5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (1) (B) states: Evidence of compliance with local building and zoning requirements, if applicable.

Evidence of local building approval was not received.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

The floors located in the hall next to the kitchen, infant/toddler classrooms and the pre-k classroom was/were not in good condition as evidenced by there were approximately 10 wooden panel planks in the pre-k room that were cracked, buckled and not attached to the floor, in both infant/toddler classrooms there were approximately 10 planks cracked, buckled and not attached to the floor, and in the hallway by the bathrooms, there were approximately 8 planks cracked and buckled All the areas on the floor with cracked planks caused a tripping hazard.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

The facility's outdoor space was not safe for children's activities as evidenced by the synthetic grass material was lifting and bunching in multiple areas around the play area posing a trip hazard.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

The facility's outdoor space was not safe for children's activities as evidenced by there is a ramp that children have access to was observed with a twelve inch gap that children can get entrapped by.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. G states: Cribs, portable cribs and playpens shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation. Examples include bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, pillow-like toys, wedges, infant positioners, special mattresses, special sleep surfaces, and other similar items.

Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by three children had blankets while sleeping in a crib.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. G states: Cribs, portable cribs and playpens shall be free of soft objects, loose bedding or any object that can increase the risk of entrapment, suffocation or strangulation. Examples include bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, pillow-like toys, wedges, infant positioners, special mattresses, special sleep surfaces, and other similar items.

Soft objects, loose bedding or any object that can increase risk of entrapment, suffocation or strangulation was observed as evidenced by one child had a bid on while sleeping in a crib.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number from the department.

A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Robin Smith, Shika Alzuaidi, Ahlamal Sadoon, and Lashanda Cannamore.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.

The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2024, the staff listed need the following information: Margo Wilson needs 12 clock hours, Robin Smith needs 12 clock hours, Cedric Scott needs 12 clock hours, Zakia Qayomi needs 7.5 clock hours, Jelisa Pointer needs 12 clock hours, Darren Cunningham needs 2 clock hours and Lashonda Cannamore needs 4 clock hours. As of 4/1/26 Cedric Scott, Jelisa Pointer, and D. Cunningham are no longer employed.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.

The director is not routinely on duty, as evidenced by inspections conducted on 3/5/26, 2/19/26, 8/13/25, 6/13/25, 3/7/25, and 2/28/25 director was not present and on premise. During the inspection on 2/19/26 it was stated that director, Robin Smith was on vacation , during the inspection conducted on 3/5/26 it was stated that the director Robin Smith was present in the morning, but left due to low ratio. In response to if the director could come back, teacher Lashanda Cannamore stated she is not sure if the director was able to. Director was not present during a return inspection on 4/1/26, it was stated that Robin Smith was out for a family emergency.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (4) (A) . states: Every three (3) years, the child care provider, group child care home provider, child care staff members, and volunteers in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs/deseadministrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Safe sleep training was not completed within the past 3 years for the following staff Robin Smith and Darren Cunningham.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.112 · 5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: The staff/child ratio and group size shall be followed as outlined in the below chart unless it meets an exception in subparagraphs (1)(B)-(G) below: Infants, toddlers, and 2-year-olds shall have one caregiver for every four children with no more than eight children per group; Groups composed solely of children 24 to 36 months shall have one caregiver for every eight children with no more than 16 children per group; Groups composed solely of children 3 to 4 years shall have one caregiver for every 10 children with no more than 20 children per group; Groups composed solely of children 5 years or older shall have one caregiver for every 16 children with no more than 32 children per group; A mixed group of children consisting of no more than four children age 2 years, and at least one child older than 3 years shall have one caregiver for every 10 children with no more than 20 children per group; A mixed group of children consisting of more than four children ages 24 to 36 months, and at least one child older than 36 months shall have one caregiver for every eight children with no more than 16 children per group.

Staff/child ratio requirements were not met as evidenced by five children , ages 12-months-old to 24-months-old, were cared for by one adult caregiver(s).

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.222 · 5 CSR 25-500.222 Records and Reports (6) states: Daily staff and volunteer attendance records shall be maintained and kept on file a minimum of one (1) year.

Daily attendance records were not maintained on file as evidenced by there was no staff/volunteer attendance record for the following staff: Robin Smith.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.

