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 Olivia Bell 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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Open / not marked corrected.

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 Olivia Bell 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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Open / not marked corrected.

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 an incorrect exemption form was 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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Open / not marked corrected.

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 2 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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Open / not marked corrected.