The Young Men's Christian Association Of Joplin, Missouri

5 CSR 25-500.032 Organization and Administration

Violation: The child care facility is not organized according to the policies and procedures in that lines of administrative authority are not clearly established.

Rule Reference: 5 CSR 25-500.032 Organization and Administration (1) states: Each child care facility shall be organized according to written policies and procedures which clearly establish job responsibilities and lines of administrative authority.

Correction Required: The child care facility shall be organized according to policies and procedures.

Correction Verification: Submit Documentation

Compliance Date: 6/4/2026

5 CSR 25-500.042 Licensing Process

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 6/4/2026

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Eric Dye, Rachel Benson, Peyton Marbough, and Shelby Morales, within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Eric Dye, Peyton Marbough, and Shelby Morales.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Shelby Morales, Rachel Benson, Peyton Marbough, Rachel Benson, and Eric Dye,.

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

Correction Required: All caregivers shall obtain a MOPD ID.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The facility does not have an approved director on staff.

Rule Reference: 5 CSR 25-500.102 Personnel (2) (A) 3. states: The licensee is required to maintain an approved certificated group child care home provider or center director on staff.

Correction Required: The facility shall have an approved director/group home provider.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: In the absence of the director, there was no responsible individual designated to be in charge of the facility.

Rule Reference: 5 CSR 25-500.102 Personnel (2) (A) 5. states: In the absence of the center director or group child care home provider, another responsible individual shall be designated to be in charge of the facility.

Correction Required: The facility shall designate someone in charge in the absence of the director/group home provider.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The department did not receive notification of a director change.

Rule Reference: 5 CSR 25-500.102 Personnel (2) (A) 6. states: The center owner(s), or the board president or chairperson, shall notify the department immediately when there is a change of directors and shall have a qualifying criminal background check on file as required by 5 CSR 25-600.020 General Requirements.

Correction Required: The facility shall notify the department immediately when there is a change of directors and submit required background check request.

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: A medical examination report did not include either a completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: Jennifer Mercado, Ashlai Luellen, Shelby Morales, Peyton Marbough, Rachel Benson, and Eric Dye.

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 tuberulin skin test (TST) as required.

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report was not on file for Jennifer Mercado, Shelby Morales, Peyton Marbough, Rachel Benson, and Eric Dye 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 25-500.202 Nutrition and Food Service

Violation: The provider did not supply and serve food according to the Meal and Snack Food Chart as evidenced by the juice provided was not 100% fruit juice.

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

Correction Required: Nourishing food shall be provided as required.

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: 2 child(ren) records did not include home 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: Records were not available for inspection by the department upon request as evidenced by the file box containing children and staff records was not on site. YMCA staff informed CI La Montia that the box was at the YMCA headquarters for the staff to review the files.

Rule Reference: 5 CSR 25-500.222 Records and Reports (10) states: All records shall be available in the facility for inspection by the department upon request.

Correction Required: Records shall be available at the facility for inspection.

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Shelby Morales.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.032 Organization and Administration

Violation: The child care facility is not organized according to the policies and procedures in that lines of administrative authority are not clearly established.

Rule Reference: 5 CSR 25-500.032 Organization and Administration (1) states: Each child care facility shall be organized according to written policies and procedures which clearly establish job responsibilities and lines of administrative authority.

Correction Required: The child care facility shall be organized according to policies and procedures.

Correction Verification: Submit Documentation

5 CSR 25-500.042 Licensing Process

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Eric Dye, Rachel Benson, Peyton Marbough, and Shelby Morales, within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The department did not receive notification of a director change.

Rule Reference: 5 CSR 25-500.102 Personnel (2) (A) 6. states: The center owner(s), or the board president or chairperson, shall notify the department immediately when there is a change of directors and shall have a qualifying criminal background check on file as required by 5 CSR 25-600.020 General Requirements.

Correction Required: The facility shall notify the department immediately when there is a change of directors and submit required background check request.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The facility does not have an approved director on staff.

Rule Reference: 5 CSR 25-500.102 Personnel (2) (A) 3. states: The licensee is required to maintain an approved certificated group child care home provider or center director on staff.

Correction Required: The facility shall have an approved director/group home provider.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Shirley Morales, Rachel Benson, Peyton Marbough, Rachel Benson, Eric Dye, and Trevor Lewis.

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

Correction Required: All caregivers shall obtain a MOPD ID.

Correction Verification: Submit Documentation

5 CSR 25-500.102 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: Eric Dye, Peyton Marbough, and Shelby Morales.

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 was not on file for Jennifer Mercado, Shelby Morales, Peyton Marbough, Rachel Benson, and Eric Dye 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 completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: Jennifer Mercado, Ashlai Luellen, Shelby Morales, Peyton Marbough, Rachel Benson, and Eric Dye.

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 tuberulin skin test (TST) as required.

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: 2 child(ren) records did not include home 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 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Shelby Morales.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report was not on file for Jeffrey Morgan as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

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

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

Correction Verification: Submit Documentation

Compliance Date: 8/29/2025

5 CSR 25-500.192 Health Care

Violation: Requirements for immunization reports on file were not met as evidenced by a statement, certificate or record from a physician or other recognized health facility or personnel was not on file for a child(ren).

