DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

TOT SPOT ACADEMY AND PRESCHOOL, LLC

002905093

(573) 510-1571

1327 E MAIN ST
JACKSON
MO  63755-1592

TOT SPOT ACADEMY AND PRESCHOOL, LLC

338 STATE HIGHWAY BB
MILLERSVILLE
MO  63766-6303

HOWELL, MICHAELA

totspotacademyandprek@gmail.com


BRITTANY HECHT

BIRTH - 12 YEARS

44

GROUP HOME AND CENTER

16 CHILDREN IN THE INFANT/TODDLER UNIT; 8 CHILDREN UNDER 12 MONTHS
 
Inspection Information

04/09/2026

8:30 AM

12:06 PM

UNANNOUNCED

COMPLIANCE MONITORING

2511252440


DocumentDocument-Date
APPLICATION 04/19/2022
DIAGRAM/OUTDOOR 04/19/2022
DIAGRAM/INDOOR 04/19/2022
LINES OF ADMINISTRATIVE AUTHORITY 04/19/2022
LLC ARTICLES OF ORGANIZATION 04/19/2022
LLC OPERATING AGREEMENT 04/19/2022
LOCAL FIRE DEPARTMENT NOTIFICATION 04/19/2022
SAFE SLEEP POLICY 04/19/2022
EQUIPMENT LIST 02/23/2026
ANNUAL DECLARATION 02/23/2026
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/09/2026
FIRE/SAFETY INSPECTION 01/20/2026
SANITATION INSPECTION 01/23/2026

Overlap Start TimeOverlap End TimeOverlap Submit Date
  11:00AM   1:00PM   1/22/2024



Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 30
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.
Attendance at Time of Inspection
Total Staff 8
Total Children 28
StaffChildClass AgeNote
2 9 INFANTS AND TODDLERS Kailyn Urhan & Nora Austin, Caregivers Trinity Carlson, Caregiver 7 - 4-23 Month Olds 2 - 2 Year Olds (Upon arrival there were only 2 Staff with 9 children that I, CI Hecht observed then staffing was rearranged & the I/T Group was divided & split to correct Staff/Child Ratio & Group Size.)
2 9 MIXED Kaliegh Medley, Caregiver/Designated Person in Charge Allison Bryant, Caregiver 5 - 2 Year Olds 4 - 3 Year Olds
1 0 NO CHILDREN IN ATTENDANCE Adelynn Darwin, Caregiver (Arriving for Shift)
1 0 NO CHILDREN IN ATTENDANCE Michaela Howell, Director (Arrived during Inspection)
2 10 PRESCHOOL Grace Fisher & Diamond Whitworth, Caregivers 10 - 4 & 5 Year Olds

Compliance List
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Adelynn Darwin 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
Return Inspection

Compliance Date

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 the cord for the Projector in the Pre-K Room was not attached to the wall.
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

Violation
The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that two outlets in the Pre-K Room was not covered, specifically under the front window near the Cubby/Table Area.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.
Correction Required
The facility shall use outlet covers or twist-lock outlets as required.

Correction Verification
Corrected on Site

Compliance Date
4/9/2026
Violation
The floors located between the Hallway Area & Two's & Three's Room, specifically the top stair was/were not in good condition as evidenced by the metal trim piece was cracked & sticking out.
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

Violation
There was evidence of dirt/debris in the return air vents throughout the building.
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

Violation
The use of potty chairs/junior commode/adaptor seat did not meet requirements as evidenced by the potty chair was not cleaned.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (C) 2. states: One (1) potty chair, junior commode or toilet with an adapter seat shall be provided for every four (4) children being toilet trained. Potty chairs shall be located in the bathroom and shall be emptied, cleaned and disinfected after each use.
Correction Required
The facility shall provide, clean, and disinfect potty training equipment as required.

