| Compliance List |
5 CSR 25-500.032 Organization and Administration
Compliance
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5 CSR 25-500.042 Licensing Process
Compliance
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5 CSR 25-500.052 Annual Requirements
Compliance
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5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
| | Provider Comments |
Violation
The premises were not safe and suitable as evidenced by cords for the Sound Machine & Baby swing were laying loosely on the floor in the Appalachians Room.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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
Return Inspection
Compliance Date
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Violation
Hazardous items as follows were accessible to children: various brands of Sunscreen & Off Kids Bug Spray. The item(s) was/were located under the sink in the Brooks Room & in a child's cubby in the Cascades Room.
Licensing 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
10/19/2022
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Violation
A clear glass door was not marked plainly at varying heights as evidenced by the door into the Office was not marked at varying heights.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 3. states: Clear glass doors shall be marked plainly at varying heights to avoid impact.
Correction Required
Clear glass doors shall be marked as required.
Correction Verification
Corrected on Site
Compliance Date
10/19/2022
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Violation
The floors located in the entrance door into the Foyer was/were not in good condition as evidenced by a piece of flooring is missing right at the threshold of the door.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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
Return Inspection
Compliance Date
10/19/2022
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Violation
The walls located in the entrance door into the Foyer was/were not in good condition as evidenced by there is bare drywall showing.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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
Return Inspection
Compliance Date
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Violation
There was evidence of dirt/debris in the Cascades Room, more specifically in the ceiling vent.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 9. states: The facility shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.
Correction Required
The facility shall be clean and pest free.
Correction Verification
Return Inspection
Compliance Date
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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 height of the fence was less than 42 inches high - the measured height was 29 inches, this is due to having a load of mulch delivered, with the mulch being in front of the fence which shortened the fence height.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced 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. For facilities 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. An outdoor play area used exclusively for school-age children shall not be required to have a fence. 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.
Correction Verification
Return Inspection
Compliance Date
10/19/2022
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Violation
The facility's outdoor space was not safe for children's activities as evidenced by the footing of the 3rd fence post from the back left corner was exposed.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. 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
Return Inspection
Compliance Date
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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 resilient material was not uniformly spread over the fall-zone area.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.
Correction Required
The facility shall maintain approved resilient material in all fall-zone areas.
Correction Verification
Return Inspection
Compliance Date
10/19/2022
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Violation
The observed surface area under the swings, from which a child might fall consists of bare soil.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 8. states: Concrete, asphalt, carpet, grass or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.
Correction Required
The facility shall not use concrete, asphalt, carpet, grass or bare soil under equipment from which a child might fall.
Correction Verification
Return Inspection
Compliance Date
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Violation
The requirements for toilet and handwashing facilities were not met as evidenced by the toilet would not flush.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 3. states: Toilet and hand washing facilities shall be in working order and convenient for the children's use.
Correction Required
Bathroom fixtures shall be functional and convenient.
Correction Verification
Return Inspection
Compliance Date
10/19/2022
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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 that were between 3.5 and 9 inches and allow entrapment - the openings measured 5 inches at the top of the fence on the right side of the Playground (1st panel to the right of the railroad tie).
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced 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. For facilities 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. An outdoor play area used exclusively for school-age children shall not be required to have a fence. 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.
Correction Verification
Return Inspection
Compliance Date
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Violation
The walls located in the I/T Bathroom, more specifically the door was/were not finished with material which can be cleaned easily as evidenced by paint had chipped off of the exterior & interior of the door exposing bare particle board.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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
Return Inspection
Compliance Date
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Violation
Hazardous items as follows were accessible to children: various brands of Acetaminophen & Ibuprofen. The item(s) was/were located in children's cubbies in the Cascades & Brooks Rooms.
Licensing 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
10/19/2022
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Violation
Hazardous items as follows were accessible to children: various brands of Diaper Cream. The item(s) was/were located in children's cubbies in the Cascades Room.
