5 CSR 25-400.175 · 5 CSR 25-400.175 Child Care Program (1) (E) 1 states: A safe diapering table or other approved area with a waterproof, washable surface shall be used for changing diapers. The table or area shall be cleaned thoroughly with a disinfectant after each use.

The diapering table or other approved area was not safe as evidenced by the changing pad was torn exposing the foam stuffing.

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5 CSR 25-600.020 · 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.

Criminal background check results were not on file for Cindy Schlendes. Updated 1/9/25, talked with Bridgette Limbach and was informed that Cindy needs to get her fingerprints run again before the eligible letter will be issued.

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 9. states: Concrete, asphalt, carpet or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.

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 bare soil showing under the swings .

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5 CSR 25-400.105 · 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification.

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5 CSR 25-400.105 · 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (4) (A) states: The provider shall obtain at least twelve (12) clock hours of child care-related training during each calendar year. Any assistant who works or volunteers more than five (5) hours per week shall meet the same training requirements. Clock hour training shall be approved by the department.

The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2023, the staff listed need the following information: Alyssa Hudson needs 5 hours .

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5 CSR 25-400.105 · 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification.

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5 CSR 25-400.185 · 5 CSR 25-400.185 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 adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of 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.

Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file .

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5 CSR 25-600.020 · 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.

Criminal background check results were not on file for Cindy Schlendes.

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5 CSR 25-400.125 · 5 CSR 25-400.125 Medical Examination Reports (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of 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), 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.

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 8-15-22.

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5 CSR 25-400.135 · 5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 2 states: Information regarding a child's personal development, behavior patterns, habits and individual needs.

The facility did not meet requirements for child enrollment and health information as evidenced by 1 child missing enrollment form.

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5 CSR 25-400.135 · 5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 3 states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care.

The facility did not meet requirements for child enrollment and health information as evidenced by 1 child missing enrollment form.

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5 CSR 25-400.055 · 5 CSR 25-400.055 Annual Requirements (1) (B) states: A current list of available equipment.

The equipment list was not submitted.

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5 CSR 25-400.055 · 5 CSR 25-400.055 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.

The Family Care Safety Registry check was not conducted for Alyssa Sloan, Paige Spark , Matt Hudson within thirty (30) days prior to the anniversary date.

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 1. states: An 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. It shall be fenced when necessary for the protection of children from traffic, water or other hazards. For family day care homes 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. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

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 large enough for a child to crawl or fall through - the opening measured 12 inches.

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5 CSR 25-400.105 · 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (4) (A) states: The provider shall obtain at least twelve (12) clock hours of child care-related training during each calendar year. Any assistant who works or volunteers more than five (5) hours per week shall meet the same training requirements. Clock hour training shall be approved by the department.

The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: Alyssa Sloan needs 4 hours .

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5 CSR 25-400.125 · 5 CSR 25-400.125 Medical Examination Reports (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of 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), 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.

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 8-15-22.

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5 CSR 25-400.135 · 5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 A states: They have received a copy of the provider's policies pertaining to the admission, care and discharge of children.

The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider's policies.

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5 CSR 25-400.135 · 5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 B states: They have been informed that the Licensing Rules for Family Day Care Homes in Missouri are available in the home for their review.

The provider did not have parental acknowledgement on file indicating the parent has been informed that Licensing Rules for Family Day Care Homes in Missouri are available for review.

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5 CSR 25-400.135 · 5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 C states: They and the provider have agreed on a plan for continuing communication regarding the child’s development, behavior and individual needs.

The provider did not have parental acknowledgement on file indicating the parent and provider have agreed on a plan for continuing communication.

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5 CSR 25-400.135 · 5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 D states: They understand and agree that the child may not be accepted for care when ill.

The provider did not have parental acknowledgement on file indicating the parent understands and agrees that the child may not be accepted for care when ill.

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5 CSR 25-400.135 · 5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 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

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.

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5 CSR 25-400.185 · 5 CSR 25-400.185 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 adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of 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.

Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file .

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (1) states: The child care provider shall maintain accurate records to meet administrative requirements and to ensure knowledge of the individual needs of children and their families.

The provider failed to maintain accurate records to meet administrative requirements as evidenced by 1 child missing enrollment form.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (A) states: The child’s full name, address, birth date and the date care begins and ends.

1 child(ren) records did not include child's full name, address, date of birth and date care begins and ends.

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5 CSR 25-400.210 · 5 CSR 25-400.210 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.

1 child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached.

1 child(ren) records did not include name, address and telephone number of another individual who might be reached in an emergency.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (D) states: Name and phone number of the family physician, or hospital, or both, to be used in an emergency.

1 child(ren) records did not include name and phone number of the family physician or hospital.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (E) states: Name of the individual(s) authorized to take the child from the home.

1 child(ren) records did not include name of individual authorized to take the child from the home.

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