5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (4) (D) states: Diapering supplies and warm, running water shall be adjacent to the diapering area.

The diapering area requirements were not met as evidenced by warm running water was not adjacent to the diapering area.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 5. states: The facility shall be dry, temperature controlled, well-ventilated and free of drafts. Children shall not be overheated or chilled. The temperature of the rooms shall be no less than sixty-eight degrees Fahrenheit (68 F) and no more than eighty-five degrees Fahrenheit (85 F) when measured two feet (2') from the floor.

The temperature of rooms was less than 68 degrees F measured two feet from the floor as evidenced by the temperature was 58 degrees F in the front room with eight children present, 59 degrees F in the preschool room with eight children present and 65 degrees F with three infants present.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

The walls located in front preschool classroom in a area of TV was/were not in good condition as evidenced by old paint is pilling and ripped off in some spots.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.

The premises were not safe and suitable as evidenced by a space heater located on a sink in the infant toddler room had the cord hanging down within children's reach.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.087 · 5 CSR 25-500.087 Fire Safety (13) (A) states: Unvented fuel-fired room heaters, portable electrical space heaters, or floor furnaces shall not be used during child care hours. The provider shall sign a compliance letter verifying that such equipment will not be used.

A portable electrical space heater was observed in use in infant toddler unit.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 1. A. states: An individual cot or bed shall be provided for each child who naps or sleeps. An individually assigned sheet and blanket shall be provided for each child twelve (12) months and older who naps or sleeps. Upper levels of bunk beds shall not be used.

The requirements for sleeping materials were not met as evidenced by the sheets/blankets were not individually assigned.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.222 · 5 CSR 25-500.222 Records and Reports (6) states: Daily staff and volunteer attendance records shall be maintained and kept on file a minimum of one (1) year.

Daily attendance records were not maintained on file as evidenced by there was no staff/volunteer attendance record for the following staff: Karen Davis and Twyla Kennemer.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.

The facility is owned by a legal entity that currently shows as canceled on Missouri Secretary of State's website.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.087 · 5 CSR 25-500.087 Fire Safety (2) (F) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.

Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by the disaster and tornado drill was not held at least one time every three months.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.090 · 5 CSR 25-500.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.

Requirements of facilities participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

The annual sanitation inspection was not approved.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.

The facility is owned by a legal entity that currently shows as canceled on Missouri Secretary of State's website.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (B) states: The premises shall conform to the fire and safety requirements of the State Fire Marshal or his/her designee and requirements for state or local zoning, building and sanitation.

The facility has not met the requirements for state or local sanitation as evidenced by the sanitation inspection is not approved because there is no warm running water in the facility and the water heater is not working.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.087 · 5 CSR 25-500.087 Fire Safety (2) (F) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.

Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by the disaster and tornado drill was not held at least one time every three months.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.090 · 5 CSR 25-500.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.

Requirements of facilities participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.032 · 5 CSR 25-500.032 Organization and Administration (4) states: The person(s) or legal entity who owns a child care facility shall be responsible for meeting all debts and obligations incurred by the facility and for maintaining compliance with all licensing rules for group child care homes and child care centers.

The facility did not meet all debts and obligations associated with operating a child care facility as evidenced by Director Karen Davis stated that she has not paid taxes, and is unable to submit the annual filing to the Missouri. During 1/22/2025 close supervision Karen Davis reported that she paid her last tax fees on 1/10/2025 and filed a request for Certificate of the Tax Clearance. During 2/3/2025 close supervision Karen Davis reported that she did not receive a Certificate of the Tax Clearance that was requested by her on 1/10/2025. On 1/31/2025 she resubmitted the request to Department of Revenue. CI suggested to a director to call Department of Revenue ( the call must be scheduled) and talk with them about her status with them. On 3/11/25 inspection Karen Davis reported that they had to pay $1320 towards the taxes they own to MO Department of Revenew. The check for $1320 was cleared on 2/28/25. By a report of Karen Davis she faxed another request for a Certificate of the Tax Clearance on 2/14/25 and 2/27/25 to Department of Revenue. CI Gerasimova asked Karen Davis to fax it during the 3/11/25 inspection. It has been faxed to the fax number stated on the form. CI Gerasimova suggested to also mail it to the address stated on the form . Director Karen Davis is asked to report to OOC that it was mailed -with the proof of it to be mailed by Friday 3/14/25. During 4/1/25 Close Supervision inspection a director Karen Davis reported that she still didn't hear anything from Department of Revenue. It was agreed that she will go online and schedule a phone call with a representative in Department of Revenue. She will ask them to email her a Certificate of the Tax Clearance and /or at least some kind of another proof that he balance is zero and she did pay all her taxes . Karen Davis is asked to report about scheduling the call interview on Friday 4/4/2025. During Annual Inspection on 5/7/2025 director Karen Davis notified CI Gerasimova that the email from Department and Revenue on May 1st , 2025 stating that her documents were received and will be processed in the order in was received within 5-7 business days. Karen Davis will call the number that was stated in email on Monday May 12th. During 6/18/2025 Close Supervision inspection Director Karen Davis reported that her tax clearance certificate was submitted to Secretary of State on June 6, 2025 as well as business filing and remission packet.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

The annual sanitation inspection was not approved.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-600.020 · 5 CSR 25-600.020 General Requirements (5) states: Criminal background checks shall be completed for each child care staff member every five (5) years.

