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19 CSR 30-61.025 Organization and Administration
Compliance
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19 CSR 30-61.045 Initial Licensing Information
Compliance
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19 CSR 30-61.055 License Renewal
Violation
| | Provider Comments |
Violation
The fire inspection was not approved.
Licensing Rule Reference
19 CSR 30-61.055 License Renewal 1 (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.
Correction Required
The facility shall submit evidence of compliance with fire and safety requirements for renewal.
Correction Verification
Submit Documentation
Compliance Date
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Violation
The provider did not meet requirements for requests/results of background reviews. Reviews were missing/out of date for the following provider/other personnel/other household members: Aleta Tate and Shirley Williams.
Licensing Rule Reference
19 CSR 30-61.055 License Renewal 2 states: The child care provider, other personnel and other household members shall be screened for child abuse/neglect prior to renewal of the license.
Correction Required
Required requests/results of current background checks shall be on file.
Correction Verification
Submit Documentation
Compliance Date
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19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Violation
| | Provider Comments |
Violation
The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by no resilient material was present.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 6 states: The fall-zone area under and around outdoor equipment where children might fall and be injured shall be covered with impact absorbing materials which effectively cushions the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material. Grass may be an approved resilient material, but if grass becomes worn or sparse, the area must be covered with another approved resilient material.
Correction Required
The facility shall maintain approved resilient material in all fall-zone areas.
Correction Verification
Return Inspection
Compliance Date
3/20/2019
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Violation
The walls located the front room at the arch way was/were not in good condition as evidenced by 3 inch area of peeling paint.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 2 (A) 6 states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.
Correction Verification
Submit Documentation
Compliance Date
11/21/2018
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Violation
The walls located in the baby room was/were not in good condition as evidenced by there were 2 two inch circular areas of peeling paint about the shelving unit.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 2 (A) 6 states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.
Correction Verification
Submit Documentation
Compliance Date
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Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by there are multiple stacks of rusted peeling chairs in the outside play area.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.
Correction Verification
Submit Documentation
Compliance Date
1/18/2019
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Violation
The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence had openings large enough for a child to crawl or fall through - the opening measured over 12 inches, the gate leading the the driveway and street was open.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 1 states: An outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water or other hazards. For family day care homes initially licensed after the effective date of these rules, or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.
Correction Required
The outdoor play area shall be accessible without hazard and provide a safe fence around the outdoor play area as required.
Correction Verification
Corrected on Site
Compliance Date
3/20/2019
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Violation
The premises were not safe and suitable as evidenced by cabinet door in the bathroom was peeling and falling off hinge.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 1 (A) states: The premises shall be safe and suitable for the care of children.
Correction Required
The premises shall be safe and suitable for the care of children.
Correction Verification
Submit Documentation
Compliance Date
11/21/2018
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19 CSR 30-61.086 Fire Safety
Violation
| | Provider Comments |
Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.
Licensing Rule Reference
19 CSR 30-61.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.
Correction Verification
Return Inspection
Compliance Date
3/20/2019
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Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by the disaster and tornado drill was not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-61.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.
Correction Verification
Return Inspection
Compliance Date
3/20/2019
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19 CSR 30-61.090 Disaster and Emergency Preparedness
Violation
| | Provider Comments |
Violation
The facility has not developed, implemented or maintained policies and procedures for responding to a disaster emergency.
Licensing Rule Reference
19 CSR 30-61.090 Disaster and Emergency Preparedness 1 (A) states: The facility shall develop, implement, and maintain policies and procedures for responding to a disaster emergency, including a written plan for:
Correction Required
Facility must have plan on file as required.
Correction Verification
Submit Documentation
Compliance Date
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19 CSR 30-61.095 Furniture, Equipment and Materials
Violation
| | Provider Comments |
Violation
Requirements for the crib mattress/playpen pad/bedding were not met as evidenced by the mattress/pad was not sized correctly.
