PURPOSE: This rule sets forth the requirements for child abuse/neglect and criminal background screenings, medical examinations, personnel records, job descriptions, and staff orientation and training.

1. (1) Pre-Employment Requirements.

   1. (A) The licensed residential care facility (LRCF) shall require all professional staff to provide a copy of their official college transcript or college diploma and shall keep such transcripts or diplomas on file pursuant to the requirements set forth in subsection (4)(A) of this rule. The LRCF shall require any person employed in a position requiring a general educational development certificate or high school diploma to provide a copy of such certificate or diploma to the LRCF, which the LRCF shall keep on file pursuant to the requirements set forth in subsection (4)(A) of this rule.
   2. (B) The LRCF shall require prospective employees to submit at least three (3) character references from unrelated persons. At least one (1) reference shall be from a previous employer, supervisor, teacher, or professor. The LRCF shall contact all references and maintain documentation of the reference checks in the LRCF’s employee records pursuant to the requirements set forth in subsection (4)(A) of this rule. Documentation of the contact shall include the date, person making the contact, and the content of the contact.
   3. (C) The LRCF shall establish a written job description for each position, which shall be given to staff at the time of employment. Each description shall describe the duties and responsibilities of the position, address supervision, required knowledge, skills, and abilities, minimum experience, educational requirements, and shall include examples of work performed.

2. (2) Annual Requirements.

   1. (A) The LRCF shall conduct an annual check of the family care safety registry (FCSR) for all employees and contractors and those owners and volunteers who have access to children. The LRCF shall maintain documentation of the FCSR checks in its personnel records.
   2. (B) The LRCF shall conduct an annual background check for employees, contractors, owners, and volunteers with access to children who reside outside of Missouri by searching the criminal records database and child abuse and neglect registry of the states where such persons reside. If the LRCF is not legally permitted to search such databases and registries, such employees, contractors, owners, and volunteers shall conduct a background check on themselves in such databases and registries and provide the results to the LRCF.
   3. (C) The LRCF shall require an annual driver record check for any employees, interns, volunteers, or contract personnel who transport residents. No individual with a suspended or revoked driver's license or record of driving while under the influence of alcohol or any other intoxicating substance within the last five (5) years shall transport residents.

3. (3) Health Verification.

   1. (A) All staff, employees, interns, volunteers, and contracted personnel shall be free of symptoms of communicable disease or other evidence of ill health that poses a threat to children.
   2. (B) If the division has reason to question the capabilities of any individual working directly with children served by the LRCF, the division may require the individual to submit to a medical examination and obtain a report of an appropriate medical professional that the individual is medically fit to perform the services for the LRCF without reasonable risk to the children.

4. (4) Personnel Records. The LRCF shall maintain personnel records for each staff member, employee, intern, volunteer, and contracted employee as indicated below. The LRCF shall maintain the records on site and shall keep the records for at least three (3) years following the date of separation from the LRCF.

   1. (A) For staff members and employees, the personnel record shall include—

      1. 1. Verification of education and experience, and a copy of

professional license, if applicable;

1. 2. Verification of the names of three (3) persons, unrelated

to the staff member, who can provide character or professional references;

1. 3. Results of annual checks of the family care safety

registry;

1. 4. Documentation that the individual has completed

the background checks and that the division has found the individual eligible for employment or presence at the LRCF pursuant to section 210.493, RSMo, and 13 CSR 35-71.015;

1. 5. Documentation that employees who reside outside of

Missouri have completed an annual background check of a criminal records database and child abuse and neglect registry of the state in which such employees reside;

1. 6. The date that employment commenced;
2. 7. Copies of annual performance evaluations;
3. 8. Results of an annual driver record check for any

employee, intern, volunteer, and any contracted personnel who transport residents;

1. 9. A copy of the following documents signed and dated by

the employee:

1. A. Job description;
2. B. Confidentiality policy;
3. C. Discipline policy;
4. D. Child abuse/neglect reporting policy;
5. E. Critical incident reporting policy;
6. F. Acknowledgment of receipt of program policy;
7. G. Acknowledgment of personnel policy; and
8. H. Acknowledgment of completed agency orientation;
9. 10. Documentation that the staff member has successfully

completed all required training;

1. 11. Documentation of current first aid/cardiopulmonary

resuscitation training and certification for applicable staff;

1. 12. Documentation of current medication aide certification,

when applicable; and

1. 13. Documentation of current physical restraint training

certification, when applicable.

1. (B) For interns, volunteers, and contracted employees who have direct contact with children, the personnel record shall include—

   1. 1. Copy of professional credentials, if applicable;
   2. 2. Results of annual checks of the family care safety

registry and documentation that the individual has completed the background check process and been found eligible for service as provided in section 210.493, RSMo, and 13 CSR 35- 71.015;

1. 3. Results of annual checks of the out-of-state criminal

records database and child abuse and neglect registry for those interns, volunteers, and contracted employees who reside outside of Missouri;

1. 4. A copy of the following documents signed and dated by

the intern, volunteer, or contracted employee:

1. A. The contract or any agreement outlining purpose of

presence on site;

1. B. The confidentiality policy;
2. C. The discipline policy;
3. D. The child abuse/neglect reporting policy;
4. E. The critical incident reporting policy;
5. F. Acknowledgment of receipt of program policy, if

applicable;

1. G. Acknowledgment of receipt of manuals or policies

related to the agreement/contract, if applicable; and

1. H. Acknowledgment of completed facility orientation,

if applicable.

