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 zoning approval was not received.

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5 CSR 25-500.052 · 5 CSR 25-500.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.

The annual sanitation inspection was not approved.

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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.

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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 multiple outlets were missing protective outlet covers.

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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: a bottle of Comet Cleaner and a bottle of Clorox Cleaner. The item(s) was/were located under the sink in a cabinet in the pre-school classroom and the cabinet was not locked.

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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 two drainage pipes approximately seven inches in diameter missing the protective covers located in the outdoor play area near the back fence.

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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, a chair, in the outdoor play area was not in good condition as evidenced by it was missing two chair legs.

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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, a Hello Kitty toy car, in the outdoor play area was not in good condition as evidenced by it was missing two wheels.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.

The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate CPR was not on site.

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5 CSR 25-500.102 · 5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.

The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate first aid was not on site.

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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 8 electrical outlets were missing protective outlet covers.

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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 the gate to the chain-link fence was missing a latch and in the bottom left corner of the gate the chain-link was detached from the gate pole resulting in an opening measuring over 3.5 inches.

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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 a 2 foot metal pole with sharp rusty edges, overgrown plant limbs coming through the chain-link fence that were eye level to a child, and food wrappers.

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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: Joyce Brent

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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.

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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.

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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 11/20/2023.

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5 CSR 25-500.192 · 5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.

Requirements for immunization reports on file were not met as evidenced by one immunization record(s) was/were not on file.

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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;

One child(ren) records did not include employers' name of parent(s), guardian or legal custodian.

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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;

Two child(ren) records did not include work schedule of parent(s), guardian or legal custodian.

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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;

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

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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;

Two child(ren) records did not include employers' address of parent(s), guardian or legal custodian.

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5 CSR 25-500.222 · 5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;

One child(ren) records did not include telephone number of family physician or hospital.

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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 six children , ages 14-months old to 2-years old, were cared for by one adult caregiver(s).

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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 2-months old to 15-months old, were cared for by one adult caregiver(s).

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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 six children , ages 14-months old to 2-years old, were cared for by one adult caregiver(s).

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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 11/21/2023.

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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;

One child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.

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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;

Two child(ren) records did not include address of another individual who might be reached in an emergency.

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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 Chermaine Thedford.

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