Correction Verification
Corrected on Site

Compliance Date
4/9/2026
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 the gate from the Pre-K playground to the grassy area was not functioning properly. The gate can easily be pushed open.
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

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 not secure at the top in two areas. This was located in the grassy area. One section was near the double gate and the other section was located in the back-right 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
Return Inspection

Compliance Date

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 39 inches. This section of fence was located on the far-left of the dividing fence.
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
10/22/2025
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. This gap was located between the dividing fence post and the post for the storage area.
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

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 33 inches. This section of fence was located near the storage area.
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
10/22/2025
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 the fence was not secure at the top. On the I/T playground, this was located to the right of the gate.
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

Violation
The facility's outdoor space was not safe for children's activities as evidenced by the metal screen covering a 15x6 opening was not secure.
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
10/22/2025
Violation
The facility's outdoor space was not safe for children's activities as evidenced by wood siding located on the exterior of the building was splintered in various areas.
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

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

Violation
The premises were not safe and suitable as evidenced by the TV in the Two's & Three's Room was not secured to the shelf.
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

Violation
The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that one outlet in the Two's & Three's Room was not covered, specifically under the side window.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.
Correction Required
The facility shall use outlet covers or twist-lock outlets as required.

Correction Verification
Corrected on Site

Compliance Date
4/9/2026
Violation
There was evidence of dirt/debris in the ceiling fans throughout the building.
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

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 the fence was wobbly & could be easily moved back & forth, specifically at the 2nd & 3rd panels from the back left corner of the fence that divides the Preschool Playground & the Grassy Area.
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

5 CSR 25-500.087 Fire Safety
Compliance
5 CSR 25-500.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
The facility's disaster and emergency plan was not available in the office.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster and emergency plan is readily available in the office area and in each room used for care of children;
Correction Required
The facilities disaster and emergency plan must be available in required locations.

Correction Verification
Return Inspection

Compliance Date

Violation
The facility’s name, address and telephone number was not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. A. states: The name, address, and telephone number of the facility;
Correction Required
Facility must post information as required.

Correction Verification
Return Inspection

Compliance Date

Violation
The facility's list of emergency numbers are not posted in each room used for child care, specifically they were not available in any room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;
Correction Required
The facility must post all emergency numbers as required.

Correction Verification
Return Inspection

Compliance Date

Violation
The facility’s name and phone number of the owner’s principal place of business was not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. C. states: When a facility operates at more than one (1) site, the name and telephone number of the facility's principal place of business;
Correction Required
Facility must post information as required.

Correction Verification
Return Inspection

Compliance Date

Violation
The facility’s name and phone number of the building’s owner/manager was not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. D. states: When a facility occupies space it does not own, the name and telephone number of the owner of the building or the building manager;
Correction Required
Facility must post information as required.

Correction Verification
Return Inspection

Compliance Date

Violation
The facility's evacuation route diagram was not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 2. states: A diagram of evacuation routes from the room;
Correction Required
Facility must post information as required.

Correction Verification
Return Inspection

Compliance Date

Violation
The facility's special instructions for infants and non-ambulatory children were not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 3. states: Any special instructions for infants and non-ambulatory children;
Correction Required
Facility must post information as required.

Correction Verification
Return Inspection

Compliance Date

Violation
The facility's disaster and emergency plan was not available in each room used for childcare as evidenced by the plan was not available.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster and emergency plan is readily available in the office area and in each room used for care of children;
Correction Required
The facilities disaster and emergency plan must be available in required locations.

Correction Verification
Return Inspection

Compliance Date

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
Corrected on Site

Compliance Date
4/9/2026
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: Breanna Brugger.
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
Return Inspection

Compliance Date

Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2024, the staff listed need the following information: Darren McIntosh needs one hour.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date
4/9/2026
Violation
The director is not routinely on duty, as evidenced by attendance records only show an average of 30 hours per week.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.
Correction Required
The director/group home provider shall be routinely on duty, as required.

