5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (1) (L) states: The child care provider shall ensure that documentation of caregiver completion of the facility orientation is maintained and on file for review by the department.

Documentation of caregiver completion of the facility orientation was not on file for the following staff: Carson Franz.

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5 CSR 25-500.042 · 5 CSR 25-500.042 Licensing Process (13) (C) states: Board president or chairperson;

The name, address and telephone number of the board president was not prominently posted near the license.

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5 CSR 25-500.042 · 5 CSR 25-500.042 Licensing Process (4) (I) states: Lines of administrative authority;

The lines of administrative authority did not include the required information as evidenced by the facility did not have an updated lines of administrative authority posted near the license.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (3) (C) states: Caregivers who were employed after the first of the year shall obtain one (1) clock of hour training for each one (1) month of employment, regardless of the date employment began.

A caregiver did not obtain one clock hour of training for each month of employment. The staff listed need the following information: Taylor Barnard needs 3 clock hours and Kierstyn Wright needs 3.75 for 2024.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.

The director is not routinely on duty, as evidenced by Evalyn Crawford is listed as the director, but is not routinely on duty.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (2) (A) 1. B. states: Once the center director or group child care home provider is certificated by the department, the Center Director/Group Child Care Home Provider Approval Request form shall be submitted to the department and maintained on file at the facility. See Center Director/Group Child Care Home Provider Approval Request form, revised 2021 and 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.

The facility has not submitted the approval request for proposed director.

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5 CSR 25-500.192 · 5 CSR 25-500.192 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 immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the 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 the vaccination records in child A's file immunization record(s) was/were not on file .

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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 Carson Franz and MacKenzie Barnes.

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5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (1) (C) states: A current list of available equipment.

The equipment list did not contain a list of equipment as required in 5 CSR 25-500.092.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (1) (K) . 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 facility orientation shall include--

A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Taylor Barnard.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. 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: Anne Shotwell needs 12 hours and Kierstyn Wright needs 12 hours.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.

The director is not routinely on duty, as evidenced by Evalyn Crawford is not on duty during the highest attendance at least fifty percent of the operating hours.

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5 CSR 25-500.132 · 5 CSR 25-500.132 Admission Policies and Procedures (3) states: The provider shall have available a copy of the Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri and shall advise the parent(s) at the time of enrollment of his/her child of the availability of the rules for review.

The provider did not have available a copy of the Licensing Rules for Group Day Care Homes and Child Day Care Center of Missouri.

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5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (1) (C) states: A current list of available equipment.

The equipment list did not contain a list of equipment as required in 5 CSR 25-500.092.

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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) (B) 1. F. states: Each child shall be provided individual space, accessible to the child, for storage of each childs' clothing and other personal belongings.

Individual storage space requirements were not met as evidenced by there was no space for each child's belongings.

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5 CSR 25-500.090 · 5 CSR 25-500.090 Disaster and Emergency Preparedness (1) (C) 2. states: Diagrams that identify exit routes from each area of the facility used for child care to a safe location out of the facility and to a safe location within the facility where children and staff members can stay until the threat of danger passes;

The facility's disaster plan did not include exit routes to a safe location out of the facility.

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5 CSR 25-500.090 · 5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;

The facility's list of emergency numbers that are posted do not include the numbers for poison control.

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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, 9 laundry baskets used for the children's belongings, in the hall was not in good condition as evidenced by broken and falling apart.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (1) (K) . 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 facility orientation shall include--

A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Andrew Abbott

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (3) (C) states: Caregivers who were employed after the first of the year shall obtain one (1) clock of hour training for each one (1) month of employment, regardless of the date employment began.

A caregiver did not obtain one clock hour of training for each month of employment. The staff listed need the following information: Kyra Feesler needs 9 hours.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. 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: Anne Shotwell needs 12 hours and Kierstyn Wright needs 12 hours.

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5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.

Medical examination report was not on file for Andrew Abbott, Sophia Rogers, and Kassidy Sayavong 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 25-500.122 · 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 completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: Andrew Abbott, and Sophia Rogers.

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5 CSR 25-500.222 · 5 CSR 25-500.222 Records and Reports (10) states: All records shall be available in the facility for inspection by the department upon request.

Records were not available for inspection by the department upon request as evidenced by current FCSR screenings were sent to CI Donson by email, for the following staff: Andrew Abbott, Evalyn Crawford, Kyra Feesler, Sophia Rogers, Kassidy Sayavong, Anne Shotwell and Kierstyn Wright, however they were unavailable for review.

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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 Andrew Abbott and Anne Shotwell.

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5 CSR 25-500.042 · 5 CSR 25-500.042 Licensing Process (12) states: Once granted, the license shall be posted near the entrance of the facility where it may be seen easily by parents or others who visit.

Posting requirements were not met as evidenced by the license was not posted near the entrance.

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5 CSR 25-500.042 · 5 CSR 25-500.042 Licensing Process (13) (A) states: The child care provider(s);

The name, address and telephone number of the child care provider(s) was not prominently posted near the license.

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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 completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: LynnLee Shepherd.

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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 Kierstyn Wright.

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