Licensing Rule Reference
19 CSR 30-61.095 Furniture, Equipment and Materials 1 (B) 2 C 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 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
3/20/2019
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Violation
Requirements for feeding equipment for infants and toddlers were not met as evidenced by the restraints were not available.
Licensing Rule Reference
19 CSR 30-61.095 Furniture, Equipment and Materials 1 (C) 2 states: Infants and toddlers. Infants and toddlers who are unable to sit at a table shall be served meals at a feeding table, high chair, infant seat or other safely designed infant seating equipment. Equipment shall be provided which will allow a child to sit comfortably and securely while being fed. Appropriate restraints shall be used.
Correction Required
The facility shall provide and use infant/toddler feeding equipment, with appropriate restraints, as required.
Correction Verification
Submit Documentation
Compliance Date
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19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel
Violation
| | Provider Comments |
Violation
The requirements for documentation of 12 clock hours of annual training were not met as evidenced by there were no training documents on file. The staff listed needs the following information: Aleta Tate and Shirley Williams needs 12 hrs for 2018.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel 4 (A) states: The provider shall obtain at least twelve (12) clock hours of child care-related training during each year of employment in training which is approved by the department in health, safety, nutrition, guidance and discipline, appropriate activities and learning experiences for children, positive communication and interaction with parents, planning and setting up an appropriate environment for children, professional and administrative practices, or other child-related areas. Any assistant working more than five (5) hours per week shall meet the same training requirements.
Correction Required
Required training hours shall be documented for each employee.
Correction Verification
Submit Documentation
Compliance Date
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Violation
Requirements for safe sleep training were not met as evidence by the assistant did not complete safe sleep training in that there was no safe sleep certificate on file.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel 5 . states: Every three (3) years the provider and assistant(s) in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment, by Moon RY, which is incorporated by reference in this rule and published in PEDIATRICS Volume 128, No. 5, November 1, 2011, and available from the University of Vermont College of Medicine, Given Building S261, 89 Beaumont Avenue, Burlington, Vermont 05405-0068, telephone number 802-656-2505, fax number 802-656-4844, or at www.pediatrics.aapublications.org/content/128/5/1030.full. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Provider and assistant shall complete department approved safe sleep training as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
Requirements for safe sleep training were not met as evidence by the provider did not complete safe sleep training in that there was no safe sleep certificate on file.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel 5 . states: Every three (3) years the provider and assistant(s) in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment, by Moon RY, which is incorporated by reference in this rule and published in PEDIATRICS Volume 128, No. 5, November 1, 2011, and available from the University of Vermont College of Medicine, Given Building S261, 89 Beaumont Avenue, Burlington, Vermont 05405-0068, telephone number 802-656-2505, fax number 802-656-4844, or at www.pediatrics.aapublications.org/content/128/5/1030.full. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Provider and assistant shall complete department approved safe sleep training as required.
Correction Verification
Submit Documentation
Compliance Date
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19 CSR 30-61.115 Day Care Family and Household
Compliance
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19 CSR 30-61.125 Medical Examination Reports
Violation
| | Provider Comments |
Violation
A medical examination report was not on file for the provider.
Licensing Rule Reference
19 CSR 30-61.125 Medical Examination Reports 1 (B) states: The provider shall have a medical examination report on file at the time of initial licensure.
Correction Required
Medical reports shall be on file as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
A medical examination report was not on file for the assistant and/or volunteer.
Licensing Rule Reference
19 CSR 30-61.125 Medical Examination Reports 1 (D) states: Assistants who are employed or volunteer more than five (5) hours per week shall have a medical examination report on file within thirty (30) days of beginning work in the home.
Correction Required
Medical reports shall be on file as required.
Correction Verification
Submit Documentation
Compliance Date
12/13/2018
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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 9.5.17.
Licensing Rule Reference
19 CSR 30-61.125 Medical Examination Reports 2 (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of licensed physician and completed not more than twelve (12) months prior to admission.
