R&b Rising Star Development Center Llc

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

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 4/14/2026

5 CSR 25-500.102 Personnel

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

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: 4/14/2026

5 CSR 25-500.122 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 4/14/2026

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: Alisa Carter.

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: 4/13/2026

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

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

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

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

Correction Verification: Submit Documentation

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

Violation: Hazardous items as follows were accessible to children: the bottle of bleach, can of disinfectant spray . The item(s) was/were located on the edge of the sink in the bathroom in the 2-years-old classroom, in the unlocked cabinet under the changing table in the Toddler 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: Corrected on Site

Compliance Date: 4/8/2026

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Requirements for the crib mattress/playpen padding/bedding were not met as evidenced by a crib mattress/pad was not in good condition in that one mattress has multiple tears.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. D. states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used. Only fitted sheet shall be used and shall be changed immediately when soiled or wet.

Correction Required: Sleeping equipment shall meet safety and sanitation requirements.

Correction Verification: Corrected on Site

Compliance Date: 4/8/2026

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Requirements for the crib mattress/playpen padding/bedding were not met as evidenced by a non-fitted sheet was used.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. D. states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used. Only fitted sheet shall be used and shall be changed immediately when soiled or wet.

Correction Required: Sleeping equipment shall meet safety and sanitation requirements.

Correction Verification: Corrected on Site

Compliance Date: 4/8/2026

5 CSR 25-500.102 Personnel

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

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 Alisa Carter 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: Alisa Carter.

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: One child(ren) records did not include full name 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: Corrected on Site

Compliance Date: 4/8/2026

5 CSR 25-500.222 Records and Reports

Violation: One 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: Corrected on Site

Compliance Date: 4/8/2026

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Outdoor equipment, yellow school bus, in the PS playground was not in good condition as evidenced by there is a peeling yellow paint on the handle of the bus.

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/16/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Outdoor equipment, yellow school bus, in the PS playground was not in good condition as evidenced by there is a peeling yellow paint on the handle of the bus.

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 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Recordia Kennedy 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: 4/17/2025

5 CSR 25-500.102 Personnel

Violation: Safe sleep training was not completed within the past 3 years for the following staff Azana Coleman, Brenda Regland, Jacquelyn Thomas.

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: 4/25/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: The medical examination report on file for Recordia Kennedy, Layshaun Armour was older than 12 months before the individual's begin date at the facility.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (1) (C) states: Medical examination reports shall be completed not more than twelve (12) months prior to beginning work in the facility and may be transferable to another child care facility for subsequent employment.

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

Correction Verification: Submit Documentation

Compliance Date: 4/28/2025

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: Ericka Taylor, Kelli Starks.

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: 4/22/2025

5 CSR 25-500.122 Medical Examination Reports

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

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: 4/28/2025

5 CSR 25-500.052 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

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

Violation: Hazardous items as follows were accessible to children: the disinfectant spray, the bottle of Clorox. The item(s) was/were located in the unlocked cabinet under the changing table in the I/T classroom, in the corner in the bathroom.

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

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Corrected on Site

Compliance Date: 4/16/2025

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 there were outlet covers missing in the Classrooms #3, #4, and #8.

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

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

Correction Verification: Corrected on Site

Compliance Date: 4/16/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Requirements for the crib mattress/playpen padding/bedding were not met as evidenced by a non-fitted sheet was used.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. D. states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used. Only fitted sheet shall be used and shall be changed immediately when soiled or wet.

Correction Required: Sleeping equipment shall meet safety and sanitation requirements.

Correction Verification: Corrected on Site

Compliance Date: 4/16/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Requirements for the crib mattress/playpen padding/bedding were not met as evidenced by a crib mattress/pad was not in good condition in that there was a hole observed in one of the mattresses .

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. D. states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used. Only fitted sheet shall be used and shall be changed immediately when soiled or wet.

Correction Required: Sleeping equipment shall meet safety and sanitation requirements.

Correction Verification: Corrected on Site

Compliance Date: 4/16/2025

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: Melvin Coleman

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: Corrected on Site

Compliance Date: 4/16/2025

5 CSR 25-500.102 Personnel

Violation: Safe sleep training was not completed within the past 3 years for the following staff Azana Coleman, Brenda Regland, Jacquelyn Thomas.

