Lake Hills Early Learning Academy

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 Rachel Berggren as evidenced by a cleared TB report was not on file for caregivers within 30 days of working in the facility.

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 4 (D) states: The fall-zone area under and around outdoor equipment over twenty-four inches (24") high covered with impact-absorbing materials that will effectively cushion the fall of a child. Materials may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.

The equipment, a climber, that is over 24 inches high, does not have sufficient impact absorbing material present as evidenced by there is a border of concrete block within the fall zone.

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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 2 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.

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

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5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (3) states: Child care facilities shall meet immunization requirements for children as defined by section 210.003, RSMo.

Requirements for immunization reports on file were not met as evidenced by an immunization record was not on file the first day a child attended and there was no exemption on file.

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5 CSR 25-300.080 · 5 CSR 25-300.080 Sanitation Requirements (3) (C) states: The diapering surface, after each use, shall be cleaned and sanitized with a sanitizer approved by the department.

The facility did not meet the requirements for diapering surfaces. The diapering surface was not cleaned and sanitized after each use.

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 1 states: The premises of all facilities shall be safe and suitable for the care of children.

The premises were not safe and suitable as evidenced by 2 outlet covers were missing in the younger children's room and 4 outlet covers were missing in the large room with tables and chairs.

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 4 (A) states: An outdoor play area available on or adjoining the child care property. Facilities with a capacity of more than ten (10) children shall have a fenced play area. Play areas in facilities with a capacity of ten (10) or fewer children shall be fenced when necessary for the protection of children from traffic, water or other hazards. Fences shall be at least forty-two inches (42") high. Openings in fences shall be no greater than three and one-half inches (3 1/2").

Requirements for the outdoor play area were not met as evidenced by the fence had openings that were greater than 3 1/2 inches and allow entrapment - the openings measured approximately 5 1/2 inches (under the gate).

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 4 (D) states: The fall-zone area under and around outdoor equipment over twenty-four inches (24") high covered with impact-absorbing materials that will effectively cushion the fall of a child. Materials may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.

The equipment, a dome climber and slides, that is over 24 inches high, does not have sufficient impact absorbing material present as evidenced by they was no approved resilient surfacing as the slides and dome were placed on grass.

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 4 (G) states: Outdoor equipment shall be safely constructed, in good condition, and free of sharp, loose or pointed parts. Stationary equipment such as swings, slides and climbers shall be anchored securely.

Equipment in the outdoor play area, the swings, was not in good condition as evidenced by the saucer swing had a hole in it and the chain covers on the regular swing were torn.

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