Criminal background check results were older than five (5) years for Austin Davis.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.

The facility is owned by a legal entity that currently shows as canceled on Missouri Secretary of State's website.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (B) states: The premises shall conform to the fire and safety requirements of the State Fire Marshal or his/her designee and requirements for state or local zoning, building and sanitation.

The facility has not met the requirements for state or local sanitation as evidenced by the sanitation inspection is not approved because there is no warm running water in the facility and the water heater is not working.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (4) (D) states: Diapering supplies and warm, running water shall be adjacent to the diapering area.

The diapering area requirements were not met as evidenced by warm running water was not adjacent to the diapering area.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (5) (B) states: Kitchens used for meal preparation shall have sufficient equipment to accommodate the licensed capacity of the facility. The equipment shall include a stove, sink, hot and cold running water, a refrigerator and storage space for food, dishes and cooking utensils.

The facility's kitchen did not meet requirements as evidenced by there was no hot or cold running water.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.087 · 5 CSR 25-500.087 Fire Safety (2) (F) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.

Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.

Open Not marked corrected in the state record

Open / not marked corrected.

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 2024, the staff listed need the following information: Angel Jester needs 0.25 hours of training.

Open Not marked corrected in the state record

Open / not marked corrected.

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(s) was/were not on file for Briana Vorhees 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 25-500.032 · 5 CSR 25-500.032 Organization and Administration (4) states: The person(s) or legal entity who owns a child care facility shall be responsible for meeting all debts and obligations incurred by the facility and for maintaining compliance with all licensing rules for group child care homes and child care centers.

The facility did not meet all debts and obligations associated with operating a child care facility as evidenced by Director Karen Davis stated that she has not paid taxes, and is unable to submit the annual filing to the Missouri. During 1/22/2025 close supervision Karen Davis reported that she paid her last tax fees on 1/10/2025 and filed a request for Certificate of the Tax Clearance. During 2/3/2025 close supervision Karen Davis reported that she did not receive a Certificate of the Tax Clearance that was requested by her on 1/10/2025. On 1/31/2025 she resubmitted the request to Department of Revenue. CI suggested to a director to call Department of Revenue ( the call must be scheduled) and talk with them about her status with them. On 3/11/25 inspection Karen Davis reported that they had to pay $1320 towards the taxes they own to MO Department of Revenew. The check for $1320 was cleared on 2/28/25. By a report of Karen Davis she faxed another request for a Certificate of the Tax Clearance on 2/14/25 and 2/27/25 to Department of Revenue. CI Gerasimova asked Karen Davis to fax it during the 3/11/25 inspection. It has been faxed to the fax number stated on the form. CI Gerasimova suggested to also mail it to the address stated on the form . Director Karen Davis is asked to report to OOC that it was mailed -with the proof of it to be mailed by Friday 3/14/25. During 4/1/25 Close Supervision inspection a director Karen Davis reported that she still didn't hear anything from Department of Revenue. It was agreed that she will go online and schedule a phone call with a representative in Department of Revenue. She will ask them to email her a Certificate of the Tax Clearance and /or at least some kind of another proof that he balance is zero and she did pay all her taxes . Karen Davis is asked to report about scheduling the call interview on Friday 4/4/2025.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.

The facility is owned by a legal entity that currently shows as canceled on Missouri Secretary of State's website.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (B) states: The premises shall conform to the fire and safety requirements of the State Fire Marshal or his/her designee and requirements for state or local zoning, building and sanitation.

The facility has not met the requirements for state or local sanitation as evidenced by the sanitation inspection is not approved because there is no warm running water in the facility and the water heater is not working.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (4) (D) states: Diapering supplies and warm, running water shall be adjacent to the diapering area.

The diapering area requirements were not met as evidenced by warm running water was not adjacent to the diapering area.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (5) (B) states: Kitchens used for meal preparation shall have sufficient equipment to accommodate the licensed capacity of the facility. The equipment shall include a stove, sink, hot and cold running water, a refrigerator and storage space for food, dishes and cooking utensils.

