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 Charkala Townsend.

Open Not marked corrected in the state record

Open / not marked corrected.

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 form did not contain all required information in that two medical exams did not have a statement signed by the physician indicating that a child can participate in the child care program.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.070 · 5 CSR 25-300.070 Fire Safety Requirements (5) (A) states: An emergency plan for fires and tornadoes shall be posted conspicuously and shall include the route for the drills and special instructions for nonambulatory infants and children.

The facility's evacuation/emergency plan is posted but does not include instructions for infants/nonambulatory children.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 5 (D) 2 states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen. The pad shall be in good condition, waterproof, clean and dry. Sheets and covers shall be changed when soiled or wet.

Requirements for the crib mattress/playpen pad were not met as evidenced by a crib mattress or playpen pad was not in good condition as evidenced by three mattresses had holes in them exposing foam.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (A) states: The child's full name, address, birth date and the date care begins and ends.

The facility did not meet requirements for child enrollment and health information on file as evidenced by one child files did not have the child’s full name, address, birth date and the date care begins and ends.

Open Not marked corrected in the state record

Open / not marked corrected.

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 two 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.

Open Not marked corrected in the state record

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 two child files did not have the name, address and telephone number of another individual (friend or relative) who might be reached in an emergency.

Open Not marked corrected in the state record

Open / not marked corrected.

RSMo 210.254 Religious organization operating facilities exempt under licensing laws required to file parental notice of responsibility and fire, safety inspections annually. 1. states: Child-care facilities operated by religious organizations pursuant to the exempt status recognized in subdivision (17) of subsection 1 of section 210.211 shall upon enrollment of any child provide the parent or guardian enrolling the child two copies of a notice of parental responsibility, one copy of which shall be retained in the files of the facility after the enrolling parent acknowledges, by signature, having read and accepted the information contained therein.

An approved Notice of Parental Responsibility was not on file for each child in care.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.020 · 5 CSR 25-300.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures (6) (C) states: A child care facility operated by a religious organization shall provide the parent or guardian enrolling the child two (2) copies of the Notice of Parental Responsibility form for the enrolling parent to acknowledge, by signature, having read and accepted the information. One (1) copy shall be kept by the parent or guardian and the other copy shall be retained in the child's record at the facility.

An approved Notice of Parental Responsibility was not on file for one child(ren).

Open Not marked corrected in the state record

Open / not marked corrected.

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

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 Trice, Ramona.

Open Not marked corrected in the state record

Open / not marked corrected.