5 CSR 25-400.085 · 5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 5. states: The home 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 that 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 meaured two feet from the floor as evidenced by temperature taken inside the childcare space was 58 degrees when taken two feet from the floor.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (A) states: The child’s full name, address, birth date and the date care begins and ends.

1 child(ren) records did not include child's full name, address, date of birth and date care begins and ends.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.

1 child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached.

1 child(ren) records did not include name, address and telephone number of another individual who might be reached in an emergency.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (D) states: Name and phone number of the family physician, or hospital, or both, to be used in an emergency.

1 child(ren) records did not include name and phone number of the family physician or hospital.

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5 CSR 25-400.045 · 5 CSR 25-400.045 Licensing Process (4) (P) states: Other information required by the department to make a determination regarding licensure of the family child care home.

Additional information is required to make a determination regarding licensure, specifically LLC's Operating Agreement

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5 CSR 25-400.045 · 5 CSR 25-400.045 Licensing Process (4) (M) states: A written disaster and emergency plan;

A written disaster and emergency plan did not contain information as required in 5 CSR 25-400.090, as evidenced by Needs to put her emergency responses in the emergency plan.

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5 CSR 25-400.045 · 5 CSR 25-400.045 Licensing Process (4) (M) states: A written disaster and emergency plan;

A written disaster and emergency plan did not contain information as required in 5 CSR 25-400.090, as evidenced by needs a diagram of safe location inside the facility.

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5 CSR 25-400.045 · 5 CSR 25-400.045 Licensing Process (4) (G) states: Written policies and procedures which clearly establish job responsibilities and lines of administrative authority;

The written policies and procedures did not include job responsibilities or the lines of administrative authority.

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5 CSR 25-400.045 · 5 CSR 25-400.045 Licensing Process (4) (C) 3. states: Narrative description of child care practices and concepts;

The written policies did not include a description of the provider's child care practices and concepts.

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5 CSR 25-400.125 · 5 CSR 25-400.125 Medical Examination Reports (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School), revised 2021, is 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. This rule does not incorporate any subsequent amendments or additions.

Requirements for infant-toddler/preschool child medical examination reports on file 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 8/24/2022, 9/9/2021, 9/4/19, 4/29/2024, 12/4/23, 4/8/2024.

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5 CSR 25-400.125 · 5 CSR 25-400.125 Medical Examination Reports (1) (E) . 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: Shonda Payne.

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5 CSR 25-400.125 · 5 CSR 25-400.125 Medical Examination Reports (1) (D) states: Assistants who are employed or volunteer more than five (5) hours per week shall have a medical examination report on file within thirty (30) days of beginning work in the home.

A medical examination report was not on file for assistant(s): Shonda Payne.

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5 CSR 25-400.185 · 5 CSR 25-400.185 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.

Requirements for immunization reports on file were not met as evidenced by 2 immunization record(s) was/were not on file .

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached.

2 child(ren) records did not include address of another individual who might be reached in an emergency.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.

1 child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.

1 child(ren) records did not include employers' name of parent(s), guardian or legal custodian.

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5 CSR 25-400.210 · 5 CSR 25-400.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.

1 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.

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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 Shonda Payne.

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