Kids Of Creation

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 Grace Replogle, Megan Borders and Rebekah Simmerman.

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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 25-300.090 · 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 slide and swings, that is over 24 inches high, does not have sufficient impact absorbing material present as evidenced by resilient surface needs to be replaced where bare ground is visible.

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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 Kara Witt.

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5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (4) states: A parent of a school-age child shall provide a statement at the time of enrollment indicating the child's health history, any current health problems and any restrictions necessary for the child's care.

Requirements for children's medical examination reports were not met as evidenced by the school-age child health report was not on file the first day the child attended - the admission date was 2/5/2023.

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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 8 inches between the two sides of 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 slide and all the swings, that is over 24 inches high, does not have sufficient impact absorbing material present as evidenced by the resilient surfacing needs to be replaced where bare ground is visible.

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5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (C) states: Full name, address and phone number of a friend or relative who might be reached in an emergency when a parent, guardian or legal custodian cannot be reached.

The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child files did not have the name, address and telephone number of another individual (friend or relative) who might be reached in an emergency.

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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 13 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 (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 Carrie Lee.

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5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (4) states: A parent of a school-age child shall provide a statement at the time of enrollment indicating the child's health history, any current health problems and any restrictions necessary for the child's care.

Requirements for children's medical examination reports were not met as evidenced by the school-age child health report was not on file the first day the child attended - the admission date was 5/30/23.

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 7 states: Indoor play equipment and materials shall be provided and shall be clean and in good condition with all parts intact. Infants and toddlers shall have safe toys. Toys, parts of toys or other materials small enough to be swallowed shall not be used.

Requirements for indoor play equipment and materials were not met. Toys/materials were not clean as evidenced by the fans in the 2 year old room and 4 year old room were not clean.

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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 to ensure that those needs were being met as evidenced by there was no plan on file for a child with a food allergy.

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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 6 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 (C) states: Full name, address and phone number of a friend or relative who might be reached in an emergency when a parent, guardian or legal custodian cannot be reached.

The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child files did not have the name, address and telephone number of another individual (friend or relative) who might be reached in an emergency.

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

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