5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (J) 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: used toilet brush and used toilet plunger. The item(s) was/were located next to the children's toilet on the floor.

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (G) states: Porches, decks, stairwells or other areas in approved child care space having a drop-off of more than twenty-four inches (24") from which children might fall and be injured shall have an approved railing or approved barrier. The railing or barrier shall be constructed to prevent the child from crawling or falling through, or becoming entrapped.

A deck with a drop-off of more than 24 inches had a railing/barrier with openings of more than four inches (4). The measurement of railing/barrier openings is 5".

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 9. states: Concrete, asphalt, carpet or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.

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 bare ground at base of blue slide and under the dome climber.

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5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 5. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by sharp broken siding on the building accessible to the children, the PVC pipe that is the barrier keeping the resilient surfacing in the small area is cracked and sharp, the black barrier around the large area of resilient surfacing is broken and sharp.

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5 CSR 25-400.086 · 5 CSR 25-400.086 Fire Safety (2) (C) 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 30-61.086 Fire Safety were not met as evidenced by the evacuation time was not recorded.

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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, motor cycle , in on the small area of resilient surfacing was not in good condition as evidenced by holes in handle bars where stinging insects can build a nest.

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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 25-600.020 · 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 Jessica Cahalan, Melissa Cahalan, Thomas Cahalan and Lane VanNote.

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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 (1) (C) states: A listing of household members and assistant(s).

The listing of household members and assistants was not submitted.

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5 CSR 25-400.055 · 5 CSR 25-400.055 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and 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, indicating the licensee’s intent to continue operating a licensed family child care home and agreement to comply with all statutes and department licensing rules;

The Annual Declaration was not submitted.

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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 2022, the staff listed need the following information: Jessica Cahalan needs 9 hours and Melissa Cahalan needs 7 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 provider, Melissa Cahalan.

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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), Jessica Cahalan.

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