The annual fire safety inspection was not approved.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (1) (B) states: Evidence of compliance with local building and zoning requirements, if applicable.

Evidence of local building approval was not received.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by resilient material was not uniformly spread over the fall-zone area.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

The facility's outdoor space was not safe for children's activities as evidenced by the synthetic grass material was lifting and bunching in multiple areas around the play area posing a trip hazard.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

The facility's outdoor space was not safe for children's activities as evidenced by there is a ramp that children have access to was observed with a twelve inch gap that children can get entrapped by.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 4. states: Paper towels, soap and toilet paper shall be provided and easily accessible so the children can reach them without assistance.

Bathroom supplies were not available and accessible to children as evidenced by there were no paper towels.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

The floors located in the hall next to the kitchen, infant/toddler classrooms and the pre-k classroom was/were not in good condition as evidenced by there were approximately 10 wooden panel planks in the pre-k room that were cracked, buckled and not attached to the floor, in both infant/toddler classrooms there were approximately 10 planks cracked, buckled and not attached to the floor, and in the hallway by the bathrooms, there were approximately 8 planks cracked and buckled All the areas on the floor with cracked planks caused a tripping hazard.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: paper cutter with a sharp blade, tin can of cleaning agent, pet cleaner, dreft scent beads, spray paint. The item(s) was/were located in the unlocked office.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: Aquaphor and Balmex. The item(s) was/were located in the infant toddler room on the diaper table.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: oven/stove, freezer, Signet sink sanitizer, goof off, and cleaner/disinfectant. The item(s) was/were located in the kitchen and door was open allowing children access.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: ibuprofen. The item(s) was/were located mixed age room.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

Hazardous items as follows were accessible to children: Purex. The item(s) was/were located in the laundry room and the door was not locked.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.

The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that electric outlet in the pre-k room was exposed.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.

Children were not restricted to approved space as evidenced by the furnace room in the hallway was not locked and the furnace room inside the child restroom was not locked allowing children access.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (4) (A) . states: Every three (3) years, the child care provider, group child care home provider, child care staff members, and volunteers in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs/deseadministrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.

Safe sleep training was not completed within the past 3 years for the following staff Robin Smith and Darren Cunningham.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.

The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2024, the staff listed need the following information: Margo Wilson needs 12 clock hours, Robin Smith needs 12 clock hours, Cedric Scott needs 12 clock hours, Zakia Qayomi needs 7.5 clock hours, Jelisa Pointer needs 12 clock hours, Darren Cunningham needs 2 clock hours and Lashonda Cannamore needs 4 clock hours.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number from the department.

A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Robin Smith, Shika Alzuaidi, Ahlamal Sadoon, and Lashanda Cannamore.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.112 · 5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: The staff/child ratio and group size shall be followed as outlined in the below chart unless it meets an exception in subparagraphs (1)(B)-(G) below: Infants, toddlers, and 2-year-olds shall have one caregiver for every four children with no more than eight children per group; Groups composed solely of children 24 to 36 months shall have one caregiver for every eight children with no more than 16 children per group; Groups composed solely of children 3 to 4 years shall have one caregiver for every 10 children with no more than 20 children per group; Groups composed solely of children 5 years or older shall have one caregiver for every 16 children with no more than 32 children per group; A mixed group of children consisting of no more than four children age 2 years, and at least one child older than 3 years shall have one caregiver for every 10 children with no more than 20 children per group; A mixed group of children consisting of more than four children ages 24 to 36 months, and at least one child older than 36 months shall have one caregiver for every eight children with no more than 16 children per group.

Staff/child ratio requirements were not met as evidenced by 12 children , ages 2-years-old through 4-years-old (six children in the group were 2-years-old), were cared for by one adult caregiver(s).

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-600.020 · 5 CSR 25-600.020 General Requirements (5) states: Criminal background checks shall be completed for each child care staff member every five (5) years.

Criminal background check results were older than five (5) years for Margo Wilson.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (B) 1. H. states: An area for staff breaks shall be provided in the facility separate from child care space.