Licensing 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
10/19/2022
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Violation
The premises were not safe and suitable as evidenced by the TV in the Brooks Room was not secured, it was sitting on top of the cubbies.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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
Return Inspection
Compliance Date
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Violation
The walls located in the Brooks Room, more specifically to the left of the vanity was/were not finished with material which can be cleaned easily as evidenced by the paint had chipped off exposing bare drywall.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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
Return Inspection
Compliance Date
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5 CSR 25-500.087 Fire Safety
Violation
| | Provider Comments |
Violation
The door, located in the Brooks Room, used as an exit from the facility was locked/latched and the lock/latch was not disengaged easily.
Licensing Rule Reference
5 CSR 25-500.087 Fire Safety (4) (C) 3. states: No door in a means of egress shall be locked against egress travel when the building is occupied. Locking devices that impede or prohibit egress or that cannot be disengaged easily shall not be used. Dead bolt locks that require a key to unlock the door from the inside shall not be used. Locking or latching devices installed on doors shall not be located higher than fifty inches (50") above the finished floor.
Correction Required
Exit doors shall not be locked/impede exit from the building.
Correction Verification
Return Inspection
Compliance Date
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5 CSR 25-500.090 Disaster and Emergency Preparedness
Compliance
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5 CSR 25-500.092 Furniture, Equipment and Materials
Violation
| | Provider Comments |
Violation
A child was on a cot; no parental permission was on file.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. B. states: With written parental consent on file, cots may be used for napping or sleeping for toddlers twelve (12) months and older.
Correction Required
The facility shall use cots for toddlers only with written parental permission.
Correction Verification
Return Inspection
Compliance Date
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Violation
Outdoor equipment, the brown playhouse, in the Playground was unsafe as evidenced by the side & the back had come unattached from each other.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor 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
Outdoor play equipment shall be safe and in good repair.
Correction Verification
Return Inspection
Compliance Date
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Violation
Outdoor equipment, the small climber, in the Playground was unsafe as evidenced by the orange & purple side had come unattached from each other.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor 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
Outdoor play equipment shall be safe and in good repair.
Correction Verification
Return Inspection
Compliance Date
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5 CSR 25-500.102 Personnel
Violation
| | Provider Comments |
Violation
Safe sleep training was not completed within the past 3 years for the following staff AW.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) . states: Safe Sleep Training. Every three (3) years the center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios 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 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 http://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 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
Return Inspection
Compliance Date
10/19/2022
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Violation
EM did not complete safe sleep training within 30 days of employment or volunteering at the facility.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) (C) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall complete safe sleep training described in section (4) 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
Return Inspection
Compliance Date
10/19/2022
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Violation
AE & HM did not complete safe sleep training within 30 days of employment or volunteering at the facility.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) (C) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall complete safe sleep training described in section (4) 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
Return Inspection
Compliance Date
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5 CSR 25-500.112 Staff/Child Ratios
Compliance
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5 CSR 25-500.122 Medical Examination Reports
Violation
| | Provider Comments |
Violation
Medical examination report(s) was/were not on file for EM, EN & AW as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing 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
Return Inspection
Compliance Date
10/19/2022
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Violation
A medical examination report did not include either a completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: JJ, EM, EN & AW.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberulin skin test (TST) as required.
Correction Verification
Return Inspection
Compliance Date
10/19/2022
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Violation
The medical examination report and/or the school-age health report form(s) used was not supplied by the department or did not contain all the required information as evidenced by the form on file did not contain the information as requested on the department form.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (2) (E) states: The medical examination report form and the health history report for school-age children shall be supplied by the department or the facility may use its own form if it contains all the information on the department’s form. The School-Age Child Health Report 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 athttps://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
Return Inspection
Compliance Date
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Violation
Medical examination report(s) was/were not on file for AE & KS as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing 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
Return Inspection
Compliance Date
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Violation
A medical examination report did not include either a completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: AE, HJ & KS.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberulin skin test (TST) as required.
