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 no Infant/Toddler Feeding and Care plan was on file for Child B.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.025 · 5 CSR 25-400.025 Organization and Administration (2) states: If a family child care home is owned by a legal entity, the legal entity shall designate a person to be responsible for the daily operation of the facility and to meet the requirements of the child care provider. The department shall be notified in writing immediately if there is a change of the person designated to be responsible for the daily operation of the facility and to meet the requirements of the child care provider.

The family child care home is owned by a legal entity and did not designate a person to be responsible for the daily operation of the facility and to meet the requirements of the child care provider .

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.025 · 5 CSR 25-400.025 Organization and Administration (2) states: If a family child care home is owned by a legal entity, the legal entity shall designate a person to be responsible for the daily operation of the facility and to meet the requirements of the child care provider. The department shall be notified in writing immediately if there is a change of the person designated to be responsible for the daily operation of the facility and to meet the requirements of the child care provider.

The family child care home is owned by a legal entity and did not immediately notify the department in writing of a change in the person designated to be responsible for the daily operation of the facility.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.105 · 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (J) . 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 child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:

A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Emily Hammond.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.105 · 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

The provider did not conduct a Family Care Safety Registry screening for Emily Hammond, who was hired on 06/28/2024.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.125 · 5 CSR 25-400.125 Medical Examination Reports (1) (E) . 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.

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: Emily Hammond.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.125 · 5 CSR 25-400.125 Medical Examination Reports (1) (G) states: The medical examination report form shall be supplied by the department or the provider may use his/her own form if it contains all the information on the department's form. The Medical Examination Report for Caregivers and Staff 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.

Medical examination report did not contain all required information as evidenced by Emily Hammond did not have a medical examination report on file at the facility.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.135 · 5 CSR 25-400.135 Admission Policies and Procedures (4) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.

An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not from a qualified professional source.

Open Not marked corrected in the state record

Open / not marked corrected.

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 required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for Child B child(ren).

Open Not marked corrected in the state record

Open / not marked corrected.

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 Emily Hammond.

Open Not marked corrected in the state record

Open / not marked corrected.

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: Lillie Liebhart needs 3 approved clock hours.

Open Not marked corrected in the state record

Open / not marked corrected.

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 Gracee Gooding, start date 02/27/2024.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.025 · 5 CSR 25-400.025 Organization and Administration (2) states: If a family child care home is owned by a legal entity, the legal entity shall designate a person to be responsible for the daily operation of the facility and to meet the requirements of the child care provider. The department shall be notified in writing immediately if there is a change of the person designated to be responsible for the daily operation of the facility and to meet the requirements of the child care provider.

The family child care home is owned by a legal entity and did not designate a person to be responsible for the daily operation of the facility and to meet the requirements of the child care provider .

Open Not marked corrected in the state record

Open / not marked corrected.

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 Jackie Nichols, Megan Barte, Amanda Smith and Lillie Liebhart. within thirty (30) days prior to the anniversary date.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 4. states: Artificial or natural lighting shall supply at least ten (10) foot candles of light throughout each room used for child care.

Lighting requirements for rooms used by children were not met as evidenced by lighting was insufficient to observe and supervise children in the main room where children were napping, all lights were turned off, the windows and doors were completely covered and did not provide enough light to observe and supervise sleeping children in their cribs at the back right hand section of the facility close to the stairs.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.105 · 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.

The provider did not conduct a Family Care Safety Registry screening for Gracee Gooding, who was hired on 02/27/2024.

Open Not marked corrected in the state record

Open / not marked corrected.

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: Lillie Liebhart needs 3 approved clock hours.

Open Not marked corrected in the state record

Open / not marked corrected.

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 Gracee Gooding, start date 02/27/2024.

Open Not marked corrected in the state record

Open / not marked corrected.