First Presbyterian Preschool

5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) . states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.

Medical examination reports, including TB testing, were not on file for Julie Pelz, Tara Warfield, and Michelle Knipple as evidenced by a cleared TB report was not on file for caregivers within 30 days of working in the facility.

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5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) . states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.

Medical examination reports, including TB testing, were not on file for Rachel Jones as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 1 (D) states: Hazardous materials such as cleaning supplies, poisonous materials, medicines, alcoholic beverages or hazardous personal care items shall be inaccessible to children and stored to prevent cross-contamination of food and food-related materials.

Hazardous items as follows were accessible to children: pepper spray. The item(s) was/were located in all three preschool classrooms.

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5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 1 states: The facility director shall have an admitting procedure for each child in care that includes a plan for caring for the child if s/he becomes ill or needs emergency medical treatment. The director shall maintain an individual file on each child in order to communicate with the parent(s), guardian or legal custodian. The director shall have a plan for any child with special health needs, identified through a physical assessment by a licensed physician or an advance practice nurse, to ensure that those needs are met during care.

The facility's admitting procedure did not include an individualized special care plan for a child with special needs to ensure that those needs were being met as evidenced by two children's files did not have individualized plan for specialized care form.

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5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) 3. states: After the initial physical assessment, all caregivers working in a facility during child care hours shall be tested for tuberculosis at least every two (2) years. Caregivers with previously positive tuberculin tests shall be under the management of a physician.

TB reports on file were older than 24 months for Mishay Westfall.

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RSMo 252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. 1. states: All buildings and premises used by a child-care facility to care for more than six children except those exempted from the licensing provisions of the department of elementary and secondary education pursuant to subdivisions (1) to (15) of subsection 1 of section 210.211, shall be inspected annually for fire and safety by the state fire marshal, the marshal's designee or officials of a local fire district and for health and sanitation by the department of elementary and secondary education or the department's designee, including officials of the department of health and senior services, or officials of the local health department. Evidence of compliance with the inspections required by this section shall be kept on file and available to parents of children enrolling in the child-care facility.

Requirements for sanitation inspection were not met as evidenced by the inspection has not been conducted.

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