5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) 2. states: The facility may use the department's physical assessment form, MO 580-1879 (6- 94), or the facility may use its own form if it contains all the information on the department's form.

Medical examination reports including TB testing were not on file for caregivers as evidenced by the medical form did not contain all required information in that Sharron Ross's and Natasha Westbrook's medical did not have the physical examination box checked indicating the patient is in good physical and emotional health and free of contagious disease, Natasha Westbrook's medical also was missing the date of the exam.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) . states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.

Medical examination reports, including TB testing, were not on file for Bridget Barni, Michala Lewis, Charlene Ehll and Sawyer Stein 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 25-300.050 · 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 there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 11/28/2022 and 7/18/22.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) . states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.

Medical examination reports, including TB testing, were not on file for Bridget Barni, Sharron Ross, Sawyer Stein, Michala Lewis and Charlene Ehll as evidenced by a cleared TB report was not on file for caregivers within 30 days of working in the facility.

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 not posted.

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) (B) states: A written record shall be kept of the dates and types of drills conducted.

Requirements of 19 CSR 30-60.080 Fire Safety were not met as evidenced by the date and/or type of drill were not recorded.

Open Not marked corrected in the state record

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5 CSR 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 2 (D) states: Police, fire department, poison control, ambulance and other emergency numbers posted near the telephone.

Emergency numbers for the police, fire department, poison control, and ambulance were not posted.

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 4 (A) states: An outdoor play area available on or adjoining the child care property. Facilities with a capacity of more than ten (10) children shall have a fenced play area. Play areas in facilities with a capacity of ten (10) or fewer children shall be fenced when necessary for the protection of children from traffic, water or other hazards. Fences shall be at least forty-two inches (42") high. Openings in fences shall be no greater than three and one-half inches (3 1/2").

Requirements for the outdoor play area were not met as evidenced by the fence had openings that were greater than 3 1/2 inches and allow entrapment - the openings measured approximately 5 inches.

Open Not marked corrected in the state record

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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 2 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

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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 1 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.

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 1 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

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5 CSR 25-300.110 · 5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (E) states: The name of the individual(s) authorized to take the child from the premises.

The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child files did not have the name of the individual(s) authorized to take the child.

Open Not marked corrected in the state record

Open / not marked corrected.

RSMo 252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. 1. states: All buildings and premises used by a child-care facility to care for more than six children except those exempted from the licensing provisions of the department of elementary and secondary education pursuant to subdivisions (1) to (15) of subsection 1 of section 210.211, shall be inspected annually for fire and safety by the state fire marshal, the marshal's designee or officials of a local fire district and for health and sanitation by the department of elementary and secondary education or the department's designee, including officials of the department of health and senior services, or officials of the local health department. Evidence of compliance with the inspections required by this section shall be kept on file and available to parents of children enrolling in the child-care facility.

Requirements for sanitation inspection were not met as evidenced by the inspection has not been conducted.

Open Not marked corrected in the state record

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5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) 2. states: The facility may use the department's physical assessment form, MO 580-1879 (6- 94), or the facility may use its own form if it contains all the information on the department's form.

Medical examination reports including TB testing were not on file for caregivers as evidenced by the medical form did not contain all required information in that the form was not completed with the date of the exam and did not state whether the employee was in good mental and physical health.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) . states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.

Medical examination reports, including TB testing, were not on file for Emily Bowman, Sawyer Stein, Natasha Westbrook and Alexis Williams as evidenced by a cleared TB report was not on file for caregivers within 30 days of working in the facility.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) . states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.

Medical examination reports, including TB testing, were not on file for Natasha Westbrook and Alexis Williams 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 25-300.050 · 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 there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 01/02/2024.

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 2 (E) states: At least thirty-five (35) square feet of usable floor space for each preschool and school-age child, and at least forty-five (45) square feet of usable floor space for each infant/toddler.

The facility did not provide 45 square feet of usable floor space for each child coming into the facility for day care as evidenced by 17 children were present in the infant/toddler unit and the facility is only approved for 16 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 4 (D) states: The fall-zone area under and around outdoor equipment over twenty-four inches (24") high covered with impact-absorbing materials that will effectively cushion the fall of a child. Materials may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.

The equipment, a swing and a bridge, that is over 24 inches high, does not have sufficient impact absorbing material present as evidenced by there is no resilient material present to impact a fall.

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) (D) states: A child care facility operated by a religious organization shall file the Notice of Parental Responsibility form with the department annually during the month of August.

A copy of the Notice of Parental Responsibility form was not filed annually, during the month of August, with the department.

Open Not marked corrected in the state record

Open / not marked corrected.

5 CSR 25-300.050 · 5 CSR 25-300.050 Health Requirements (1) (D) . states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.

Medical examination reports, including TB testing, were not on file for Nylia Idhen, Alisa Lovan, Bailee Rousso and Kelly Kaufenberg 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 25-300.090 · 5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 4 (D) states: The fall-zone area under and around outdoor equipment over twenty-four inches (24") high covered with impact-absorbing materials that will effectively cushion the fall of a child. Materials may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.

The equipment, a swing and a bridge, that is over 24 inches high, does not have sufficient impact absorbing material present as evidenced by there is no resilient material present to impact a fall.

Open Not marked corrected in the state record

Open / not marked corrected.