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 Livia Westmoreland as evidenced by the medical examination was not signed by the required medical source.

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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 the medical examination was not signed by the required medical source.

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