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5 CSR 25-400.025 Organization and Administration
Not Observed
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5 CSR 25-400.045 Licensing Process
Violation
| | Provider Comments |
Violation
The number of children was/were exceeded as evidenced by provider Marlenia Cook was the sole provider for twenty five children. The capacity on her license is for 10 children. During an inspection on 10/27/21 the number of children was/were exceeded as evidenced by Marlenia Cook and assistant Kay Cook were caring for 17 children including 4 under 2 years.
Licensing Rule Reference
5 CSR 25-400.045 Licensing Process (18) states: The number and ages of children a family child care home is authorized to have in care at any one time shall be specified on the license and shall not be exceeded except as permitted within these rules.
Correction Required
The provider shall maintain compliance with the specifications on the license.
Correction Verification
Return Inspection
Compliance Date
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5 CSR 25-400.055 Annual Requirements
Not Observed
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5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Violation
| | Provider Comments |
Violation
The facility did not provide at least 35 square feet of usable floor space for each child coming into the facility for day care as evidenced by space was reduced by the amount of children present. The facility is licensed for 10 children; however, measured space shows enough floor space for 14 children and 25 children were present.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (B) 1. states: At least thirty-five (35) square feet of usable floor space shall be provided for each child coming into the home for day care.
Correction Required
The facility shall provide thirty-five square feet of usable space per child.
Correction Verification
Return Inspection
Compliance Date
10/27/2021
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5 CSR 25-400.086 Fire Safety
Violation
| | Provider Comments |
Violation
The means of egress in the playroom was obstructed in that a child napping on a cot was blocking the exit door leading to the playground.
Licensing Rule Reference
5 CSR 25-400.086 Fire Safety 1 (M) states: Means of egress is a continuous and unobstructed way of travel from any point in a building or structure to a public way. A means of egress consists of three (3) distinct parts: the exit access, the exit, and the exit discharge.
Correction Required
Means of egress must be unobstructed.
Correction Verification
Return Inspection
Compliance Date
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5 CSR 25-400.090 Disaster and Emergency Preparedness
Not Observed
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5 CSR 25-400.095 Furniture, Equipment and Materials
Violation
| | Provider Comments |
Violation
Stationary equipment, the sphere climber and the air plane, was unsafe as evidenced by the equipment was not securely anchored.
Licensing Rule Reference
5 CSR 25-400.095 Furniture, Equipment and Materials 3 (D) states: Stationary equipment such as swings, slides and climbers shall be securely anchored, have no exposed footings and be placed to avoid accidents or collisions.
Correction Required
Stationary equipment shall be safely installed, stable and securely anchored.
Correction Verification
Return Inspection
Compliance Date
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Violation
The requirements for sleeping materials were not met as evidenced by 1 children 12 months or older was/were sleeping/napping on the ground on a blanket. Marlenia states a cot was put out for the child; however the child wanders around the nap room and fell asleep on the ground in front of the tv instead of the cot.
Licensing Rule Reference
5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 1 A states: A cot, bed, sofa, padded playpen or crib shall be provided for each child who naps or sleeps. An individually assigned sheet and blanket shall be provided for each child twelve (12) months and older who naps or sleeps. Upper levels of bunk beds shall not be used.
Correction Required
The facility shall provide sleeping equipment and bedding as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
An infant was observed sleeping in a/an bouncer.
Licensing Rule Reference
5 CSR 25-400.095 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
Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by one infant was covered with blanket while napping.
Licensing Rule Reference
5 CSR 25-400.095 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
10/27/2021
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Violation
Infant sleeping requirements were not met as evidenced by soft materials or objects were placed under a sleeping infant in that two children had a blanket underneath them.
Licensing Rule Reference
5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 2 D states: Soft materials or objects such as pillows, quilts, comforters, or sheepskins, even if covered by a sheet, shall not be placed under a sleeping infant. If a mattress cover to protect against wetness is used, it shall be tight fitting and thin.
Correction Required
Infant sleeping requirements shall be met.
Correction Verification
Return Inspection
Compliance Date
10/27/2021
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Violation
Requirements for infant/toddler sleeping equipment were not met as evidenced by a crib/playpen was not provided for each infant in that there are 3 approved pieces of napping equipment for infants; however, all 3 pieces of equipment had children napping in them. There were 2 additional children under the age one-year present. One child was napping in a baby swing and one child was napping in Marlenia Cook's arms as there were no additional approved napping equipment for them to use .
Licensing Rule Reference
5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 2 A states: A crib, portable crib or playpen shall be provided and used for each infant. Stack cribs shall not be used.
Correction Required
The facility shall provide approved sleeping equipment as required.
Correction Verification
Return Inspection
Compliance Date
10/27/2021
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5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel
Violation
| | Provider Comments |
Violation
Staff/child ratio requirements were not met as evidenced by 4 children under age two and 21 children over age two were cared for by 1 caregiver(s).
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (2) (A) states: A family child care home may be licensed for up to ten (10) children. The following staff/child ratios must be maintained at all times and shall not be exceeded except as permitted under these rules: 1 caregiver present, with up to 4 children, all may be under age two (2); 1 caregiver present, with 5-6 children, 3 children may be under age two (2); 1 caregiver present, with 7-10 children, 2 children may be under age two (2); 2 caregivers present, with up to 8 children, 8 children may be under age two (2); 2 caregivers present, with up to 10 children, 4 children may be under age two (2).
Correction Required
Staff/child ratios shall be maintained at all times.
