| Compliance List |
5 CSR 25-500.032 Organization and Administration
Not Observed
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5 CSR 25-500.042 Licensing Process
Not Observed
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5 CSR 25-500.052 Annual Requirements
Not Observed
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5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
| | Provider Comments |
Violation
Children were not restricted to approved space as evidenced by the door to the laundry room was open and the storage door was unlocked allowing access to children.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.
Correction Required
Caregivers shall restrict children to approved space.
Correction Verification
Corrected on Site
Compliance Date
12/5/2025
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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
Submit Documentation
Compliance Date
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5 CSR 25-500.087 Fire Safety
Not Observed
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5 CSR 25-500.090 Disaster and Emergency Preparedness
Not Observed
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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
Safe sleep training was not completed within the past 3 years for the following staff Ashley Robertson.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) (A) . states: Every three (3) years, the child care provider, group child care home provider, child care staff members, and volunteers 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 Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs/deseadministrativerules/incorporated-reference-materials. 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
Submit Documentation
Compliance Date
12/5/2025
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Violation
Morganne Elms 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) (A) 3. states: The child care provider, group child care home provider, child care staff members, and volunteers shall complete safe sleep training described in subsection (4)(A) 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
12/5/2025
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5 CSR 25-500.112 Staff/Child Ratios
Not Observed
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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 Morganne Elms and Ashley Robertson 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
12/5/2025
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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: Morganne Elms.
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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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 5/13/2024.
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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5 CSR 25-500.132 Admission Policies and Procedures
Violation
| | Provider Comments |
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 25-500.132 Admission Policies and Procedures (8) (E) 8. 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
Submit Documentation
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 Group Day Care Homes and Child Day Care Centers in Missouri are available for review.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. B. states: They have been informed that the Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available in the facility for their review;
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 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 25-500.132 Admission Policies and Procedures (8) (E) 8. 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
Submit Documentation
Compliance Date
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Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 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 25-500.132 Admission Policies and Procedures (8) (E) 8. 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 requested.
Correction Verification
Submit Documentation
Compliance Date
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5 CSR 25-500.142 Nighttime Care
Not Observed
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5 CSR 25-500.162 Overlap Care of Children
Not Observed
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5 CSR 25-500.172 Emergency School Closings
Not Observed
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5 CSR 25-500.182 Child Care Program
Not Observed
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5 CSR 25-500.192 Health Care
Not Observed
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5 CSR 25-500.202 Nutrition and Food Service
Not Observed
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5 CSR 25-500.212 Transportation and Field Trips
Not Observed
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5 CSR 25-500.222 Records and Reports
Violation
| | Provider Comments |
Violation
1 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 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
1 child(ren) records did not include name of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
1 child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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Violation
1 child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (F) states: Field trip and transportation authorization.
Correction Required
Child enrollment information shall be completed and on file as required.
Correction Verification
Submit Documentation
Compliance Date
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5 CSR 25-600.020 General Requirements
Not Observed
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5 CSR 25-600.040 Background Screening Findings
Not Observed
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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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