5 CSR 25-500.082 · 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.

The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by an electrical plate was missing in that there was no outlet plate in Toddler B room.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Toddler B was/were not in good condition as evidenced by adhesive residue.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Twos room was/were not in good condition as evidenced by hole in wall.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located in PreK was/were not in good condition as evidenced by molding is separating from the wall.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located on outside playground was/were not in good condition as evidenced by molding pulling off from wall.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Preschool bathroom was/were not in good condition as evidenced by rust on door frame.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The facility's outdoor space was not safe for children's activities as evidenced by weeds growing along the fence.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Furniture/equipment, trash can, in Prek was not in good condition as evidenced by dirt or food residue.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Furniture/equipment, vanities , in the preschool bathroom and twos bathroom was not in good condition as evidenced by covering peeling exposing particle board.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by shelves were closed and turned to the wall in Pre K.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by Shelf in Toddler B has laminate chipping exposing particle board..

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by stool in Preschool bathroom was dirty..

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.

Children were not restricted to approved space as evidenced by closet door in Toddler A was standing open.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

The annual fire safety inspection was not approved.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (B) states: The premises shall conform to the fire and safety requirements of the State Fire Marshal or his/her designee and requirements for state or local zoning, building and sanitation.

The facility has not met the requirements for fire and safety as evidenced by there is not an approved fire inspection.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by an electrical plate was missing in that there was no outlet plate in Toddler B room.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: all purpose cleaner and disinfecting wipes. The item(s) was/were located in unlocked vanity in Twos bathroom.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located in Toddler A was/were not in good condition as evidenced by chipping paint.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The facility's outdoor space was not safe for children's activities as evidenced by weeds growing along the fence.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Toddler B was/were not in good condition as evidenced by chipping paint on outside door frame.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Toddler B was/were not in good condition as evidenced by adhesive residue.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Twos was/were not in good condition as evidenced by chipped paint on door frame.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Twos room was/were not in good condition as evidenced by hole in wall.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located in PreK was/were not in good condition as evidenced by molding is separating from the wall.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located on outside playground was/were not in good condition as evidenced by molding pulling off from wall.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Preschool bathroom was/were not in good condition as evidenced by rust on door frame.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: Adult scissors. The item(s) was/were located on teachers desk in the Preschool room..

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: Cough and Cold medicine. The item(s) was/were located on cubbies in Preschool room..

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: Sunscreen, hand sanitizer, screwdriver, deodorant, packing tape dispenser with cutting edge, paper cutter, and adult scissors. The item(s) was/were located in shelves behind teacher's desk and on top of cubbies, and under the sink.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Toddler and Twos was/were not in good condition as evidenced by doors have chipped paint.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Furniture/equipment, vanities , in the preschool bathroom and twos bathroom was not in good condition as evidenced by covering peeling exposing particle board.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by yellow chairs in twos and Pre K were not clean.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Outdoor equipment, Little Tykes car, in playground was not in good condition as evidenced by cracked roof support.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by Shelf in Toddler B has laminate chipping exposing particle board..

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by rugs and cushions in Toddler B were dirty..

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by blue table in Infant A has chipping paint.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by upholstered bench in Twos room was soiled.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by stool in Preschool bathroom was dirty..

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Furniture/equipment, trash can, in Prek was not in good condition as evidenced by dirt or food residue.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by shelves were closed and turned to the wall in Pre K.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by orange cushion has a hole in covering.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 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.

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: Diana Jones.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.222 · 5 CSR 25-500.222 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;

One child(ren) records did not include work schedule of parent(s), guardian or legal custodian.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.222 · 5 CSR 25-500.222 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;

One child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located in Preschool under windows was/were not in good condition as evidenced by chipping paint.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Pre K girls bathroom was/were not in good condition as evidenced by molding pulling away from the wall.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located in Preschool was/were not in good condition as evidenced by jagged edge on molding.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The facility's outdoor space was not safe for children's activities as evidenced by wooden boards were sticking up next to the fence causing a tripping hazard.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 7. states: Bathrooms shall be clean and odor free.

The bathroom was not clean and odor free as evidenced by urine and/or excrement odor was detected.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: Hand soap. The item(s) was/were located in unlocked sink cabinet in Younger Infant room.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located in Preschool was/were not in good condition as evidenced by jagged edge on molding.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The facility's outdoor space was not safe for children's activities as evidenced by wooden boards were sticking up next to the fence causing a tripping hazard.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located in Preschool under windows was/were not in good condition as evidenced by chipping paint.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 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.

The walls located Pre K girls bathroom was/were not in good condition as evidenced by molding pulling away from the wall.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: Sunscreen. The item(s) was/were located in unlocked cabinet under sink in two year old room.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.087 · 5 CSR 25-500.087 Fire Safety (2) (F) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.

Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by the date of the drill was not recorded.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. D. states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used. Only fitted sheet shall be used and shall be changed immediately when soiled or wet.

Requirements for the crib mattress/playpen padding/bedding were not met as evidenced by a fitted sheet was not used.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Outdoor equipment, little tykes car, in younger playground was not in good condition as evidenced by bar support for roof was missing.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Outdoor equipment, child sized chair, in younger playground was not in good condition as evidenced by torn vinyl on the seat and instructions were hanging down from underneath the seat.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 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.