Correction Verification
Return Inspection
Compliance Date
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5 CSR 25-500.132 Admission Policies and Procedures
Compliance
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5 CSR 25-500.142 Nighttime Care
Compliance
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5 CSR 25-500.162 Overlap Care of Children
Compliance
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5 CSR 25-500.172 Emergency School Closings
Compliance
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5 CSR 25-500.182 Child Care Program
Compliance
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5 CSR 25-500.192 Health Care
Violation
| | Provider Comments |
Violation
The requirements for administering medication were not met as follows: medication was available for administering to a child, however there was no written permission on file.
Licensing Rule Reference
5 CSR 25-500.192 Health Care (3) (B) states: All medication shall be given to a child only with the dated, written permission of the parent(s) stating the length of time medication may be given.
Correction Required
All medication shall be administered and recorded as required.
Correction Verification
Return Inspection
Compliance Date
10/19/2022
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Violation
The requirements for nonprescription medications were not met as evidenced by a medication was not labeled by the parent with the child's name.
Licensing Rule Reference
5 CSR 25-500.192 Health Care (3) (D) states: All nonprescription medication shall be in the original container and labeled by the parent(s) with the child's name, and instructions for administration, including the times and amounts for dosages.
Correction Required
Medications shall be stored and labeled as required.
Correction Verification
Return Inspection
Compliance Date
10/19/2022
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Violation
Medication was not stored in a locked container.
Licensing Rule Reference
5 CSR 25-500.192 Health Care (3) (E) states: All medication shall be stored out of reach of children or in a locked container.
Correction Required
Medication shall be inaccessible to children and handled as required.
Correction Verification
Return Inspection
Compliance Date
10/19/2022
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Violation
Medication was not stored out of children's reach.
Licensing Rule Reference
5 CSR 25-500.192 Health Care (3) (E) states: All medication shall be stored out of reach of children or in a locked container.
Correction Required
Medication shall be inaccessible to children and handled as required.
Correction Verification
Corrected on Site
Compliance Date
10/19/2022
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5 CSR 25-500.202 Nutrition and Food Service
Violation
| | Provider Comments |
Violation
The provider did not supply and serve food according to the Meal and Snack Food Chart as evidenced by 2 children had brought their own lunch, more specifically they bring their own Breakfast, Lunch & Snack daily.
Licensing Rule Reference
5 CSR 25-500.202 Nutrition and Food Service (1) (A) states: The provider shall supply and serve nourishing food according to the Meal and Snack Food Chart provided in this rule.
Correction Required
Nourishing food shall be provided as required.
Correction Verification
Return Inspection
Compliance Date
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Violation
The provider did not meet requirements for a written diet plan for each infant and toddler as evidenced by the written diet plan was not updated for a child in that the Toddler Feeding Preference was not completed.
Licensing Rule Reference
5 CSR 25-500.202 Nutrition and Food Service (2) (B) states: The written diet plan for each infant/toddler shall be followed. The parent(s) shall update the plan according to the individual needs of the child until they grant permission in writing for the child to eat table foods.
Correction Required
A written diet plan shall be on file for each infant/toddler, updated as needed and followed by caregivers.
Correction Verification
Return Inspection
Compliance Date
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5 CSR 25-500.212 Transportation and Field Trips
Compliance
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5 CSR 25-500.222 Records and Reports
Compliance
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5 CSR 25-600.020 General Requirements
Violation
| | Provider Comments |
Violation
Criminal background check results were not on file for MB, EM, HM, EN, RR, AW & GW.
Licensing 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
Return Inspection
Compliance Date
10/19/2022
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Violation
Criminal background check results were not on file for JC, HC & HJ.
Licensing 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
Return Inspection
Compliance Date
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5 CSR 25-600.040 Background Screening Findings
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. —
Compliance
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RSMo 210.211. License required - exceptions - written notice of licensure status, when.
Compliance
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