5 CSR 25-400.086 · 5 CSR 25-400.086 Fire Safety (11) (B) states: Protective covers or inserts for electrical receptacles shall be installed in all areas occupied by children.

The requirements for protective outlet covers were not met as evidenced by 4 outlets did not have protective covers.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.095 · 5 CSR 25-400.095 Furniture, Equipment and Materials (1) (B) 1 E states: Sleeping equipment shall be arranged to provide at least a two-foot (2') aisle on one (1) long side of the equipment.

Arrangement of sleeping equipment was not met as evidenced by no aisle was provided on the long side of napping equipment.

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 (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School), 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.

Requirements for infant-toddler/preschool child medical examination reports on file 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 9-30-2024.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.175 · 5 CSR 25-400.175 Child Care Program (1) (E) 2 states: Diapering supplies and warm, running water shall be adjacent to the diapering area.

Warm, running water was not adjacent to the diapering area.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.175 · 5 CSR 25-400.175 Child Care Program (1) (E) 8 states: The diapering area and hand washing area shall be separate from any food service area and any food-related materials.

Separation requirements of diapering/hand wash areas from food service were not met as evidenced by the diapering table was in the dining room where the children eat and next to the kitchen. Kaili stated that she had been changing diapers on the diaper table in the dining room and using the kitchen sink to wash her hands after diaper changes as it is the only sink within 8 feet.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.185 · 5 CSR 25-400.185 Health Care (3) (B) states: All medication shall be given to a child only with the dated, written permission of the parent(s) stating the length of time the medication may be given.

The requirements for administering medication were not met as follows: medication was available for administering to a child, however there was no written permission on file.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.185 · 5 CSR 25-400.185 Health Care (3) (D) states: All nonprescription medication shall be in the original container and labeled by the parent(s) with the child's name and instructions for administration, including the times and amounts for dosages.

The requirements for nonprescription medications were not met as evidenced by a medication was not labeled by the parent with the child's name.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-400.185 · 5 CSR 25-400.185 Health Care (3) (D) states: All nonprescription medication shall be in the original container and labeled by the parent(s) with the child's name and instructions for administration, including the times and amounts for dosages.

The requirements for nonprescription medications were not met as evidenced by a medication was not labeled by the parent with instructions for administration including times and dosage amounts.

Open Not marked corrected in the state record

Open / not marked corrected.