The Family Care Safety Registry check was not conducted for Brooklyn Warnes within thirty (30) days prior to the anniversary date.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Furniture/equipment, Sink vanity, in toddler 2 was not in good condition as evidenced by door is loose at the hinge causing it to hang unevenly.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Furniture/equipment, Yellow chairs, in Early Preschool was not in good condition as evidenced by dirt on chairs.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Outdoor equipment, Little Tykes car, in playground was not in good condition as evidenced by hole in roof support with jagged edges.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 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.

Maurina Clark did not complete safe sleep training within 30 days of employment or volunteering at the facility.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (4) (A) . states: Every three (3) years, the child care provider, group child care home provider, child care staff members, and volunteers in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs/deseadministrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Safe sleep training was not completed within the past 3 years for the following staff Madison Hill.

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5 CSR 25-500.112 · 5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: Birth Through Two (2) Years. Groups composed of mixed ages through two (2)- years shall have no less than one (1) adult to four (4) children, with no more than eight (8) children in a group;

Staff/child ratio requirements were not met as evidenced by Eight children, ages 1 , were cared for by one caregiver(s).

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5 CSR 25-500.122 · 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.

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: Ayla Bausch.

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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 Maurina Clark.

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5 CSR 25-500.052 · 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.

The Family Care Safety Registry check was not conducted for Brooklyn Warnes within thirty (30) days prior to the anniversary date.

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5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.

Children were not restricted to approved space as evidenced by Hall closet standing open.

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5 CSR 25-500.082 · 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.

The walls located in the toddler room was/were not in good condition as evidenced by adhesive on door.

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5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 4. states: Paper towels, soap and toilet paper shall be provided and easily accessible so the children can reach them without assistance.

Bathroom supplies were not available and accessible to children as evidenced by there were no paper towels.

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5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Furniture/equipment, Yellow chairs, in Early Preschool was not in good condition as evidenced by dirt on chairs.

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5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Outdoor equipment, pink bike, in younger playground was not in good condition as evidenced by basket on back had cracked leaving sharp edges.

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5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Outdoor equipment, Little Tykes car, in playground was not in good condition as evidenced by hole in roof support with jagged edges.

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5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Furniture/equipment, Sink vanity, in toddler 2 was not in good condition as evidenced by door is loose at the hinge causing it to hang unevenly.

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5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Furniture/equipment, wooden cubbies, in Preschool was not in good condition as evidenced by adhesive residue on the front of individual cubbies.

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5 CSR 25-500.102 · 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.

Maurina Clark did not complete safe sleep training within 30 days of employment or volunteering at the facility.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (4) (A) . states: Every three (3) years, the child care provider, group child care home provider, child care staff members, and volunteers in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs/deseadministrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Safe sleep training was not completed within the past 3 years for the following staff Madison Hill.

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5 CSR 25-500.112 · 5 CSR 25-500.112 Staff/Child Ratios (1) (C) states: Ages Three Through Four (3 - 4) Years. Groups composed solely of three (3)- and four (4)-year olds shall have no less than one (1) adult to ten (10) children;

Staff/child ratio requirements were not met as evidenced by 23 children, ages 11 four year olds and 12 five years and up, were cared for by two caregiver(s).

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5 CSR 25-500.112 · 5 CSR 25-500.112 Staff/Child Ratios (2) states: If a center has an attendance of more than fifty (50) children, the center director or individual in charge shall not be included in staff/child ratios except during naptime or on an emergency substitute basis.

More than 50 children were observed in care and the director/individual in charge was included in the staff/child ratios; this occurred outside of naptime and there was no emergency.

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5 CSR 25-500.122 · 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.

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: Ayla Bausch.

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5 CSR 25-500.222 · 5 CSR 25-500.222 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;

One child(ren) records did not include home telephone number of parent(s), guardian or legal custodian.

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5 CSR 25-500.222 · 5 CSR 25-500.222 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;

Two child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.

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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 Maurina Clark.

Open Not marked corrected in the state record

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5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.

Children were not restricted to approved space as evidenced by the infant room closet was not closed and inside closet were exposed pipes.

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5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.

Children were not restricted to approved space as evidenced by the staff room door and kitchen door was standing open.

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5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: detergent. The item(s) was/were located in supply closet with the door open.

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5 CSR 25-500.082 · 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.

The walls located in the toddler room was/were not in good condition as evidenced by adhesive on door.

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5 CSR 25-500.082 · 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.

The walls located in Pre K bathrooms was/were not clean as evidenced by dirt by light switch in both bathrooms.

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5 CSR 25-500.082 · 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.

The walls located in the preschool room was/were not in good condition as evidenced by wall trim coming off wall and by the baseboard.

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5 CSR 25-500.082 · 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.

The walls located in toddler room was/were not clean as evidenced by dirt on the door to outside.

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5 CSR 25-500.082 · 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.

The walls located in infant room was/were not in good condition as evidenced by adhesive residue on half wall.

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5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by rug in 2's room was dirty.

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5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by the cubbies in Preschool had adhesive residue.

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5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (A) 1. states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.

The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by in the toddler room there was adhesive residue on the changing table.

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