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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 Marianna Drazich 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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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 verification of required immunizations was not satisfactory in that one child had a religious exemption on file rather than a parental exemption.

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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 Caroline Kelly 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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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 3 (C) states: Locks or latches shall not be used on bathroom or bathroom stall doors used by children below the first grade.

Doors to the bathroom or stalls did not meet requirements as evidenced by there was a latch on the bathroom stall.

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 4 (C) states: The play area shall be safe for children's activities. It shall be well-maintained and free of hazards such as poisonous plants, broken glass, barbed wire, open wells, rocks and other debris, and shall have good drainage.

The facility's outdoor space was not safe for children's activities as evidenced by the presence of the ground under a concrete step on the large play area is eroding exposing jagged concrete and creating a gap over 3 1/2 inches.

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 5 (C) states: Sleeping equipment arranged to provide at least a two foot (2') aisle on one (1) long side of the equipment.

Sleeping equipment was not arranged to provide required spacing as evidenced by the aisle on the long side of the napping equipment was too narrow - the space measured less than 24 inches.

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