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 Jenny Benton, Robin Wilken and Anda Reidt.

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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 Katey Parmentier and Taylor Page 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 9-23-2024.

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5 CSR 25-300.070 · 5 CSR 25-300.070 Fire Safety Requirements (5) states: Fire and tornado drills shall be conducted at least every three (3) months and shall include all children in care. Unscheduled drills shall be held at the discretion of the state fire marshal or department. Each fire drill shall include a complete evacuation of all persons from the building.

Requirements of 19 CSR 30-60.080 Fire Safety were not met as evidenced by fire drills were not held at least one time every three months.

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5 CSR 25-300.070 · 5 CSR 25-300.070 Fire Safety Requirements (5) states: Fire and tornado drills shall be conducted at least every three (3) months and shall include all children in care. Unscheduled drills shall be held at the discretion of the state fire marshal or department. Each fire drill shall include a complete evacuation of all persons from the building.

Requirements of 19 CSR 30-60.080 Fire Safety were not met as evidenced by tornado drills were not held at least one time every three months.

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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 an admission date was needed for 2 children, 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 2 children still need parents work addresses, 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 1 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 2 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 (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 1 child did not have dads work address, 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 (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 3 children still need parents work telephone numbers, 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 25-300.040 · 5 CSR 25-300.040 Staffing Requirements (8) states: Background screening information received by the provider shall be retained in the individual’s file in a confidential manner and made available for review when requested by the department.

Background screening information received by the provider was not available for review as evidenced by Michelle Homeyer did not have a Family Care Safety Registry on file but does have one that was conducted.

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5 CSR 25-300.040 · 5 CSR 25-300.040 Staffing Requirements (2) states: All caregivers shall review the rules of this chapter.

A caregiver has not reviewed the rules of this chapter as evidenced by Zaylee Duncan did not have a statement stating that the License Exempt rules have been read and understood nor reviewed.

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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 Lindsey Duncan.

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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: Sanitation wipes. The item(s) was/were located in the blue room in a teachers desk in a unlocked drawer accessible to children and low to the ground.

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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 floors located in the gymnasium was/were not in good condition as evidenced by there was a piece of flooring missing near the exit door to the main playground.

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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 floors located in the gymnasium was/were not easily cleanable as evidenced by the flooring appeared to be rigid and not smooth. Upon closer inspection tape was on the floor in the place of where tile was needed to the left of the exit door to the main playground.

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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 4 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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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 fire safety inspection were not met as evidenced by the inspection has not been conducted.

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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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