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: The medical examination report on file for Recordia Kennedy, Layshaun Armour was older than 12 months before the individual's begin date at the facility.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (1) (C) states: Medical examination reports shall be completed not more than twelve (12) months prior to beginning work in the facility and may be transferable to another child care facility for subsequent 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 included either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) which was completed more than 12 months before beginning work in the facility for the following staff: Recordia Kennedy, Layshaun Armour.

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: 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: Ericka Taylor, Kelli Starks.

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 25-500.182 Child Care Program

Violation: Separation requirements of diapering/hand wash areas from food service were not met as evidenced by food was prepared at the hand sink.

Rule Reference: 5 CSR 25-500.182 Child Care Program (1) (E) 7. states: The diapering area and hand washing area shall be separate from any food service area and any food-related materials.

Correction Required: Caregivers shall keep food items/supplies separate from diapering items.

Correction Verification: Corrected on Site

Compliance Date: 4/16/2025

5 CSR 25-500.222 Records and Reports

Violation: One child(ren) records did not include 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: Corrected on Site

Compliance Date: 4/16/2025

5 CSR 25-500.222 Records and Reports

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

Rule Reference: 5 CSR 25-500.222 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: Corrected on Site

Compliance Date: 4/16/2025

5 CSR 25-500.222 Records and Reports

Violation: Two 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: Corrected on Site

Compliance Date: 4/16/2025

5 CSR 25-500.222 Records and Reports

Violation: Three 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: Corrected on Site

Compliance Date: 4/16/2025

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

Violation: The observed surface area under the play structure with the slide and the single yellow slide, from which a child might fall consists of grass.

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: 10/31/2024

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

Violation: The floors located in right top corner in the classroom 8 was/were not in good condition as evidenced by there are four buckled flooring tiles with rust and brown substance on them.

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/21/2024

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

Violation: The walls located on the side with windows in the classroom 17 was/were not in good condition as evidenced by the radiator panel is detached causing the entrapment hazard .

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/18/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Outdoor equipment, the Merry Go Cycle, in the playground with the rubber mulch was not in good condition as evidenced by the seat is cracked.

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/24/2024

5 CSR 25-500.102 Personnel

Violation: Melvin Coleman, and Diamond Perks did not complete safe sleep training within 30 days of employment or volunteering at the facility.

Rule Reference: 5 CSR 25-500.102 Personnel (4) (A) 3. states: The child care provider, group child care home provider, child care staff members, and volunteers shall complete safe sleep training described in subsection (4)(A) of this rule within thirty (30) days of employment or volunteering at the facility.

Correction Required: The department-approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification: Submit Documentation

Compliance Date: 10/23/2024

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

Violation: The walls located on the side with windows in the classroom 17 was/were not in good condition as evidenced by the radiator panel is detached causing the entrapment hazard .

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 urine and/or excrement odor was detected.

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: Corrected on Site

Compliance Date: 10/16/2024

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

Violation: The requirements for toilet and handwashing facilities were not met as evidenced by the toilet would not flush.

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

Correction Required: Bathroom fixtures shall be functional and convenient.

Correction Verification: Corrected on Site

Compliance Date: 10/16/2024

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

Violation: The observed surface area under the play structure with the slide and the single yellow slide, from which a child might fall consists of grass.

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 facility's outdoor space was not safe for children's activities as evidenced by there were multiple folded inflatables observed sitting in the boat .

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: Corrected on Site

Compliance Date: 10/16/2024

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

Violation: The floors located in right top corner in the classroom 8 was/were not in good condition as evidenced by there are four buckled flooring tiles with rust and brown substance on them.

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: Outdoor equipment, the Merry Go Cycle, in the playground with the rubber mulch was not in good condition as evidenced by the seat is cracked.

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: Melvin Coleman, and Diamond Perks did not complete safe sleep training within 30 days of employment or volunteering at the facility.

Rule Reference: 5 CSR 25-500.102 Personnel (4) (A) 3. states: The child care provider, group child care home provider, child care staff members, and volunteers shall complete safe sleep training described in subsection (4)(A) of this rule within thirty (30) days of employment or volunteering at the facility.

