5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (3) states: Child care facilities shall meet immunization requirements for children as defined by section 210.003, RSMo.

Requirements for immunization reports on file were not met as evidenced by an immunization record was not on file the first day a child attended and there was no exemption on file.

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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 Heather Clark.

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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 Sandra Swon 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 25-300.050 · 5 CSR 25-300.050 Health Requirements (2) states: Within thirty (30) days following the admission of an infant, toddler or preschool child, a physical assessment report signed by a licensed physician or registered professional nurse shall be on file at the facility. The facility may use the department's physical assessment form, MO 580-1878 (6-94), or the facility may use its own form if it contains all the information on the department's form. The report shall have been completed not more than twelve (12) months before admission.

Requirements for children's medical examination reports 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 7-5-2022 and 1-5-2023.

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 1 (F) states: Walls, ceilings, floors and equipment shall be finished with materials that can be cleaned easily and shall be free of splinters, cracks and chipped paint. Floor covering shall be in good condition. The facility shall be free of all lead hazards and asbestos that is friable or dangerous.

The walls located in the infant area was/were not in good condition as evidenced by there was peeling paint on the corner of the wall.

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5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (A) states: The child's full name, address, birth date and the date care begins and ends.

The facility did not meet requirements for child enrollment and health information on file as evidenced by one child files did not have the child’s full name, address, birth date and the date care begins and ends.

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5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (B) states: The full name of the parent(s), guardian or legal custodian, home address, work schedule, home and work telephone numbers, and employer's name and address.

The facility did not meet requirements for child enrollment and health information on file as evidenced by one child files did not have the full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.

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5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (C) states: Full name, address and phone number of a friend or relative who might be reached in an emergency when a parent, guardian or legal custodian cannot be reached.

The facility did not meet requirements for child enrollment and health information on file as evidenced by one child files did not have the name, address and telephone number of another individual (friend or relative) who might be reached in an emergency.

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5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (D) states: Name and phone number of a physician and preferred hospital to be used in an emergency.

The facility did not meet requirements for child enrollment and health information on file as evidenced by one child files did not have the name and phone number of the family physician, or hospital, or both.

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5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (E) states: The name of the individual(s) authorized to take the child from the premises.

The facility did not meet requirements for child enrollment and health information on file as evidenced by one child files did not have the name of the individual(s) authorized to take the child.

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5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (F) states: Information concerning any accident or injury to a child while in care or any emergency medical care given.

The facility did not meet requirements for child enrollment and health information on file as evidenced by one child files did not have the information concerning any accident or injury to a child while in care or any emergency medical care given.

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