Alpha Tots Learning Centers, Inc.

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's evacuation route diagram was not posted in each room.

Rule Reference: 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 2. states: A diagram of evacuation routes from the room;

Correction Required: Facility must post information as required.

Correction Verification: Corrected on Site

Compliance Date: 4/15/2026

5 CSR 25-500.090 Disaster and Emergency Preparedness

Violation: The facility's list of emergency numbers are not posted in each room used for child care, specifically the infant/toddler room.

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: The facility must post all emergency numbers as required.

Correction Verification: Corrected on Site

Compliance Date: 4/15/2026

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Requirements for the crib mattress/playpen padding/bedding were not met as evidenced by a crib mattress/pad was not in good condition in that 4 pack and plays were missing a fitted mattress, using only the bottom of the pack and play.

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

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

Correction Verification: Corrected on Site

Compliance Date: 4/15/2026

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: Kylee Youngmon.

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

Compliance Date: 10/20/2025

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Kylee Youngmon and Alexis Rodriquez

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/20/2025

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Jordan Paynter 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: 10/20/2025

5 CSR 25-500.122 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/20/2025

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The facility's written policies were not provided to parents at the time of enrollment.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (1) states: The provider shall establish, implement and maintain written policies pertaining to the program goals, admission, safe sleep practices for children less than one (1) year of age, care and discharge of children and shall provide a copy to the parent(s) at the time of enrollment.

Correction Required: The provider's written policies shall be provided to the parent(s) as required.

Correction Verification: Submit Documentation

Compliance Date: 10/27/2025

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.

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

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

Correction Verification: Submit Documentation

Compliance Date: 10/20/2025

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Katelynn Mitchell .

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: 10/20/2025

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

Violation: Emergency numbers for the police, fire department, and ambulance were not posted.

Rule Reference: 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 11. states: Telephone numbers for the police, fire department, ambulance and other emergency telephone numbers shall be posted near the telephone.

Correction Required: Emergency numbers shall be posted near the telephone.

Correction Verification: Corrected on Site

Compliance Date: 10/8/2025

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

Violation: Bathroom supplies were not available and accessible to children as evidenced by soap was not within children's reach.

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

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

Correction Verification: Corrected on Site

Compliance Date: 10/8/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

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

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

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

Correction Verification: Corrected on Site

Compliance Date: 10/8/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Requirements for feeding equipment for infants and toddlers who are unable to sit at a table were not met as evidenced by no restraints are used.

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

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

Correction Verification: Corrected on Site

Compliance Date: 10/8/2025

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Kylee Youngmon and Alexis Rodriquez

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: Kylee Youngmon.

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

Correction Required: All caregivers shall obtain a MOPD ID.

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.132 Admission Policies and Procedures

Violation: The facility's written policies were not provided to parents at the time of enrollment.

Rule Reference: 5 CSR 25-500.132 Admission Policies and Procedures (1) states: The provider shall establish, implement and maintain written policies pertaining to the program goals, admission, safe sleep practices for children less than one (1) year of age, care and discharge of children and shall provide a copy to the parent(s) at the time of enrollment.

Correction Required: The provider's written policies shall be provided to the parent(s) as required.

Correction Verification: Submit Documentation

5 CSR 25-500.222 Records and Reports

Violation: 1 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.

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

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

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were not on file for Katelynn Mitchell .

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 25-500.092 Furniture, Equipment and Materials

Violation: Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by one child laying in a crib while wearing a bib, and another child with a bottle left in the crib.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. G states: Cribs, portable cribs and playpens shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation. Examples include bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, pillow-like toys, wedges, infant positioners, special mattresses, special sleep surfaces, and other similar items.

Correction Required: Infant napping equipment shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation.

Correction Verification: Corrected on Site

Compliance Date: 4/16/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

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

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

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

Correction Verification: Return Inspection

Compliance Date: 2/13/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by by a blanket was observed in a crib with a sleeping 9-month-old child..

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. G states: Cribs, portable cribs and playpens shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation. Examples include bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, pillow-like toys, wedges, infant positioners, special mattresses, special sleep surfaces, and other similar items.

Correction Required: Infant napping equipment shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation.

Correction Verification: Return Inspection

Compliance Date: 2/13/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

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

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

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

Correction Verification: Corrected on Site

Compliance Date: 2/4/2025

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by a blanket was observed in a crib with a sleeping 9-month-old child.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. G states: Cribs, portable cribs and playpens shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation. Examples include bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, pillow-like toys, wedges, infant positioners, special mattresses, special sleep surfaces, and other similar items.

Correction Required: Infant napping equipment shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation.

Correction Verification: Corrected on Site

Compliance Date: 2/4/2025

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Taylor Hicks 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: 1/31/2025

5 CSR 25-500.102 Personnel

Violation: Safe sleep training was not completed within the past 3 years for the following staff Macy Baker, Alexis Rodriquez.

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

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

Correction Verification: Submit Documentation

Compliance Date: 1/31/2025

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Sydney Tackitt, Taylor HIcks, Shae McKnight and Wendy Yeubanks.

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: 1/31/2025

5 CSR 25-500.052 Annual Requirements

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

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

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

Correction Verification: Submit Documentation

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

Violation: The bathroom was not clean and odor free as evidenced by urine and/or excrement odor was detected.

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

Correction Required: Bathrooms shall be clean and odor free.

