Noah's Ark Daycare

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 Sue Swihart and Shay Allen 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 25-300.050 · 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 Sheena Owen and Jessica Peterson as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

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RSMo 210.254 Religious organization operating facilities exempt under licensing laws required to file parental notice of responsibility and fire, safety inspections annually. 2. (5) states: The disciplinary philosophy and policies of the child-care facility.

Discipline did not meet that set forth in the Notice of Parental Responsibility.

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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 25-300.110 · 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.

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5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) 3. states: After the initial physical assessment, all caregivers working in a facility during child care hours shall be tested for tuberculosis at least every two (2) years. Caregivers with previously positive tuberculin tests shall be under the management of a physician.

TB reports on file were older than 24 months for Tim Mason, Andraya Emerson, Matt Bonass, MJ Myers and Sheri Buchanan.

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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 5/22/2023.

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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: diapering ointments, GermX, Pain medication, white out, air freshener spray, plastic bags. The item(s) was/were located within reach of children in the preschool rooms, and in the bathrooms in the infant/toddler area.

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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 plastic swings, was not in good condition as evidenced by the plastic was cracked and broken on both swings.

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