The facility's kitchen did not meet requirements as evidenced by there was no hot or cold running water.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.032 · 5 CSR 25-500.032 Organization and Administration (4) states: The person(s) or legal entity who owns a child care facility shall be responsible for meeting all debts and obligations incurred by the facility and for maintaining compliance with all licensing rules for group child care homes and child care centers.

The facility did not meet all debts and obligations associated with operating a child care facility as evidenced by Director Karen Davis stated that she has not paid taxes, and is unable to submit the annual filing to the Missouri. During 1/22/2025 close supervision Karen Davis reported that she paid her last tax fees on 1/10/2025 and filed a request for Certificate of the Tax Clearance. During 2/3/2025 close supervision Karen Davis reported that she did not receive a Certificate of the Tax Clearance that was requested by her on 1/10/2025. On 1/31/2025 she resubmitted the request to Department of Revenue. CI suggested to a director to call Department of Revenue ( the call must be scheduled) and talk with them about her status with them .

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.

The facility is owned by a legal entity that currently shows as canceled on Missouri Secretary of State's website.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.032 · 5 CSR 25-500.032 Organization and Administration (4) states: The person(s) or legal entity who owns a child care facility shall be responsible for meeting all debts and obligations incurred by the facility and for maintaining compliance with all licensing rules for group child care homes and child care centers.

The facility did not meet all debts and obligations associated with operating a child care facility as evidenced by Director Karen Davis stated that she has not paid taxes, and is unable to submit the annual filing to the Missouri.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.032 · 5 CSR 25-500.032 Organization and Administration (3) states: When the responsibility for the operation of a facility rests with a board of directors, the department shall be notified in writing immediately if there is a change of the board president or chairperson.

The department did not receive notification of a change of board president or chairperson.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.

The facility is owned by a legal entity that currently shows as canceled on Missouri Secretary of State's website.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 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 Cassandra Johnson within thirty (30) days prior to the anniversary date.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: hand sanitizer. The item(s) was/were located in both preschool classrooms within children's reach.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.

The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that preschool classroom.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: automatic mop hanging with reach of children and plastic bags inside an open box. The item(s) was/were located in the open closet of the 2's Room.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.087 · 5 CSR 25-500.087 Fire Safety (14) (C) states: Electrical extension cords shall not be used unless approved in writing by the fire inspector.

The facility was observed using an extension cord in the hallway.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 1. B. states: All bedding shall be clean with sheets laundered at least once a week. Once bedding has been used by a child, it shall not be used by another child until it has been laundered.

The requirements for sleeping materials were not met as evidenced by the sheets were not laundered at least once a week.

Open Not marked corrected in the state record

Open / not marked corrected.

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 Stephany Byram.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

The annual sanitation inspection was not approved.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.

The facility is owned by a legal entity that currently shows as canceled on Missouri Secretary of State's website.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.

The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that one of the babies room.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

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 resilient material was not uniformly spread over the fall-zone area.

Open Not marked corrected in the state record

Open / not marked corrected.

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: Bridgette Johnson, Allison Brown, Stephanie Byram, Amanda McDaniel, Haley Doyle, Angel Jester

Open Not marked corrected in the state record

Open / not marked corrected.

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: Amanda McDaniel and Jester Angel .

Open Not marked corrected in the state record

Open / not marked corrected.

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 Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Austin Davis, Karen Davis, Stephany Byram .

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.222 · 5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;

one child(ren) records did not include telephone number of family physician or hospital.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.222 · 5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;

one child(ren) records did not include name of family physician or hospital.

Open Not marked corrected in the state record

Open / not marked corrected.

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 Bridgette Johnson, Allison Brown, Stephanie Byram, Amanda McDaniel, Haley Doyle and Angel Jester.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

The walls located in a preschool classroom was/were not in good condition as evidenced by the baseboard was stapled in several areas, the baseboard was torn off the wall.During the 12/11/23 inspection CI observed that the baseboard was taped and no staples are there anymore.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 9. states: The facility shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.

There was evidence of dirt/debris in in the infants classroom: clean bottles dish drainer has rusty dry water and dirt spots. During 12/11/23 inspection CI observed that the drainer was cleaned. .

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 9. states: The facility shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.

There was evidence of dirt/debris in the 2's classroom: the floor was not mopped, having sticky spots from the dried juice/milk/food. During the 12/11/23 inspection CI observed that the floors were cleaner, with just a little food on the floor after the snack time.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 9. states: The facility shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.

There was evidence of dirt/debris in the 2's classroom: air conditioning vents in a room had dried dirt/dust.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

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 resilient material was not uniformly spread over the fall-zone area.

Open Not marked corrected in the state record

Open / not marked corrected.