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19 CSR 30-61.025 Organization and Administration
Not Observed
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19 CSR 30-61.045 Initial Licensing Information
Not Observed
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19 CSR 30-61.055 License Renewal
Not Observed
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19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Not Observed
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19 CSR 30-61.086 Fire Safety
Violation
| | Provider Comments |
Violation
A portable electrical space heater was observed in use in the kitchen.
Licensing Rule Reference
19 CSR 30-61.086 Fire Safety 12 (A) states: Unvented fuel-fired room heaters and portable electrical space heaters shall not be used during child care hours. The provider shall sign a compliance letter verifying that such equipment will not be used.
Correction Required
Space heaters/floor furnaces shall not be used.
Correction Verification
Submit Documentation
Compliance Date
2/5/2020
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19 CSR 30-61.090 Disaster and Emergency Preparedness
Violation
| | Provider Comments |
Violation
Requirements of facility's participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-61.090 Disaster and Emergency Preparedness 3 (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.
Correction Required
Fire, tornado, or other disaster drills shall be completed and recorded as required.
Correction Verification
Submit Documentation
Compliance Date
2/5/2020
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19 CSR 30-61.095 Furniture, Equipment and Materials
Violation
| | Provider Comments |
Violation
Furniture/equipment, Rock and Play, in front area was unsafe as evidenced by it had a manufactures recall.
Licensing Rule Reference
19 CSR 30-61.095 Furniture, Equipment and Materials 1 (A) 1 states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead free paint shall be used.
Correction Required
The facility shall provide safe and clean furniture/equipment as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by an infant was covered with a blanket.
Licensing Rule Reference
19 CSR 30-61.095 Furniture, Equipment and Materials 1 (B) 2 E 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
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Violation
Infant sleeping requirements were not met as evidenced by sleep clothing which allowed an infants head or face to be covered was used.
Licensing Rule Reference
19 CSR 30-61.095 Furniture, Equipment and Materials 1 (B) 2 F states: Blankets or other soft or loose bedding shall not be hung on the sides of cribs or put under the fitted sheet. Only sleep clothing that is designed to keep an infant warm without the possible hazard of covering the head or face may be used during sleep or nap time.
Correction Required
Infant sleeping requirements shall be met.
Correction Verification
Submit Documentation
Compliance Date
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Violation
An infant was observed sleeping in a/an rock and play.
Licensing Rule Reference
19 CSR 30-61.095 Furniture, Equipment and Materials 1 (B) 2 G 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
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Violation
Requirements for feeding equipment for infants and toddlers were not met as evidenced by no restraints were used.
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 provider was not present 40 hours a week during the hours of highest attendance as evidenced by Brittany is only at the daycare on Mondays.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel (1) (A) states: The provider routinely shall be present during the hours of highest attendance a minimum of forty (40) hours per week.
Correction Required
The provider shall be routinely on duty as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
The requirements for availability and understanding of the Licensing Rules for Family Day Care Facilities in Missouri were not met as evidenced by licensing rules were not available.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel (1) (H) states: The provider shall have available a copy of the Licensing Rules for Family Day Care Homes in Missouri. Providers and assistants shall review and be knowledgeable of the rules at the time they begin work, and shall be able to understand and apply the rules which relate to their respective responsibilities.
Correction Required
Licensing rules shall be available; adults working directly with children shall be knowledgeable of the rules.
Correction Verification
Submit Documentation
Compliance Date
2/5/2020
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Violation
Requirements for an approved assistant were not met as evidenced by the assistant present was not approved.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel (3) (A) states: An approved assistant shall be available. If there is a change of assistants, the provider shall notify the department immediately.
Correction Required
An approved assistant shall be available as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
Requirements for an approved assistant were not met as evidenced by the provider did not notify the department immediately of change of assistant.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel (3) (A) states: An approved assistant shall be available. If there is a change of assistants, the provider shall notify the department immediately.
