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 Joan Skare, Makeala Scott, Laura Swenson, and Erin Tieman as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Open Not marked corrected in the state record

Open / not marked corrected.

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 Makeala Scott, Laura Swenson, and Erin Tieman as evidenced by a cleared TB report was not on file for caregivers within 30 days of working in the facility.

Open Not marked corrected in the state record

Open / not marked corrected.

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: purse. The item(s) was/were located in an unlocked cabinet.

Open Not marked corrected in the state record

Open / not marked corrected.

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 hallway was/were not easily cleanable as evidenced by tape residue/labels peeling off.

Open Not marked corrected in the state record

Open / not marked corrected.

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 walls located in rooms 2 and 4 was/were not easily cleanable as evidenced by sticky/tape residue on cabinets.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 4 (A) states: S/he has been informed of the required health and safety inspections and that the inspection forms are available for review.

The facility did not meet requirements for child enrollment and health information on file as evidenced by no acknowledgements on file for child DOB: 5/30/2019.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 4 (B) states: S/he understands and agrees that the child may not be accepted for care when ill.

The facility did not meet requirements for child enrollment and health information on file as evidenced by no acknowledgements on file for child DOB: 5/30/2019.

Open Not marked corrected in the state record

Open / not marked corrected.

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 was not approved.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.020 · 5 CSR 25-300.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures (6) (C) states: A child care facility operated by a religious organization shall provide the parent or guardian enrolling the child two (2) copies of the Notice of Parental Responsibility form for the enrolling parent to acknowledge, by signature, having read and accepted the information. One (1) copy shall be kept by the parent or guardian and the other copy shall be retained in the child's record at the facility.

An approved Notice of Parental Responsibility was not on file for 2 child(ren).

Open Not marked corrected in the state record

Open / not marked corrected.

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 Amanda Haesemeier and Donna Pittsenbarger as evidenced by a cleared TB report was not on file for caregivers within 30 days of working in the facility.

Open Not marked corrected in the state record

Open / not marked corrected.

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 Victoria Geary, Kendra Lowe, Amy Schasteen, Donna Pittsenbarger, and Stephanie Stapleton as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Open Not marked corrected in the state record

Open / not marked corrected.

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 1/3/2024, 8/29/2023, 8/30/2023.

Open Not marked corrected in the state record

Open / not marked corrected.

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 ceilings located Mr. Lowe's and Mrs. Green's rooms was/were not in good condition as evidenced by dusty/broken vent covers, stained tiles.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 5 (C) states: Sleeping equipment arranged to provide at least a two foot (2') aisle on one (1) long side of the equipment.

Sleeping equipment was not arranged to provide required spacing as evidenced by the aisle on the long side of the napping equipment was too narrow - the space measured 0".

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 5 (A) states: An individual mat, cot or bed with an individually assigned sheet and blanket provided for each child who naps or sleeps. Upper levels of bunk beds shall not be used. If mats are used they shall have nonabsorbent, cleanable coverings and shall not be placed directly on concrete, linoleum, hardwood, or tile floors when children are resting or napping. They shall be used only over carpeting and shall be long enough so the child's head or feet do not rest off the mat. Mats shall be washed and sanitized at least weekly, or more often as needed, and shall be cleaned and sanitized before use by another child.

The facility failed to meet requirements for 3 children, who nap or sleep, did not have a sheet.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 1 states: The facility director shall have an admitting procedure for each child in care that includes a plan for caring for the child if s/he becomes ill or needs emergency medical treatment. The director shall maintain an individual file on each child in order to communicate with the parent(s), guardian or legal custodian. The director shall have a plan for any child with special health needs, identified through a physical assessment by a licensed physician or an advance practice nurse, to ensure that those needs are met during care.

The facility's admitting procedure did not include an individualized special care plan for a child with special needs.

Open Not marked corrected in the state record

Open / not marked corrected.

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 10 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.

Open Not marked corrected in the state record

Open / not marked corrected.

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 10 child files did not have the name, address and telephone number of another individual (friend or relative) who might be reached in an emergency.

Open Not marked corrected in the state record

Open / not marked corrected.

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 10 child files did not have the name and phone number of the family physician, or hospital, or both.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (E) states: The name of the individual(s) authorized to take the child from the premises.

The facility did not meet requirements for child enrollment and health information on file as evidenced by 4 child files did not have the name of the individual(s) authorized to take the child.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (F) states: Information concerning any accident or injury to a child while in care or any emergency medical care given.

The facility did not meet requirements for child enrollment and health information on file as evidenced by 10 child files did not have the information concerning any accident or injury to a child while in care or any emergency medical care given.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 4 (A) states: S/he has been informed of the required health and safety inspections and that the inspection forms are available for review.

The facility did not meet requirements for child enrollment and health information on file as evidenced by five child files missing parental acknowledgements.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 4 (B) states: S/he understands and agrees that the child may not be accepted for care when ill.

The facility did not meet requirements for child enrollment and health information on file as evidenced by five child files missing parental acknowledgements.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

Open Not marked corrected in the state record

Open / not marked corrected.

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 Janice Kaden, Sandra Oliver, Stephanie Stapleton, Donna Pittsenbarger, Victory Geary as evidenced by a cleared TB report was not on file for caregivers within 30 days of working in the facility.

Open Not marked corrected in the state record

Open / not marked corrected.

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 Janice Kaden, Leigh Greene, Donna Pittsenbarger, Stephanie Stapleton, Ryan Philpot, and Sandra Oliver, Victoria Geary as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Open Not marked corrected in the state record

Open / not marked corrected.

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.

Open Not marked corrected in the state record

Open / not marked corrected.