of the plan in the one year old room at the end of the hall on the larger side of the facility.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster and emergency plan is readily available in the office area and in each room used for care of children;

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

Correction Verification: Submit Documentation

Compliance Date: 2/6/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, the changing table, in the one year old classroom on the infant/toddler side of the facility was not in good condition as evidenced by edge of changing table had areas where paint had come off and where paint was ready to chip off further.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

Compliance Date: 2/6/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Requirements for feeding equipment for infants and toddlers who are unable to sit at a table were not met as evidenced by inappropriate restraints were used in that one high chair in the one year old class on the infant/toddler side of the facility did not have restraints.

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

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

Correction Verification: Submit Documentation

Compliance Date: 2/6/2025

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

Violation: Hazardous items as follows were accessible to children: plastic bags. The item(s) was/were located within reach of children in the bathroom between the school age room and the one year old classroom.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Submit Documentation

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

Violation: The walls located in the bathroom between the school age room and one year old classroom was/were not in good condition as evidenced by a hole in the wall behind one door at the door knob level and exposed drywall on the wall by the door to the one year old room.

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 bathroom was not clean and odor free as evidenced by the toilet was soiled.

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

Correction Required: Bathrooms shall be clean and odor free.

Correction Verification: Submit Documentation

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

Violation: The walls located in the two year old room was/were not in good condition as evidenced by the cove base near the sink had peeled off and the edges at the base of the walls in that corner were dirty.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

Correction Required: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification: Submit Documentation

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

Violation: The walls located in the preschool room was/were not finished with material which can be cleaned easily as evidenced by the paint had come off the wall by the group time corner, exposing drywall.

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 preschool "Women's" bathroom was/were not finished with material which can be cleaned easily as evidenced by there was no paint over the plaster used to repair the wall.

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 bathroom was not clean and odor free as evidenced by the hand sink was soiled.

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

Correction Required: Bathrooms shall be clean and odor free.

Correction Verification: Submit Documentation

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: ice melt. The item(s) was/were located in an unlocked furnace closet in the kitchen on the infant/toddler side of the facility.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Submit Documentation

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's disaster and emergency plan was not available in each room used for childcare as evidenced by there was no copy of the plan in the one year old room at the end of the hall on the larger side of the facility.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster and emergency plan is readily available in the office area and in each room used for care of children;

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

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Furniture/equipment, the changing table, in the one year old classroom on the infant/toddler side of the facility was not in good condition as evidenced by edge of changing table had areas where paint had come off and where paint was ready to chip off further.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: The facility shall provide safe and clean furniture/equipment as required.

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Requirements for feeding equipment for infants and toddlers who are unable to sit at a table were not met as evidenced by inappropriate restraints were used in that one high chair in the one year old class on the infant/toddler side of the facility did not have restraints.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The requirements for first aid/CPR were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification for the requested/licensed capacity.

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: 10/18/2024

5 CSR 25-500.102 Personnel

Violation: The requirements for first aid/CPR were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification for the requested/licensed capacity.

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: 10/18/2024

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include employers' address of 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: 8/1/2024

5 CSR 25-500.222 Records and Reports

Violation: 2 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: 8/1/2024

5 CSR 25-500.222 Records and Reports

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 8/1/2024

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Hannah Peterson and Rachelle Robinson.

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: 8/1/2024

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

Violation: Hazardous items as follows were accessible to children: Clorox and sunscreen. The item(s) was/were located Clorox was in the kitchen within reach of children, and sunscreen was located in low cubbies in the three year old room.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Corrected on Site

Compliance Date: 7/22/2024

5 CSR 25-500.102 Personnel

Violation: The requirements for first aid/CPR were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification for the requested/licensed capacity.

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 there was no documentation on file showing completion of age-appropriate CPR certification for the requested/licensed capacity.

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 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include employers' address of 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 address of another individual who might be reached in an emergency.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: 2 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 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Hannah Peterson and Rachelle Robinson.

