| 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
Violation
| | Provider Comments |
Violation
The Family Care Safety Registry check was not conducted for Amanda Deisner, Elizabeth Barnhart-Floyd, Courtney Toti, Rebecca Rafferty, Suzanne Gonzalez, Lesley Deason, Tammie Benton, Nicole Batten, Kelly Maurath, Abigail Bouwhuis-Bremer, Angela Smith, Ronda McKalip, Juliet Sanders, Misty Rhives, Emilee Schaumann, Jennifer Kierns, Emily Anderson, Cara Greenwald, Kaci Missey, Sarah Millikan & Tanya Stephens (As of 9/16/2025 checks were needed for Rebecca Rafferty, Suzanne Gonzalez, Lesley Deason, Tammie Benton, Nicole Batten, Kelly Maurath, Abigail Bouwhuis-Bremer, Angela Smith, Ronda McKalip, Juliet Sanders, Misty Rhives, Emilee Schaumann, Jennifer Kierns, Emily Anderson, Cara Greenwald, Kaci Missey, Sarah Millikan & Tanya Stephens.) within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.
Correction Verification
Submit Documentation
Compliance Date
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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 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 was not in good condition in that it was unattached from the top rail along the back run of fence, specifically at the 6th panel from the back left corner.
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
Corrected on Site
Compliance Date
9/16/2025
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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
Compliance
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5 CSR 25-500.102 Personnel
Violation
| | Provider Comments |
Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Rebecca Rafferty.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.
Correction Verification
Submit Documentation
Compliance Date
5/7/2025
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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 Courtney Toti & Rebecca Rafferty 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
5/7/2025
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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: Courtney Toti & Rebecca Rafferty.
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
5/7/2025
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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
Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file.
Licensing Rule Reference
5 CSR 25-500.192 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 immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the 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 on file as required.
Correction Verification
Submit Documentation
Compliance Date
9/16/2025
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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
Violation
| | Provider Comments |
Violation
Criminal background check results were not on file for Courtney Toti & Rebecca Rafferty.
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
Submit Documentation
Compliance Date
5/7/2025
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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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