Correction Required: The department-approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Paulette Hall

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: 4/9/2024

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report form did not contain all required information as evidenced by the medical exam forms for Katrina Bozeman, and Morgan Thomas did not have a statement signed by the doctor saying if a patient is in good physical and emotional health, and free of contagious diseases.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (1) (D) states: The medical examination report form shall be supplied by the department or the facility may use its own form if it contains all the information on the department’s form. The Medical Examination Report for Caregivers and Staff 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: Medical reports shall be on file as required.

Correction Verification: Submit Documentation

Compliance Date: 4/12/2024

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: Onyata Lockett, Montana Reece, Azana Coleman, and Keandrea Williams.

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: 5/16/2024

5 CSR 25-500.122 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 5/16/2024

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The facility did not meet requirements for child enrollment and health information as evidenced by eight children's files did not have the permission for emergency care signed by the parent.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 4. states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care;

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

Correction Verification: Submit Documentation

Compliance Date: 4/9/2024

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The facility did not meet requirements for child enrollment and health information on file as evidenced by eight child(s) file(s) did not have the parental acknowledgement they have been notified that they may request whether there are children for whom an immunization exemption has been filed for currently enrolled in or attending the facility.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. F. states: They have been notified that they may request notice at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility

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

Correction Verification: Submit Documentation

Compliance Date: 4/9/2024

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The facility did not meet requirements for child enrollment and health information on file as evidenced by eight child(s) file did not have the parental acknowledgement they have received a copy of the provider's safe sleep policy.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. E. states: They have received a copy of the provider's safe sleep policy when enrolling children less than one (1) year of age.

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

Correction Verification: Submit Documentation

Compliance Date: 4/9/2024

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The provider did not have parental acknowledgement on file indicating the parent understands and agrees that the child may not be accepted for care when ill.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. D. states: They understand and agree that the child may not be accepted for care when ill.

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

Correction Verification: Submit Documentation

Compliance Date: 4/9/2024

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The provider did not have parental acknowledgement on file indicating the parent and provider have agreed on a plan for continuing communication.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. C. states: They and the provider have agreed on a plan for continuing communication regarding the child's development, behavior and individual needs;

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

Correction Verification: Submit Documentation

Compliance Date: 4/9/2024

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The provider did not have parental acknowledgement on file indicating the parent has been informed that Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available for review.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. B. states: They have been informed that the Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available in the facility for their review;

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

Correction Verification: Submit Documentation

Compliance Date: 4/9/2024

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider's policies.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. A. states: They have received a copy of the provider's policies pertaining to the admission, care and discharge of children;

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

Correction Verification: Submit Documentation

Compliance Date: 4/9/2024

5 CSR 25-500.212 Transportation and Field Trips

Violation: Written parental consent was not on file for field trips and transportation.

Rule Reference: 5 CSR 25-500.212 Transportation and Field Trips (1) (B) states: Written parental consent shall be on file at the facility for field trips and transportation.

Correction Required: Written parental consent shall be on file at the facility for field trips and transportation.

Correction Verification: Submit Documentation

Compliance Date: 4/9/2024

5 CSR 25-500.222 Records and Reports

Violation: One 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: 4/9/2024

5 CSR 25-500.222 Records and Reports

Violation: Two child(ren) records did not include work telephone number 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: 4/9/2024

5 CSR 25-500.222 Records and Reports

Violation: Five 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: 4/9/2024

5 CSR 25-500.222 Records and Reports

Violation: Eight 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: 4/9/2024

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Lawrence Cooper-Alexander .

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: 4/23/2024

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 urine and/or excrement odor was detected.

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: Corrected on Site

Compliance Date: 4/8/2024

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

Violation: The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that there were multiple outlet with missing covers around the entire facility.

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

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

Correction Verification: Corrected on Site

Compliance Date: 4/8/2024

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 was a long string hanging near the board within children's reach in the Art Room, and there was a stand water in the boat on the I/T playground causing the drowning hazard .

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: Corrected on Site

Compliance Date: 4/8/2024

5 CSR 25-500.087 Fire Safety

Violation: Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by the type of drill was not recorded.