There was no space provided for staff breaks that is separate from child care space.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

The floors located in the 2/3-year-old room near the exit to the back hallway, Toddler room A and was/were not in good condition as evidenced by there were multiple laminate floor pieces lifted and cracked.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that there were 3 screws protruding from the fence located at the rear of the playground.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

The facility's outdoor space was not safe for children's activities as evidenced by there were multiple tree branches located throughout the infant/toddler playground.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by resilient material was not uniformly spread over the fall-zone area.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Outdoor equipment, was not in good condition, in that a table was located in the rear left side of the playground was not in good condition as evidenced by the table was disassembled and in a pile.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.

The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that the pre-k/school age room was missing three outlet covers and the hallway leading to the bathrooms from the Pre-K/School Age room had 3 outlet covers missing.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

The floors located in the 2/3-year-old room near the exit to the back hallway, Toddler room A and was/were not in good condition as evidenced by there were multiple laminate floor pieces lifted and cracked.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (B) 1. H. states: An area for staff breaks shall be provided in the facility separate from child care space.

There was no space provided for staff breaks that is separate from child care space.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 4. states: Paper towels, soap and toilet paper shall be provided and easily accessible so the children can reach them without assistance.

Bathroom supplies were not available and accessible to children as evidenced by there was no soap.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that there were 3 screws protruding from the fence located at the rear of the playground.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

The facility's outdoor space was not safe for children's activities as evidenced by there were multiple tree branches located throughout the infant/toddler playground.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by resilient material was not uniformly spread over the fall-zone area.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.

Outdoor equipment, was not in good condition, in that a table was located in the rear left side of the playground was not in good condition as evidenced by the table was disassembled and in a pile.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.042 · 5 CSR 25-500.042 Licensing Process (13) (D) states: All manager(s) and/or member(s).

The name, address and telephone number of the member(s) was not prominently posted near the license.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (1) (B) states: Evidence of compliance with local building and zoning requirements, if applicable.

Evidence of local building approval was not received.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.

The Family Care Safety Registry check was not conducted for Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Nigeria Bates, LaShonda Cannamore, Jelisa Pointer, Zakia Qayomi , Cedric Scott, Robin Scott, Shametrus Spearmon, and Margo Wilson-Cuffie within thirty (30) days prior to the anniversary date.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by resilient material was not uniformly spread over the fall-zone area.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--

A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Zakia Qayomi, Shametus Spearmon, Cedric Scott, and Robin Scott

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.

Medical examination report(s) was/were not on file for Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Cedric Scott, and Robin Scott as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Cedric Scott, and Robin Scott.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-600.020 · 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.

Criminal background check results were not on file for Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Nigeria Bates, and Cedric Scott.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.042 · 5 CSR 25-500.042 Licensing Process (13) (D) states: All manager(s) and/or member(s).

The name, address and telephone number of the member(s) was not prominently posted near the license.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (1) (B) states: Evidence of compliance with local building and zoning requirements, if applicable.

Evidence of local building approval was not received.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.

The Family Care Safety Registry check was not conducted for Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Nigeria Bates, LaShonda Cannamore, Jelisa Pointer, Zakia Qayomi , Cedric Scott, Robin Scott, Shametrus Spearmon, and Margo Wilson-Cuffie within thirty (30) days prior to the anniversary date.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by resilient material was not uniformly spread over the fall-zone area.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--

A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Zakia Qayomi, Shametus Spearmon, Cedric Scott, and Robin Scott

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.112 · 5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: The staff/child ratio and group size shall be followed as outlined in the below chart unless it meets an exception in subparagraphs (1)(B)-(G) below: Infants, toddlers, and 2-year-olds shall have one caregiver for every four children with no more than eight children per group; Groups composed solely of children 24 to 36 months shall have one caregiver for every eight children with no more than 16 children per group; Groups composed solely of children 3 to 4 years shall have one caregiver for every 10 children with no more than 20 children per group; Groups composed solely of children 5 years or older shall have one caregiver for every 16 children with no more than 32 children per group; A mixed group of children consisting of no more than four children age 2 years, and at least one child older than 3 years shall have one caregiver for every 10 children with no more than 20 children per group; A mixed group of children consisting of more than four children ages 24 to 36 months, and at least one child older than 36 months shall have one caregiver for every eight children with no more than 16 children per group.