Correction Verification
Return Inspection

Compliance Date

Violation
Adelynn Darwin 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
Return Inspection

Compliance Date

5 CSR 25-500.112 Staff/Child Ratios
Violation
 Provider Comments
Violation
Staff/child ratio requirements were not met as evidenced by 9 children , ages 9 -23 Months Old & 2-Years-Old, were cared for by 2 adult caregiver(s).
Licensing Rule Reference
5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: The staff/child ratio and group size shall be followed as outlined in the below chart unless it meets an exception in subparagraphs (1)(B)-(G) below: Infants, toddlers, and 2-year-olds shall have one caregiver for every four children with no more than eight children per group; Groups composed solely of children 24 to 36 months shall have one caregiver for every eight children with no more than 16 children per group; Groups composed solely of children 3 to 4 years shall have one caregiver for every 10 children with no more than 20 children per group; Groups composed solely of children 5 years or older shall have one caregiver for every 16 children with no more than 32 children per group; A mixed group of children consisting of no more than four children age 2 years, and at least one child older than 3 years shall have one caregiver for every 10 children with no more than 20 children per group; A mixed group of children consisting of more than four children ages 24 to 36 months, and at least one child older than 36 months shall have one caregiver for every eight children with no more than 16 children per group.
Correction Required
Staff/child ratios and group sizes shall be maintained at all times.

Correction Verification
Corrected on Site

Compliance Date
4/9/2026
Violation
Group size requirements were not met as evidenced by 9 children, ages 9 -23 Months Old & 2-Years-Old, were cared for by 2 adult caregiver(s).
Licensing Rule Reference
5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: The staff/child ratio and group size shall be followed as outlined in the below chart unless it meets an exception in subparagraphs (1)(B)-(G) below: Infants, toddlers, and 2-year-olds shall have one caregiver for every four children with no more than eight children per group; Groups composed solely of children 24 to 36 months shall have one caregiver for every eight children with no more than 16 children per group; Groups composed solely of children 3 to 4 years shall have one caregiver for every 10 children with no more than 20 children per group; Groups composed solely of children 5 years or older shall have one caregiver for every 16 children with no more than 32 children per group; A mixed group of children consisting of no more than four children age 2 years, and at least one child older than 3 years shall have one caregiver for every 10 children with no more than 20 children per group; A mixed group of children consisting of more than four children ages 24 to 36 months, and at least one child older than 36 months shall have one caregiver for every eight children with no more than 16 children per group.
Correction Required
Staff/child ratios and group sizes shall be maintained at all times.

Correction Verification
Corrected on Site

Compliance Date
4/9/2026
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Nora Austin, Adelynn Darwin & Diamond Whitworth 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

Violation
The medical examination report on file for Breanna Brugger was older than 12 months before the individual's begin date at the facility.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (C) states: Medical examination reports shall be completed not more than twelve (12) months prior to beginning work in the facility and may be transferable to another child care facility for subsequent employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Return Inspection

Compliance Date

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: Nora Austin, Adelynn Darwin & Diamond Whitworth.
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
Return Inspection

Compliance Date

Violation
A medical examination report included either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) which was completed more than 12 months before beginning work in the facility for the following staff: Breanna Brugger.
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
Return Inspection

Compliance Date

5 CSR 25-500.132 Admission Policies and Procedures
Compliance
5 CSR 25-500.142 Nighttime Care
Compliance
5 CSR 25-500.162 Overlap Care of Children
Compliance
5 CSR 25-500.172 Emergency School Closings
Compliance
5 CSR 25-500.182 Child Care Program
Compliance
5 CSR 25-500.192 Health Care
Compliance
5 CSR 25-500.202 Nutrition and Food Service
Compliance
5 CSR 25-500.212 Transportation and Field Trips
Violation
 Provider Comments
Violation
The driver of a vehicle used to transport children was not qualified as evidenced by Michaela Howell did not have a valid driver's license (Class E or CDL).
Licensing Rule Reference
5 CSR 25-500.212 Transportation and Field Trips (2) (A) states: The driver of any vehicle used to transport children shall be no less than eighteen (18) years of age and shall have a valid driver's license as required by Missouri law.
Correction Required
The driver of any vehicle used to transport children shall meet age and licensing requirements.

Correction Verification
Return Inspection

Compliance Date

5 CSR 25-500.222 Records and Reports
Compliance
5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Nora Austin, Adelynn Darwin & Diamond Whitworth.
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

5 CSR 25-600.040 Background Screening Findings
Compliance
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
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance