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 Michelle, Foderberg, Emma Foderberg, and Debbie Harvey.

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5 CSR 25-400.095 · 5 CSR 25-400.095 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, large climber, in backyard was not in good condition as evidenced by rotting board and loose/exposed screws.

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5 CSR 25-400.055 · 5 CSR 25-400.055 Annual Requirements (1) (B) states: A current list of available equipment.

The equipment list was not submitted.

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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 Michelle Foderberg, Debbie Harvey, and Emma Foderberg within thirty (30) days prior to the anniversary date.

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 9. states: The home shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.

There was evidence of dirt/debris in that high chair covers soiled.

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (4) (D) states: Areas used by children shall be free of animal excrement.

Animal excrement was observed in an outdoor area used by children; the location of the excrement was in backyard.

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5 CSR 25-400.105 · 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification.

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5 CSR 25-400.105 · 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.

The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification.

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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 2024, the staff listed need the following information: Michelle needs-12 hours.

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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 Michelle, Foderberg, Emma Foderberg, and Debbie Harvey.

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 6. states: The fall-zone area under and around outdoor equipment where children might fall and be injured shall be covered with impact absorbing materials which effectively cushions the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material. Grass may be an approved resilient material, but if grass becomes worn or sparse, the area must be covered with another approved resilient material.

The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by no resilient material was present.

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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: Michell missing-3.75 hours.

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5 CSR 25-400.055 · 5 CSR 25-400.055 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

The annual sanitation inspection was not conducted.

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (4) (D) states: Areas used by children shall be free of animal excrement.

Animal excrement was observed in an outdoor area used by children; the location of the excrement was near playground equipment.

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 1. states: An outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water or other hazards. For family day care homes initially licensed after the effective date of these rules, or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that Broken boards and Stain peeling .

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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 Michelle Foderberg and Debbie Harvey within thirty (30) days prior to the anniversary date.

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 1. states: An outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water or other hazards. For family day care homes initially licensed after the effective date of these rules, or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence had openings that were between 3.5 and 9 inches and allow entrapment - the openings measured 3.5 inches.

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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 missing outlet covers.

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5 CSR 25-400.095 · 5 CSR 25-400.095 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, highchairs, in dining area was not in good condition as evidenced by soiled covers.

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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: Michell missing-3.75 hours.

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5 CSR 25-400.105 · 5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) (A) . states: Every three (3) years the provider, assistant(s), and volunteers in a family child care home 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 dese-administrativerules/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 assistant(s), Debbie Harvey.

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5 CSR 25-400.175 · 5 CSR 25-400.175 Child Care Program (1) (E) 1 states: A safe diapering table or other approved area with a waterproof, washable surface shall be used for changing diapers. The table or area shall be cleaned thoroughly with a disinfectant after each use.

The diapering table or other approved area did not have a waterproof surface.

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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 missing outlet covers.

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5 CSR 25-400.090 · 5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster emergency plan is readily available in the office area and in each room used for care of children.

The facility's disaster and emergency plan was not available in each room used for child care as evidenced by emergency plan not in main area.

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5 CSR 25-400.090 · 5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (B) 1. A. states: The name, address, and telephone number of the facility.

The facility's name, address and telephone number was not posted in each room used for child care.

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5 CSR 25-400.090 · 5 CSR 25-400.090 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 are not posted in each room used for child care, specifically main area.

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5 CSR 25-400.090 · 5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (B) 2. states: A diagram of evacuation routes from the room.

The facility's evacuation route diagram was not posted in each room used for child care.

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5 CSR 25-400.090 · 5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (B) 3. states: Any special instructions for infants and non-ambulatory children.

The facility's special instructions for infants and non-ambulatory children were not posted in each room used for child care.

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