Staff/child ratio requirements were not met as evidenced by twelve children , ages 3-months old to 21-months old, were cared for by two adult caregiver(s).

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.

Medical examination report(s) was/were not on file for Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Cedric Scott, and Robin Scott as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Cedric Scott, and Robin Scott.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.182 · 5 CSR 25-500.182 Child Care Program (1) (A) 5. states: A caregiver shall remain in the room with preschool and school-age children while they are napping or sleeping and shall be able to see and hear them if they have difficulty during napping or when they awaken.

Requirements for supervision of napping or sleeping children were not met as evidenced by no caregiver remained in the room while children were napping.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-600.020 · 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.

Criminal background check results were not on file for Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Nigeria Bates, and Cedric Scott.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.042 · 5 CSR 25-500.042 Licensing Process (13) (D) states: All manager(s) and/or member(s).

The name, address and telephone number of the member(s) was not prominently posted near the license.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.

The Family Care Safety Registry check was not conducted for Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Nigeria Bates, LaShonda Cannamore, Jelisa Pointer, Zakia Qayomi , Cedric Scott, Robin Scott, Shametrus Spearmon, and Margo Wilson-Cuffie within thirty (30) days prior to the anniversary date.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (1) (B) states: Evidence of compliance with local building and zoning requirements, if applicable.

Evidence of local building approval was not received.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by resilient material was not uniformly spread over the fall-zone area.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--

A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Zakia Qayomi, Shametus Spearmon, Cedric Scott, and Robin Scott

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.112 · 5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: The staff/child ratio and group size shall be followed as outlined in the below chart unless it meets an exception in subparagraphs (1)(B)-(G) below: Infants, toddlers, and 2-year-olds shall have one caregiver for every four children with no more than eight children per group; Groups composed solely of children 24 to 36 months shall have one caregiver for every eight children with no more than 16 children per group; Groups composed solely of children 3 to 4 years shall have one caregiver for every 10 children with no more than 20 children per group; Groups composed solely of children 5 years or older shall have one caregiver for every 16 children with no more than 32 children per group; A mixed group of children consisting of no more than four children age 2 years, and at least one child older than 3 years shall have one caregiver for every 10 children with no more than 20 children per group; A mixed group of children consisting of more than four children ages 24 to 36 months, and at least one child older than 36 months shall have one caregiver for every eight children with no more than 16 children per group.

Staff/child ratio requirements were not met as evidenced by twenty-two children , ages 3-years old to 10-years old, were cared for by one adult caregiver(s).

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.112 · 5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: The staff/child ratio and group size shall be followed as outlined in the below chart unless it meets an exception in subparagraphs (1)(B)-(G) below: Infants, toddlers, and 2-year-olds shall have one caregiver for every four children with no more than eight children per group; Groups composed solely of children 24 to 36 months shall have one caregiver for every eight children with no more than 16 children per group; Groups composed solely of children 3 to 4 years shall have one caregiver for every 10 children with no more than 20 children per group; Groups composed solely of children 5 years or older shall have one caregiver for every 16 children with no more than 32 children per group; A mixed group of children consisting of no more than four children age 2 years, and at least one child older than 3 years shall have one caregiver for every 10 children with no more than 20 children per group; A mixed group of children consisting of more than four children ages 24 to 36 months, and at least one child older than 36 months shall have one caregiver for every eight children with no more than 16 children per group.

Group size requirements were not met as evidenced by twenty-two children, ages 3-years old to 10-years old, were cared for by two adult caregiver(s).

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Cedric Scott, and Robin Scott.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.

Medical examination report(s) was/were not on file for Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Cedric Scott, and Robin Scott as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-600.020 · 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.

Criminal background check results were not on file for Azhar Al Musawi, Dina Alnaisani, Suhad Alnaisani, Nigeria Bates, and Cedric Scott.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 1. D. states: Sleeping equipment shall be 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 there was no aisle on the long side of the napping equipment.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. D. states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used. Only fitted sheet shall be used and shall be changed immediately when soiled or wet.

Requirements for the crib mattress/playpen padding/bedding were not met as evidenced by a fitted sheet was not used.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.222 · 5 CSR 25-500.222 Records and Reports (2) (F) states: Field trip and transportation authorization.