1. (5) Staff Orientation.

   1. (A) The LRCF shall have a written statement of personnel practices that is provided to all staff at the time of employment.

   2. (B) Within thirty (30) days following appointment, employees, interns, volunteers, and contracted personnel shall be oriented to the facility’s programs, practices, and the duties of their positions. The orientation program shall include instruction in the following areas with respect to the facility:

      1. 1. Program model;
      2. 2. Policies;
      3. 3. Staff roles;
      4. 4. Health and safety procedures;
      5. 5. Crisis intervention procedures;
      6. 6. Recordkeeping requirements;
      7. 7. Separation and attachment issues;
      8. 8. Confidentiality;
      9. 9. Recognition of suicidal tendencies and appropriate

intervention;

1. 10. Procedure for identifying and reporting child abuse or

neglect, or both, in accordance with sections 210.110-210.165, RSMo;

1. 11. Procedure for identifying and reporting the abuse of

youth eighteen (18) years or older who are “eligible adults” under sections 192.2400–192.2505, RSMo, if applicable;

1. 12. Basic information on the child welfare and juvenile

justice systems, including the legal rights of children and their families; and

1. 13. Procedures to follow in an emergency.

1. (6) Staff Training.

   1. (A) A facility shall prepare a written plan of training each year for all employees and contracted personnel.

      1. 1. Employees and contracted personnel that work directly

with children shall have twenty-five (25) hours of training annually.

1. 2. Direct care staff and immediate supervisors must

maintain certification in a certified medication training program unless all medication is managed through on-site medical personnel.

1. 3. Direct care staff and immediate supervisors must

maintain certification in a current recognized and approved physical restraint program (where applicable), first aid, and cardiopulmonary resuscitation.

1. 4. Employees and contracted personnel that do not work

directly with children shall receive job-appropriate training.

1. (B) All training must be documented on a training database/ training log with the dates, location, subject, number of hours earned, and person(s) who conducted the training.
2. (C) The training may include short-term courses, seminars, institutes, workshops, and in-service training provided on site by qualified professionals. Activities related to supervision of the staff member’s routine tasks shall not be considered training for the purpose of this rule.

3. (D) The training plan shall include training in the following areas for employees and contracted personnel who work directly with children:

   1. 1. Developmental needs of children;
   2. 2. For those facilities licensed to provide residential treat-

ment and intensive residential treatment, training related specifically to treatment issues with emotionally disturbed, mentally ill, behaviorally disordered, medically fragile, physically disabled, and/or developmentally delayed children, as defined by the facility’s program;

1. 3. Prenatal and parenting skills, including safe sleep, for

facilities licensed for infant/toddler/preschool and maternity;

1. 4. Basic group dynamics;
2. 5. Trauma-informed care;
3. 6. Cultural sensitivity;
4. 7. Critical incident reporting;
5. 8. Appropriate discipline, crisis intervention, de-escalation

techniques, and behavior management techniques;

1. 9. The role of direct care and professional staff at the

operating site, including maintaining appropriate boundaries;

1. 10. Proper, safe methods and techniques of physical

restraint, if applicable;

1. 11. Fire prevention and reporting fires;
2. 12. Emergency evacuations;
3. 13. First aid and cardiopulmonary resuscitation training,

including infant CPR for facilities with an infant/toddler preschool license;

1. 14. Medication training and/or certification, including

training to identify changes in a child’s appearance or behavior that may be related to the use or disuse of any medication, including psychotropic medications;

1. 15. Substance abuse;
2. 16. Suicide prevention;
3. 17. Human trafficking;
4. 18. Legal rights of children and their families, including

basic information on the constitutional rights of children and their families while children are in care and basic information on the Missouri juvenile justice system; and

1. 19. Water safety for those agencies allowing water activ-

ities.

AUTHORITY: sections 207.020, 210.506, and 660.017, RSMo 2016, and sections 210.493 and 210.1286, RSMo Supp. 2024.* This rule originally filed as 13 CSR 40-71.045. Emergency rule filed Nov. 1, 1993, effective Nov. 12, 1993, expired March 11, 1994. Emergency rule filed March 2, 1994, effective March 12, 1994, expired July 9, 1994. Original rule filed Nov. 1, 1993, effective June 6, 1994. Emergency amendment filed July 25, 2008, effective Aug. 4, 2008, expired Jan. 30, 2009. Moved to 13 CSR 35-71.045 and amended: Filed July 25, 2008, effective Jan. 30, 2009. Amended: Filed Dec. 16, 2013, effective June 30, 2014. Emergency amendment filed Sept. 17, 2021, effective Oct. 1, 2021, expired March 29, 2022. Amended: Filed Sept. 17, 2021, effective March 30, 2022. Amended: Filed Oct. 1, 2024, effective April 30, 2025. *Original authority: 207.020, RSMo 1945, amended 1961, 1965, 1977, 1981, 1982, 1986, 1993, 2014; 210.493, RSMo 2021, amended 2023; 210.506, RSMo 1982, amended 1993, 1995; 210.1286, RSMo 2021; and 660.017, RSMo 1993, amended 1995.