Correction Required
An approved assistant shall be available 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 assistant(s), Ashlynn Slusher, did not complete safe sleep training within the past three years.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel (5) . states: Safe Sleep Training. 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: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 138, No. 5, November 1, 2016 and available at ttp://pediatrics.aappublications.org/content/pediatrics/early/2016/10/20/peds.2016- 2938.full.pdf. This rule does not incorporate any subsequent amendments or additions.
Correction Required
The child care provider and assistant(s) shall complete department approved safe sleep training as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
The assistant did not complete safe sleep training within 30 days of employment or volunteering as evidenced by Ashlynn Slusher did not have safe sleep training.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel (5) (C) states: The provider and any assistant hired or volunteering at the facility after initial licensure shall complete the safe sleep training described in section (5) of this rule within thirty (30) days of employment or volunteering at the facility.
Correction Required
The department approved safe sleep training must be completed within 30 days of employment or volunteering.
Correction Verification
Submit Documentation
Compliance Date
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19 CSR 30-61.115 Day Care Family and Household
Not Observed
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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 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
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Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Ashlynn Slusher.
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
2/5/2020
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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 10/22/19.
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
2/5/2020
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19 CSR 30-61.135 Admission Policies and Procedures
Violation
| | Provider Comments |
Violation
The provider did not have available a copy of the Licensing Rules for Family Day Care Homes in Missouri.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures (3) states: The provider shall have available a copy of the Licensing Rules for Family Day Care Homes in Missouri and shall advise the parent (s) at the time of enrollment of his/her child of the availability of the rules for review.
Correction Required
Licensing Rules for Group Day Care Homes and Child Day Care Centers of Missouri shall be available.
Correction Verification
Submit Documentation
Compliance Date
2/5/2020
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Violation
The facility did not meet requirements for child enrollment and health information as evidenced by 4 children did not have Comment on Child's Development completed on the enrollment form.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures (6) (E) 2 states: Information regarding a child's personal development, behavior patterns, habits and individual needs.
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
The facility did not meet requirements for child enrollment and health information as evidenced by 7 children did not have the Authorization for Emergency Medical Care completed on the enrollment form.
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
Not Observed
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19 CSR 30-61.155 Overlap Care of Children
Not Observed
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19 CSR 30-61.165 Emergency School Closings
Not Observed
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19 CSR 30-61.175 Child Care Program
Not Observed
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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 required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for 1 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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19 CSR 30-61.190 Nutrition and Food Service
Not Observed
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19 CSR 30-61.200 Transportation and Field Trips
Not Observed
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19 CSR 30-61.210 Records and Reports
Violation
| | Provider Comments |
Violation
Daily attendance records were not maintained on file as required as evidenced by there were no caregiver/volunteer attendance records.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (6) states: Daily attendance records for all caregivers shall be maintained and kept on file a minimum of one (1) year.
Correction Required
Caregiver/Volunteer attendance records shall be maintained and retained as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
The provider failed to maintain accurate records to meet administrative requirements as evidenced by four children did not have individual files.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (1) states: The child care provider shall maintain accurate records to meet administrative requirements and to ensure knowledge of the individual needs of children and their families.
Correction Required
Accurate records shall be maintained.
Correction Verification
Submit Documentation
Compliance Date
2/5/2020
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Violation
The provider failed to maintain accurate records to meet administrative requirements as evidenced by four children did not have a Children's Enrollment Form on file.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (1) states: The child care provider shall maintain accurate records to meet administrative requirements and to ensure knowledge of the individual needs of children and their families.
Correction Required
Accurate records shall be maintained.
Correction Verification
Submit Documentation
Compliance Date
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Violation
Four child(ren) records did not include child's full name, address, date of birth and date care begins and ends.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (2) (A) states: The child’s full name, address, birth date and the date care begins and ends.
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
Seven 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
Submit Documentation
Compliance Date
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Violation
Four child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached.
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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19 CSR 30-63.040 Background Screening Findings
Not Observed
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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 210.115. Reports of abuse, neglect, and under age eighteen deaths - persons required to report - supervisors and administrators not to impede reporting - deaths required to be reported to the division or child fatality review panel, when - report made to another state, when.
Not Observed
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RSMo 210.211. License required - exceptions - written notice of licensure status, when.
Not Observed
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RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Not Observed
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