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 was not on file for Samantha Garcia and Larry Meeks 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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5 CSR 25-500.122 · 5 CSR 25-500.122 Medical Examination Reports (2) (C) states: Medical examination requirements shall not apply to any child if the parent(s) files a signed statement of objection based on religious beliefs.

A medical examination report was not on file within 30 days of admission and there was no parent's signed religious objection.

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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 5 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;

2 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;

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

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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;

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

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