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

Violation: The floors located PreK Room, Preschool Room, Kitchen was/were not clean as evidenced by the floors appeared to be dirty, especially around the edges.

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: 3/25/2024

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

Violation: The walls located in the PreK bathroom, Preschool room, 3 year old room, and one year old room was/were not in good condition as evidenced by chipped 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: 5/10/2024

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

Violation: The walls located in the PreK bathroom, Preschool room, 3 year old room, and one year old room was/were not in good condition as evidenced by chipped 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 floors located PreK Room, Preschool Room, Kitchen was/were not clean as evidenced by the floors appeared to be dirty, especially around the edges.

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, vinyl soft blocks, in the Explorer Room was not in good condition as evidenced by frayed edges.

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: Corrected on Site

Compliance Date: 2/26/2024

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

Violation: The observed surface area under the slide in the center outdoor play area, from which a child might fall consists of bare soil.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 8. states: Concrete, asphalt, carpet, grass or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.

Correction Required: The facility shall not use concrete, asphalt, carpet, grass or bare soil under equipment from which a child might fall.

Correction Verification: Submit Documentation

Compliance Date: 10/2/2023

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 surface under the dome climber consisted of rough edged rocks.

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: 10/2/2023

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 one of the planks on the outdoor walkway needed to be nailed down and posed a tripping hazard.

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/2/2023

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 the bolt on the gate between two outdoor play areas was not recessed into the gate.

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/2/2023

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that two of the privacy fence boards were broken and warped.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard.

Correction Verification: Submit Documentation

Compliance Date: 10/2/2023

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: Tatum Lampe.

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/3/2023

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Jacilyn Bilyeu, Susanna Blocker, Iris Burton, Cindy Castro, April Corban, Ashlyn Eli, Addison Eli, Haley Greer, Kim Hutton, David Hutton, Shelby Jordan, Britany Kincanon, LeAnn Kinyon, Grace May, Kelsey Mooberry, Michelle Mosher, Micah Pianalto, Jazzmyne Pickett, Isabela Schultz, and Jasmine Tinker within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

Compliance Date: 9/15/2023

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

Violation: The observed surface area under the slide in the center outdoor play area, from which a child might fall consists of bare soil.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 8. states: Concrete, asphalt, carpet, grass or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.

Correction Required: The facility shall not use concrete, asphalt, carpet, grass or bare soil under equipment from which a child might fall.

Correction Verification: Submit Documentation

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

Violation: The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by the resilient material used is unapproved in that the surface under the dome climber consisted of rough edged rocks.

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

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 one of the planks on the outdoor walkway needed to be nailed down and posed a tripping hazard.

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

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

Correction Verification: Submit Documentation

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

Violation: The facility's outdoor space was not safe for children's activities as evidenced by the bolt on the gate between two outdoor play areas was not recessed into the gate.

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

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

Correction Verification: Submit Documentation

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

Violation: The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that two of the privacy fence boards were broken and warped.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

Correction Required: The outdoor play area shall be accessible without hazard.

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: Cleaning supplies. The item(s) was/were located in an unlocked supply closet in the school age 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: Submit Documentation

Compliance Date: 8/14/2023

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

Violation: Hazardous items as follows were accessible to children: Cleaning supplies. The item(s) was/were located in an unlocked cabinet in the kitchen.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Submit Documentation

Compliance Date: 8/14/2023

5 CSR 25-500.092 Furniture, Equipment and Materials

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 7/13/2023

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Outdoor equipment, the Little Tykes climber, in the outdoor play area was not in good condition as evidenced by broken vinyl which poses a pinch hazard.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Correction Required: Outdoor play equipment shall be safe and in good repair.

Correction Verification: Submit Documentation

Compliance Date: 8/14/2023

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Ashlyn Eli and Haley Greet 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: 9/7/2023

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: Tatum Lampe.

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