Correction Verification
Return Inspection
Compliance Date
10/27/2021
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Violation
Staff/child ratio requirements were not met as evidenced by 4 children under age two and 13 children over age two were cared for by 2 caregiver(s).
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (2) (A) states: A family child care home may be licensed for up to ten (10) children. The following staff/child ratios must be maintained at all times and shall not be exceeded except as permitted under these rules: 1 caregiver present, with up to 4 children, all may be under age two (2); 1 caregiver present, with 5-6 children, 3 children may be under age two (2); 1 caregiver present, with 7-10 children, 2 children may be under age two (2); 2 caregivers present, with up to 8 children, 8 children may be under age two (2); 2 caregivers present, with up to 10 children, 4 children may be under age two (2).
Correction Required
Staff/child ratios shall be maintained at all times.
Correction Verification
Return Inspection
Compliance Date
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5 CSR 25-400.115 Day Care Family and Household
Compliance
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5 CSR 25-400.125 Medical Examination Reports
Violation
| | Provider Comments |
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 4/14/20, 11/16/20, and one child did not have an admission date.
Licensing Rule Reference
5 CSR 25-400.125 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
Return Inspection
Compliance Date
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Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Marlenia Cook and Kay Cook.
Licensing Rule Reference
5 CSR 25-400.125 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
Return Inspection
Compliance Date
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Violation
A medical examination report was not on file for assistant(s): Kay Cook.
Licensing Rule Reference
5 CSR 25-400.125 Medical Examination Reports (1) (D) states: Assistants who are employed or volunteer more than five (5) hours per week shall have a medical examination report on file within thirty (30) days of beginning work in the home.
Correction Required
Medical reports shall be on file as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
A medical examination report was not on file for the provider.
Licensing Rule Reference
5 CSR 25-400.125 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
Return Inspection
Compliance Date
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5 CSR 25-400.135 Admission Policies and Procedures
Violation
| | Provider Comments |
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 13 child(s) file(s) did not have the parental acknowledgement they have been notified that they may request whether there are children for whom an immunization exemption has been filed for currently enrolled in or attending the facility.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 F. states: They have been notified that they may request notice at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider’s safe sleep policy when enrolling children less than 1 year of age.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 E states: They have received a copy of the provider’s safe sleep policy when enrolling children less than one (1) year of age.
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider's policies.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 A states: They have received a copy of the provider's policies pertaining to the admission, care and discharge of children.
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
The provider did not have parental acknowledgement on file indicating the parent understands and agrees that the child may not be accepted for care when ill.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 D states: They understand and agree that the child may not be accepted for care when ill.
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
The provider did not have parental acknowledgement on file indicating the parent and provider have agreed on a plan for continuing communication.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 C states: They and the provider have agreed on a plan for continuing communication regarding the child’s development, behavior and individual needs.
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
The provider did not have parental acknowledgement on file indicating the parent has been informed that Licensing Rules for Family Day Care Homes in Missouri are available for review.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 B states: They have been informed that the Licensing Rules for Family Day Care Homes in Missouri are available in the home for their review.
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
Written permission was not on file for field trips.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 5 states: Permission for field trips, transportation to and from school and other transportation.
Correction Required
Written permission for field and transportation shall be on file as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
The facility did not meet requirements for child enrollment and health information as evidenced by there were 13 children present that did not have an enrollment form on file with this information. During a re-inspection on 10/27/21, it was observed that there were 10 children present who did not have an enrollment form on file with this information.
Licensing Rule Reference
5 CSR 25-400.135 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
Return Inspection
Compliance Date
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Violation
The facility did not meet requirements for child enrollment and health information as evidenced by there were 13 children present that did not have an enrollment form on file with this information. During the re-inspection on 10/27/21, it was observed that there were 10 children present who did not have an enrollment form on file with this information.
Licensing Rule Reference
5 CSR 25-400.135 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
Return Inspection
Compliance Date
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Violation
The provider did not require that an appointment be made for intermittent care.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (8) states: If a provider enrolls children for irregular or intermittent care, all procedures for admitting children shall be followed. Children enrolled on an irregular or intermittent basis shall be accepted only by appointment and shall not cause the home to exceed its licensed capacity.
Correction Required
The provider who offers part-time care shall follow all admission procedures and schedule childcare to prevent exceeding licensed capacity.
Correction Verification
Return Inspection
Compliance Date
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5 CSR 25-400.145 Nighttime Care
Compliance
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5 CSR 25-400.155 Overlap Care of Children
Compliance
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5 CSR 25-400.165 Emergency School Closings
Not Observed
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5 CSR 25-400.175 Child Care Program
Compliance
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5 CSR 25-400.185 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 two child(ren).
Licensing Rule Reference
5 CSR 25-400.185 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
Return Inspection
Compliance Date
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5 CSR 25-400.190 Nutrition and Food Service
Not Observed
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5 CSR 25-400.200 Transportation and Field Trips
Not Observed
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5 CSR 25-400.210 Records and Reports
Not Observed
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5 CSR 25-600.020 Background Screening Findings
Not Observed
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5 CSR 25-600.040 General Requirements
Violation
| | Provider Comments |
Violation
Criminal background check results were not on file for Marlenia Cook, caregiver, Kay Cook, assistant and Mike Cook, household member.
Licensing Rule Reference
5 CSR 25-600.040 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a family child care home, group child care home, child care center, or license-exempt 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
Return Inspection
Compliance Date
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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.
Compliance
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