1 child(ren) records did not include field trip and transportation authorization.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.222 · 5 CSR 25-500.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;

1 child(ren) records did not include name, address and telephone number of another individual who might be reached in an emergency.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. F. states: Soft materials or objects such as pillows, quilts, comforters, or sheepskins, even if covered by a sheet, shall not be placed under a sleeping infant. If a mattress cover to protect against wetness is used, it shall be tightly fitting and thin.

Infant sleeping requirements were not met as evidenced by soft materials or objects were placed under a sleeping infant in that the 3-month-old child had a bib and a blanket in the crib.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.

The Family Care Safety Registry check was not conducted for Ribbon Perry, Suhad Alnaisani, Sidney Luckett, Cailynn Bambas, Lashodna Cannamore, Jelisa Pointer, Cedric Scott, Shametrus Spearmon, Margo Wilson within thirty (30) days prior to the anniversary date.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.082 · 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 5. states: The fall-zone area under and around outdoor equipment where children might fall and be injured shall be covered with impact absorbing materials which will effectively cushion the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.

The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by no resilient material was present.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.222 · 5 CSR 25-500.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;

3 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. H states: Blankets or other soft or loose bedding shall not be hung on the sides of cribs or put under the fitted sheet. Only sleep clothing that is designed to keep an infant warm without the possible hazard of covering the head or face may be used during sleep or nap time.

Infant sleeping requirements were not met as evidenced by blankets or other soft or loose bedding was observed on the side of the crib.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.092 · 5 CSR 25-500.092 Furniture, Equipment and Materials (2) (C) 1. D. states: Cloth or plastic coated books.

The facility did not meet requirements for cloth or plastic coated books. The facility needed an additional 11 items in this category.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (1) (L) states: The child care provider shall ensure that documentation of caregiver completion of the facility orientation is maintained and on file for review by the department.

Documentation of caregiver completion of the facility orientation was not on file for the following staff: Cedric Scott, Ribbon Perry, and Sideny Luckett .

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.

The director is not routinely on duty, as evidenced by there were no attendance records and staff present stated Robin has not been at the facility.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (2) (A) 3. states: The licensee is required to maintain an approved certificated group child care home provider or center director on staff.

The facility does not have an approved director on staff.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (4) (A) 3. states: The child care provider, group child care home provider, child care staff members, and volunteers shall complete safe sleep training described in subsection (4)(A) of this rule within thirty (30) days of employment or volunteering at the facility.

Ribbon Perry, Suhad Alnaisani, Sidney Luckett, Azhar Al Musawi, Claudette Gulley did not complete safe sleep training within 30 days of employment or volunteering at the facility.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.

Medical examination report(s) was/were not on file for Cedric Scott, Sidney Luckett and Jelisa Pointer as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.

A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Cedric Scott, Jelisa Pointer and Sidney Luckett.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (B) 3. states: Persons with active contagious tuberculosis shall be excluded from employment until deemed non-infectious by the Missouri Department of Health and Senior Services or the local public health agency. The person may return to work once the above criteria have been met, as long as the person adheres to his/her prescribed treatment regimen.

A staff person with active tuberculosis was working prior to being deemed non-infectious by the Missouri Department of Health and Senior Services or the local public health agency.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (1) (D) states: The medical examination report form shall be supplied by the department or the facility may use its own form if it contains all the information on the department’s form. The Medical Examination Report for Caregivers and Staff form, revised 2021, is incorporated by reference in this rule, as published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms. This rule does not incorporate any subsequent amendments or additions.

Medical examination report form did not contain all required information as evidenced by Cailynn Bambas needs yes/no and Lashonda Cannamore needs medical signed by physician.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is incorporated by reference in this rule, as published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms. This rule does not incorporate any subsequent amendments or additions.

Requirements for infant-toddler/preschool child medical examination reports on file 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 4/24/23.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.132 · 5 CSR 25-500.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.

An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-500.222 · 5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;

2 child(ren) records did not include child's address.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-600.020 · 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.

Criminal background check results were not on file for Cedric Scott and Sideny Luckett .

Open Not marked corrected in the state record

Open / not marked corrected.