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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
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Violation
The facility did not have an adequate number of flush toilets and hand wash sinks in the infant/toddler unit as evidenced by toys and equipment stored in child restroom in Toddler 1.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (C) 1. states: One (1) flush toilet and one (1) adjacent hand washing facility with running water shall be available for every twenty-four (24) children in an infant/toddler unit.
Correction Required
The facility shall provide one flush toilet and one adjacent hand wash sink for every 24 children in the infant/toddler unit.
Correction Verification
Corrected on Site
Compliance Date
1/23/2024
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5 CSR 25-500.087 Fire Safety
Compliance
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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
Requirements for the crib mattress/playpen padding/bedding were not met as evidenced by a fitted sheet was not used.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. D. states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used. Only fitted sheet shall be used and shall be changed immediately when soiled or wet.
Correction Required
Sleeping equipment shall meet safety and sanitation requirements.
Correction Verification
Corrected on Site
Compliance Date
1/23/2024
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5 CSR 25-500.102 Personnel
Compliance
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5 CSR 25-500.112 Staff/Child Ratios
Violation
| | Provider Comments |
Violation
Staff/child ratio requirements were not met as evidenced by 11 children, ages 4-years-old to 6-years-old, were cared for by 1 caregiver(s).
Licensing Rule Reference
5 CSR 25-500.112 Staff/Child Ratios (1) (C) states: Ages Three Through Four (3 - 4) Years. Groups composed solely of three (3)- and four (4)-year olds shall have no less than one (1) adult to ten (10) children;
Correction Required
Correct staff/child ratios shall be maintained.
Correction Verification
Corrected on Site
Compliance Date
1/23/2024
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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 Emma Graves 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
Submit Documentation
Compliance Date
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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 06/05/2023.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is incorporated by reference in this rule, as published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Child medical requirements shall be completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Victoria Cushshon.
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 tuberculin skin test (TST) as required.
Correction Verification
Submit Documentation
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
Compliance
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5 CSR 25-500.202 Nutrition and Food Service
Compliance
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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
Compliance
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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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