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: Corrected on Site

Compliance Date: 4/8/2024

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 emergency plan available in the cafeteria/multi-purpose room.

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: Corrected on Site

Compliance Date: 4/8/2024

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's special instructions for infants and non-ambulatory children were not posted in each room.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 3. states: Any special instructions for infants and non-ambulatory children;

Correction Required: Facility must post information as required.

Correction Verification: Corrected on Site

Compliance Date: 4/8/2024

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Paulette Hall

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 25-500.122 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

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: Onyata Lockett, Montana Reece, Azana Coleman, and Keandrea Williams.

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 form did not contain all required information as evidenced by the medical exam forms for Katrina Bozeman, and Morgan Thomas did not have a statement signed by the doctor saying if a patient is in good physical and emotional health, and free of contagious diseases.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (1) (D) states: The medical examination report form shall be supplied by the department or the facility may use its own form if it contains all the information on the department’s form. The Medical Examination Report for Caregivers and Staff 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: Medical reports shall be on file as required.

Correction Verification: Submit Documentation

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The facility did not meet requirements for child enrollment and health information as evidenced by eight children's files did not have the permission for emergency care signed by the parent.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 4. states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care;

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

Correction Verification: Submit Documentation

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider's policies.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. A. states: They have received a copy of the provider's policies pertaining to the admission, care and discharge of children;

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

Correction Verification: Submit Documentation

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The provider did not have parental acknowledgement on file indicating the parent has been informed that Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available for review.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. B. states: They have been informed that the Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available in the facility for their review;

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

Correction Verification: Submit Documentation

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The provider did not have parental acknowledgement on file indicating the parent and provider have agreed on a plan for continuing communication.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. C. states: They and the provider have agreed on a plan for continuing communication regarding the child's development, behavior and individual needs;

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

Correction Verification: Submit Documentation

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The provider did not have parental acknowledgement on file indicating the parent understands and agrees that the child may not be accepted for care when ill.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. D. states: They understand and agree that the child may not be accepted for care when ill.

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

Correction Verification: Submit Documentation

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The facility did not meet requirements for child enrollment and health information on file as evidenced by eight child(s) file did not have the parental acknowledgement they have received a copy of the provider's safe sleep policy.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. E. states: They have received a copy of the provider's safe sleep policy when enrolling children less than one (1) year of age.

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

Correction Verification: Submit Documentation

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The facility did not meet requirements for child enrollment and health information on file as evidenced by eight child(s) file(s) did not have the parental acknowledgement they have been notified that they may request whether there are children for whom an immunization exemption has been filed for currently enrolled in or attending the facility.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. F. states: They have been notified that they may request notice at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility

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

Correction Verification: Submit Documentation

5 CSR 25-500.182 Child Care Program

Violation: The disposal of wet or soiled diapers did not meet requirements as evidenced by the disposal container was not airtight.

Rule Reference: 5 CSR 25-500.182 Child Care Program (1) (E) 5. states: Wet or soiled diapers shall be placed in an airtight disposal container located in the diaper change area. If cloth diapers are provided by the parent(s), individual airtight plastic bags shall be used to store each soiled diaper for return each day to the parent(s).

Correction Required: Caregivers shall dispose of wet or soiled diapers as required.

Correction Verification: Corrected on Site

Compliance Date: 4/8/2024

5 CSR 25-500.212 Transportation and Field Trips

Violation: Written parental consent was not on file for field trips and transportation.

Rule Reference: 5 CSR 25-500.212 Transportation and Field Trips (1) (B) states: Written parental consent shall be on file at the facility for field trips and transportation.

Correction Required: Written parental consent shall be on file at the facility for field trips and transportation.

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: Two child(ren) records did not include work telephone number 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: Five 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: Eight 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 25-500.222 Records and Reports

Violation: One 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 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Lawrence Cooper-Alexander .

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 diapering area requirements were not met as evidenced by warm running water was not adjacent to the diapering area.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (4) (D) states: Diapering supplies and warm, running water shall be adjacent to the diapering area.

Correction Required: The facility shall supply the diapering area as required.

Correction Verification: Corrected on Site

Compliance Date: 2/5/2024