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

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

Correction Verification: Submit Documentation

Compliance Date: 9/8/2025

5 CSR 25-500.112 Staff/Child Ratios

Violation: Staff/child ratio requirements were not met as evidenced by 28 children, ages school aged, were cared for by 1 adult caregiver(s).

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

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

Correction Verification: Corrected on Site

Compliance Date: 8/28/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report was not on file for Jeffrey Morgan as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.192 Health Care

Violation: Requirements for immunization reports on file were not met as evidenced by a statement, certificate or record from a physician or other recognized health facility or personnel was not on file for a child(ren).

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.042 Licensing Process

Violation: The name of the board president was not prominently posted near the license.

Rule Reference: 5 CSR 25-500.042 Licensing Process (13) (C) states: Board president or chairperson;

Correction Required: The name, address, and board president or chairperson shall be posted near the license.

Correction Verification: Submit Documentation

Compliance Date: 4/24/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report was not on file for Jeffrey Morgan as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.192 Health Care

Violation: Requirements for immunization reports on file were not met as evidenced by a statement, certificate or record from a physician or other recognized health facility or personnel was not on file for a child(ren).

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.042 Licensing Process

Violation: The name of the board president was not prominently posted near the license.

Rule Reference: 5 CSR 25-500.042 Licensing Process (13) (C) states: Board president or chairperson;

Correction Required: The name, address, and board president or chairperson shall be posted near the license.

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report was not on file for Jeffrey Morgan as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.192 Health Care

Violation: Requirements for immunization reports on file were not met as evidenced by a statement, certificate or record from a physician or other recognized health facility or personnel was not on file for a child(ren).

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The requirements for availability and understanding of the Licensing Rules for Group Child Care Homes and Child Care Centers in Missouri were not met as evidenced by the caregiver(s) stated that he/she was unaware of specific licensing rule(s) in that when asked what staff/child ratio for the school age children, caregiver stated it was 1 staff to 20 children. When asked if she had read the licensing rule books caregiver stated no, she had not.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (H) states: The provider shall have available a copy of the Licensing Rules for Group Child Care Homes and Child Care Centers in Missouri. All caregivers and volunteers working directly with children shall be required to review and be knowledgeable of the rules at the time they begin work and shall be able to understand and apply those rules which relate to their respective responsibilities.

Correction Required: Licensing rules shall be available and all caregivers working directly with children shall be knowledgeable of the rules.

Correction Verification: Submit Documentation

Compliance Date: 10/10/2024

5 CSR 25-500.132 Admission Policies and Procedures

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/30/2024

5 CSR 25-500.102 Personnel

Violation: The requirements for availability and understanding of the Licensing Rules for Group Child Care Homes and Child Care Centers in Missouri were not met as evidenced by the caregiver(s) stated that he/she was unaware of specific licensing rule(s) in that when asked what staff/child ratio for the school age children, caregiver stated it was 1 staff to 20 children. When asked if she had read the licensing rule books caregiver stated no, she had not.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (H) states: The provider shall have available a copy of the Licensing Rules for Group Child Care Homes and Child Care Centers in Missouri. All caregivers and volunteers working directly with children shall be required to review and be knowledgeable of the rules at the time they begin work and shall be able to understand and apply those rules which relate to their respective responsibilities.

Correction Required: Licensing rules shall be available and all caregivers working directly with children shall be knowledgeable of the rules.

Correction Verification: Submit Documentation

5 CSR 25-500.132 Admission Policies and Procedures

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's list of emergency numbers that are posted do not include the numbers for poison control.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;

Correction Required: Facility must post information as required.

Correction Verification: Submit Documentation

Compliance Date: 9/9/2024

5 CSR 25-500.102 Personnel

Violation: The requirements for availability and understanding of the Licensing Rules for Group Child Care Homes and Child Care Centers in Missouri were not met as evidenced by the caregiver(s) stated that he/she was unaware of specific licensing rule(s) in that when asked what staff/child ratio for the school age children, caregiver stated it was 1 staff to 20 children. When asked if she had read the licensing rule books caregiver stated no, she had not.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (H) states: The provider shall have available a copy of the Licensing Rules for Group Child Care Homes and Child Care Centers in Missouri. All caregivers and volunteers working directly with children shall be required to review and be knowledgeable of the rules at the time they begin work and shall be able to understand and apply those rules which relate to their respective responsibilities.

Correction Required: Licensing rules shall be available and all caregivers working directly with children shall be knowledgeable of the rules.

Correction Verification: Submit Documentation

5 CSR 25-500.112 Staff/Child Ratios

Violation: Staff/child ratio requirements were not met as evidenced by 19 children, ages 6-years-old to 10 years-old, were cared for by 1 adult caregiver(s).

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

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

Correction Verification: Return Inspection

Compliance Date: 9/9/2024

5 CSR 25-500.132 Admission Policies and Procedures

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's list of emergency numbers that are posted do not include the numbers for poison control.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;

Correction Required: Facility must post information as required.

