Fisher, Sandy Jo

5 CSR 25-400.095 Furniture, Equipment and Materials

Violation: Outdoor equipment, green and yellow tractor, in the main playground was unsafe as evidenced by the tractor's steering wheel was located on the ground away from the tractor broken off, and the area where the steering wheel would be on the tractor was cracked and presented sharp and broken edges.

Rule Reference: 5 CSR 25-400.095 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 equipment shall have no exposed hazards.

Correction Verification: Corrected on Site

Compliance Date: 7/23/2026

5 CSR 25-400.185 Health Care

Violation: Facility did not submit the 2025 annual summary report showing immunization status of each child enrolled by January 15.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 3/9/2026

5 CSR 25-400.055 Annual Requirements

Violation: The annual sanitation inspection was not approved.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

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

Correction Verification: Submit Documentation

Compliance Date: 1/22/2026

5 CSR 25-400.125 Medical Examination Reports

Violation: A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Dennis Fisher .

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (1) (E) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

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

Correction Verification: Submit Documentation

Compliance Date: 3/9/2026

5 CSR 25-400.125 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 3/9/2026

5 CSR 25-400.055 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The annual sanitation inspection was not approved.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

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

Correction Verification: Submit Documentation

5 CSR 25-400.125 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.125 Medical Examination Reports

Violation: A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Dennis Fisher .

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (1) (E) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

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

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Sandy Fisher and Dennis Fisher.

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: 8/5/2025

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Sandy Fisher and Dennis Fisher.

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 25-400.055 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The annual sanitation inspection was not approved.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

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

Correction Verification: Submit Documentation

Compliance Date: 1/27/2025

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

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2024, the staff listed need the following information: Sandy Fisher needs an additional 5.75 hours.

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

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

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Sandy Fisher and Dennis Fisher.

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 25-400.055 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The annual sanitation inspection was not approved.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

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

Correction Verification: Submit Documentation

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

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2024, the staff listed need the following information: Sandy Fisher needs an additional 5.75 hours.

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

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

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Sandy Fisher and Dennis Fisher.

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 25-400.086 Fire Safety

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 6/11/2024

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

Violation: Safe sleep training was not completed within the past 3 years for the assistant(s), Michelle Cook.

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

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

Correction Verification: Submit Documentation

Compliance Date: 6/11/2024

5 CSR 25-400.055 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Sandy Fisher, Dennis Fisher, and Michelle Cook within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

Compliance Date: 5/31/2024

5 CSR 25-400.086 Fire Safety

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

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

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

Correction Verification: Submit Documentation

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

Violation: Safe sleep training was not completed within the past 3 years for the assistant(s), Michelle Cook.

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

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

Correction Verification: Submit Documentation

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

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: Dennis Fisher needs 12 training hours.

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

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

Correction Verification: Submit Documentation

Compliance Date: 6/10/2024

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

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

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. 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. 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. First aid/CPR training may count toward the annual clock hour training requirement.

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: 6/10/2024

5 CSR 25-400.125 Medical Examination Reports

Violation: A medical examination report was not on file for assistant(s): Dennis Fisher and Michelle Cook.

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

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

Correction Verification: Submit Documentation

Compliance Date: 6/10/2024

5 CSR 25-400.125 Medical Examination Reports

Violation: A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Dennis Fisher and Michelle Cook.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (1) (E) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

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

Correction Verification: Submit Documentation

Compliance Date: 6/10/2024

5 CSR 25-400.055 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Sandy Fisher, Dennis Fisher, and Michelle Cook within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The annual fire safety inspection was not approved.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

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

Correction Verification: Submit Documentation

Compliance Date: 2/9/2024

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

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

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. 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. 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. First aid/CPR training may count toward the annual clock hour training requirement.

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

Violation: Safe sleep training was not completed within the past 3 years for the assistant(s), Dennis Fisher and Michelle Cook.

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

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

Correction Verification: Submit Documentation

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

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: Dennis Fisher needs 12 training hours.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.125 Medical Examination Reports

Violation: A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Dennis Fisher and Michelle Cook.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (1) (E) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

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

Correction Verification: Submit Documentation

5 CSR 25-400.125 Medical Examination Reports

Violation: A medical examination report was not on file for assistant(s): Dennis Fisher and Michelle Cook.

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

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

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Dennis Fisher and Michelle Cook.

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

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

Correction Verification: Submit Documentation

Compliance Date: 4/1/2024

5 CSR 25-400.055 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Sandy Fisher, Dennis Fisher, and Michelle Cook within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.055 Annual Requirements

Violation: The annual fire safety inspection was not approved.

Rule Reference: 5 CSR 25-400.055 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

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

Correction Verification: Submit Documentation

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

Violation: Safe sleep training was not completed within the past 3 years for the assistant(s), Dennis Fisher and Michelle Cook.

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

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

Correction Verification: Submit Documentation

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

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: Dennis Fisher needs 12 training hours.

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

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

Correction Verification: Submit Documentation

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

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

Rule Reference: 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. 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. 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. First aid/CPR training may count toward the annual clock hour training requirement.

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 25-400.125 Medical Examination Reports

Violation: A medical examination report was not on file for assistant(s): Dennis Fisher and Michelle Cook.

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

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

Correction Verification: Submit Documentation

5 CSR 25-400.125 Medical Examination Reports

Violation: A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Dennis Fisher and Michelle Cook.

Rule Reference: 5 CSR 25-400.125 Medical Examination Reports (1) (E) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

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

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Dennis Fisher and Michelle Cook.

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

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

Correction Verification: Submit Documentation