Correction Verification: Corrected on Site

Compliance Date: 10/25/2024

5 CSR 25-500.102 Personnel

Violation: Safe sleep training was not completed within the past 3 years for the following staff Macy Baker, Alexis Rodriquez.

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

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

Correction Verification: Submit Documentation

5 CSR 25-600.020 General Requirements

Violation: Criminal background check results were older than five (5) years for Sydney Tackitt, Taylor HIcks, Shae McKnight and Wendy Yeubanks.

Rule Reference: 5 CSR 25-600.020 General Requirements (5) states: Criminal background checks shall be completed for each child care staff member every five (5) years.

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

Correction Verification: Submit Documentation

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Macy Baker, Tara Bauer, Bailey Fanning, Neena Gill, Taylor Hicks, Jacie Higgins, Patricia Lockhart, Cayanne Meierer, Katelynn Mitchell, Charmaine Payne, Nicole Otunomo, Sydney Tackitt, and Wendy Yeubanks 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: Corrected on Site

Compliance Date: 2/21/2024

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

Violation: Hazardous items as follows were accessible to children: Toilet cleaner, bug fogger, DW-40. The item(s) was/were located in the staff bathroom (in the toddler room) sink cabinet where the child locks were not working.

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

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Corrected on Site

Compliance Date: 2/21/2024

5 CSR 25-500.087 Fire Safety

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

Rule Reference: 5 CSR 25-500.087 Fire Safety (2) (F) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.

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

Correction Verification: Corrected on Site

Compliance Date: 2/21/2024

5 CSR 25-500.087 Fire Safety

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

Rule Reference: 5 CSR 25-500.087 Fire Safety (2) (F) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.

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

Correction Verification: Corrected on Site

Compliance Date: 2/21/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by a quilted fitted sheet was observed in an infant pack n play.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. G states: Cribs, portable cribs and playpens shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation. Examples include bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, pillow-like toys, wedges, infant positioners, special mattresses, special sleep surfaces, and other similar items.

Correction Required: Infant napping equipment shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation.

Correction Verification: Corrected on Site

Compliance Date: 2/21/2024

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: The facility did not meet requirements for push-pull toys. The facility needed an additional 8 (infant room) items in this category.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (C) 1. A. states: Push-pull toys;

Correction Required: The facility shall provide approved equipment as required.

Correction Verification: Corrected on Site

Compliance Date: 2/21/2024

5 CSR 25-500.102 Personnel

Violation: A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Sheila Brand, Lilli Taylor, Katelynn Mitchell

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

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

Correction Verification: Corrected on Site

Compliance Date: 2/21/2024

5 CSR 25-500.122 Medical Examination Reports

Violation: Medical examination report(s) was/were not on file for Charmaine Payne 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: Corrected on Site

Compliance Date: 2/21/2024

5 CSR 25-500.122 Medical Examination Reports

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

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

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

Correction Verification: Corrected on Site

Compliance Date: 2/21/2024

5 CSR 25-500.122 Medical Examination Reports

Violation: Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 6/15/2022.

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

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

Correction Verification: Corrected on Site

Compliance Date: 2/21/2024

5 CSR 25-500.052 Annual Requirements

Violation: The Family Care Safety Registry check was not conducted for Macy Baker, Tara Bauer, Bailey Fanning, Neena Gill, Taylor Hicks, Jacie Higgins, Patricia Lockhart, Cayanne Meierer, Katelynn Mitchell, Charmaine Payne, Nicole Otunomo, Sydney Tackitt, and Wendy Yeubanks within thirty (30) days prior to the anniversary date.

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

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

Correction Verification: Submit Documentation

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

Violation: Hazardous items as follows were accessible to children: Toilet cleaner, bug fogger, DW-40. The item(s) was/were located in the staff bathroom (in the toddler room) sink cabinet where the child locks were not working.

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

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Submit Documentation

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

Violation: Hazardous items as follows were accessible to children: soft scrub cleaner. The item(s) was/were located in the bottom drawer of the sink cabinet in the two and three year old bathroom.

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

Correction Required: Hazardous items shall be inaccessible to children.

Correction Verification: Corrected on Site

Compliance Date: 10/19/2023

5 CSR 25-500.087 Fire Safety

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

Rule Reference: 5 CSR 25-500.087 Fire Safety (2) (F) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.

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

Correction Verification: Submit Documentation

5 CSR 25-500.087 Fire Safety

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

Rule Reference: 5 CSR 25-500.087 Fire Safety (2) (F) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.

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

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by a quilted fitted sheet was observed in an infant pack n play.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. G states: Cribs, portable cribs and playpens shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation. Examples include bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, pillow-like toys, wedges, infant positioners, special mattresses, special sleep surfaces, and other similar items.

Correction Required: Infant napping equipment shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation.

Correction Verification: Submit Documentation

5 CSR 25-500.092 Furniture, Equipment and Materials

Violation: The facility did not meet requirements for push-pull toys. The facility needed an additional 8 (infant room) items in this category.

Rule Reference: 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (C) 1. A. states: Push-pull toys;

Correction Required: The facility shall provide approved equipment as required.

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: Nicole Otunomo, Sheila Brand, Lilli Taylor, Katelynn Mitchell and Kailey Lutz

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

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

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

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

Correction Verification: Submit Documentation

5 CSR 25-500.122 Medical Examination Reports

Violation: Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 6/15/2022.

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

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

Correction Verification: Submit Documentation