Correction Required
Child medical requirements shall be completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form.
Licensing Rule Reference
19 CSR 30-61.125 Medical Examination Reports 1 (E) . states: Medical examination reports shall include a “Risk Assessment for Tuberculosis” form, included herein, completed and signed by a health care professional, as provided by the Missouri Department of Health and Senior Services (MDHSS). If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
TB reports shall be on file as required.
Correction Verification
Submit Documentation
Compliance Date
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19 CSR 30-61.135 Admission Policies and Procedures
Violation
| | Provider Comments |
Violation
The facility's written policies were not implemented as evidenced by there was no safe sleep policy available for CCFS to review.
Licensing Rule Reference
19 CSR 30-61.135 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
Return Inspection
Compliance Date
3/20/2019
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Violation
The facility did not meet requirements for child enrollment and health information as evidenced by Child 2 and Child 3 need authorization for emergency medical care.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 6 (E) 3 states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care.
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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19 CSR 30-61.145 Nighttime Care
Compliance
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19 CSR 30-61.155 Overlap Care of Children
Compliance
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19 CSR 30-61.165 Emergency School Closings
Compliance
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19 CSR 30-61.175 Child Care Program
Violation
| | Provider Comments |
Violation
The diapering table or other approved area did not have a waterproof surface.
Licensing Rule Reference
19 CSR 30-61.175 Child Care Program 1 (E) 1 states: A safe diapering table or other approved area with a waterproof, washable surface shall be used for changing diapers. The table or area shall be cleaned thoroughly with a disinfectant after each use.
Correction Required
The facility shall provide a safe and clean diapering table as required.
Correction Verification
Submit Documentation
Compliance Date
12/13/2018
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19 CSR 30-61.185 Health Care
Violation
| | Provider Comments |
Violation
Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file .
Licensing Rule Reference
19 CSR 30-61.185 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 adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of 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 completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
Requirements for immunization reports on file were not met as evidenced by required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for 2 child(ren).
Licensing Rule Reference
19 CSR 30-61.185 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 adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of 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 completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
Facility did not submit the 2018 annual summary report showing immunization status of each child enrolled by January 15.
Licensing Rule Reference
19 CSR 30-61.185 Health Care 4 (D) states: The administrator of each day care facility shall prepare a record of immunization of each child enrolled in or attending the facility. An annual summary report shall be made by January 15 showing the immunization status of each child enrolled, using forms provided by the department. The immunization records shall be available for review by department personnel upon request.
Correction Required
Facility shall submit an annual summary report by January 15 showing the immunization status of each child enrolled.
Correction Verification
Submit Documentation
Compliance Date
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19 CSR 30-61.190 Nutrition and Food Service
Compliance
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19 CSR 30-61.200 Transportation and Field Trips
Compliance
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19 CSR 30-61.210 Records and Reports
Violation
| | Provider Comments |
Violation
1 child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-61.210 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
Return Inspection
Compliance Date
3/20/2019
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Violation
1 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-61.210 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
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RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance
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RSMo 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules.
Compliance
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RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Violation
| | Provider Comments |
Violation
Requirements for sanitation inspection were not met as evidenced by the inspection was not approved
Licensing Rule Reference
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. 1 states: All buildings and premises used by a child-care facility to care for more than four children except those exempted from the licensing provisions of the department of health and senior services pursuant to subdivisions (1), (2), (3), (4) and (6) of section 210.211, shall be inspected annually for fire and safety by the state fire marshal, the marshal's designee or officials of a local fire district and for health and sanitation by the department of health and senior services or officials of the local health department. Evidence of compliance with the inspections required by this section shall be kept on file and available to parents of children enrolling in the child-care facility.
Correction Required
An approved sanitation and fire/safety inspection shall be kept on file and be available as required.
Correction Verification
Return Inspection
Compliance Date
3/20/2019
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