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The requirements for availability and understanding of the Licensing Rules for Group Child Care Homes and Child Care Centers in Missouri were not met as evidenced by the caregiver(s) stated that he/she was unaware of specific licensing rule(s) in that when asked what staff/child ratio for the school age children, caregiver stated it was 1 staff to 20 children. When asked if she had read the licensing rule books caregiver stated no, she had not.

Rule Reference: 5 CSR 25-500.102 Personnel (1) (H) states: The provider shall have available a copy of the Licensing Rules for Group Child Care Homes and Child Care Centers in Missouri. All caregivers and volunteers working directly with children shall be required to review and be knowledgeable of the rules at the time they begin work and shall be able to understand and apply those rules which relate to their respective responsibilities.

Correction Required: Licensing rules shall be available and all caregivers working directly with children shall be knowledgeable of the rules.

Correction Verification: Submit Documentation

5 CSR 25-500.112 Staff/Child Ratios

Violation: Staff/child ratio requirements were not met as evidenced by 19 children, ages 6-years-old to 10 years-old, were cared for by 1 adult caregiver(s).

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

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

Correction Verification: Return Inspection

5 CSR 25-500.122 Medical Examination Reports

Violation: A school-age child's health report was not on file at the time of enrollment as evidenced by no medical reports on file for VT, AS, OB, ER, JF, AK.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (D) states: The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child's health history, any current health problems, and any restrictions necessary for the child's care.

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

Correction Verification: Submit Documentation

Compliance Date: 8/23/2024

5 CSR 25-500.132 Admission Policies and Procedures

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The director is not routinely on duty, as evidenced by there is no approved director.

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

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

Correction Verification: Submit Documentation

Compliance Date: 5/9/2024

5 CSR 25-500.122 Medical Examination Reports

Violation: A school-age child's health report was not on file at the time of enrollment as evidenced by no medical reports on file for VT, AS, OB, ER, JF, AK.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (D) states: The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child's health history, any current health problems, and any restrictions necessary for the child's care.

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The director is not routinely on duty, as evidenced by there is no approved director.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: A school-age child's health report was not on file at the time of enrollment as evidenced by no medical reports on file for VT, AS, OB, ER, JF, AK.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (D) states: The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child's health history, any current health problems, and any restrictions necessary for the child's care.

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The facility is owned by a legal entity and evidence of good standing was not available.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.

Correction Required: The facility shall submit evidence that the legal entity is in good standing with the Missouri Secretary of State and state law.

Correction Verification: Submit Documentation

Compliance Date: 3/20/2024

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for any staff 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: 3/20/2024

5 CSR 25-500.052 Annual Requirements

Violation: The Annual Declaration was not submitted.

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

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

Correction Verification: Submit Documentation

Compliance Date: 3/20/2024

5 CSR 25-500.052 Annual Requirements

Violation: The staff sheet was not submitted.

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

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

Correction Verification: Submit Documentation

Compliance Date: 3/20/2024

5 CSR 25-500.052 Annual Requirements

Violation: The equipment list was not submitted.

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

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

Correction Verification: Submit Documentation

Compliance Date: 3/20/2024

5 CSR 25-500.102 Personnel

Violation: The director is not routinely on duty, as evidenced by there is no approved director.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: A school-age child's health report was not on file at the time of enrollment as evidenced by no medical reports on file for VT, AS, OB, ER, JF, AK.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (D) states: The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child's health history, any current health problems, and any restrictions necessary for the child's care.

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The facility is owned by a legal entity and evidence of good standing was not available.

Rule Reference: 5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.

Correction Required: The facility shall submit evidence that the legal entity is in good standing with the Missouri Secretary of State and state law.

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Annual Declaration was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The staff sheet was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The equipment list was not submitted.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: Additional clock hours needed for 2022 showing on OPEN; Pamela Falkensten - 5; Melissa Strubberg - 1.

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

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

Correction Verification: Corrected on Site

Compliance Date: 1/25/2024

5 CSR 25-500.102 Personnel

Violation: The director is not routinely on duty, as evidenced by there is no approved director.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: A school-age child's health report was not on file at the time of enrollment as evidenced by no medical reports on file for VT, AS, OB, ER, JF, AK.

Rule Reference: 5 CSR 25-500.122 Medical Examination Reports (2) (D) states: The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child's health history, any current health problems, and any restrictions necessary for the child's care.

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Melissa Strubberg, Pamela Falkensten 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: 10/26/2023

5 CSR 25-500.102 Personnel

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: Additional clock hours needed for 2022 showing on OPEN; Pamela Falkensten - 5; Melissa Strubberg - 1.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.102 Personnel

Violation: The director is not routinely on duty, as evidenced by there is no approved director.

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report was not on file for Pamela Falkensten 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: 10/26/2023

5 CSR 25-500.122 Medical Examination Reports

Violation: A medical examination report did not include either a completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: Pamela Falkensten.

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 tuberulin skin test (TST) as required.

Correction Verification: Submit Documentation

Compliance Date: 10/26/2023

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/26/2023

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Pamela Falkensten.

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: 10/26/2023