Mo. Code Regs. Ann. tit. 19, § 30-62.112
PURPOSE: This rule provides the number of staff required for specific ages and numbers of children in care.
(1) The following staff/child ratios shall be maintained on the premises at all times:
AUTHORITY: section 210.221.1(3), RSMo Supp. 1993.* This rule previously filed as 13 CSR 40-62.100, 13 CSR 40-62.112 and 19 CSR 40-62.112. Original rule filed March 29, 1991, effective Oct. 31, 1991. Changed to 19 CSR 40-62.112, effective Dec. 9, 1993. Changed to 19 CSR 30-62.112 July 30, 1998. *Original authority: 210.221.1(3), RSMo 1949, amended 1955, 1987, 1993. 19 CSR 30-62.122 Medical Examination Reports PURPOSE: This rule sets forth the requirements for medical examinations for caregivers and children in care. (1) Staff and Volunteers. (A) All adults working in a day 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, 19 CSR 30-62 on file at the facility at the time of initial licensure or within thirty (30) days following employment. (B) Medical examination reports shall include a tuberculin skin test, a chest X ray or appropriate follow-up of a previous examination that indicates the individual is free of contagion. (C) Medical examination reports shall be completed not more than twelve (12) months prior to beginning work in the facility and may be transferable to another day care facility for subsequent employment. (D) The medical examination report form shall be supplied by the department or the facility may use its own form if it contains all the information on the department’s form (see 19 CSR 40-61.125). (E) After the initial medical examination, all adults working in a day care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall have an annual tuberculin skin test, a chest X ray or appropriate follow-up of a previous examination that indicates the individual is free of contagion. (F) If at any time the department has reason to question the physical or emotional health of any adult working or volunteering in the facility, the department shall require a physical or mental examination of these persons. (G) Staff or volunteers shall not work when ill if the health or well-being of children is endangered. (2) Children. (A) 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. (B) The examination report shall determine if a child’s medical history and current state of health is satisfactory participation in a day care program. (C) Medical examination requirements shall not apply to any child if the parent(s) files a signed statement of objection based on religious beliefs. (D) The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child’s health history, any current health problems and any restrictions necessary for the child’s care. (E) The medical examination report form and the health history report for school-age children shall be supplied by the department or the facility may use its own form if it contains all the information on the department’s form (see 19 CSR 40-61.125). AUTHORITY: section 210.221.1(3), RSMo Supp. 1993.* This was previously filed as 13 CSR 40-62.110, 13 CSR 40-62.122 and 19 CSR 40-62.122. Original rule filed March 29,1991, effective Oct. 31, 1991. Changed to 19 CSR 40-62.122, effective Dec. 9, 1993. Emergency amendment filed Aug. 18, 1993, effective Aug. 28, 1993, expired Dec. 25, 1993. Emergency amendment filed Jan. 4, 1994, effective Jan. 14, 1994, expired May 13, 1994. Amended: Filed Aug. 18, 1993, effective April 9, 1994. Changed to 19 CSR 30-62.122 July 30, 1998. *Original authority: 210.221.1(3), RSMo 1949, amended 1955, 1987, 1993. 19 CSR 30-62.132 Admission Policies and Procedures PURPOSE: This rule defines admission policies and procedures for children in care. PUBLISHER’S NOTE: The publication of the full text of the material that the adopting agency has incorporated by reference in this rule would be unduly cumbersome or expensive. Therefore, the full text of that material will be made available to any interested person at both the Office of the Secretary of State and the office of the adopting agency, pursuant to section 536.031.4, RSMo. Such material will be provided at the cost established by state law. (1) The provider shall establish written policies pertaining to the program goals, admission, care and discharge of children and shall provide a copy to the parent(s) at the time of enrollment. (2) The provider shall have available a copy of the Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri and shall advise the parent(s) at the time of enrollment of his/her child of the availability of the rules for review. (3) Only children two (2) years of age and older shall be accepted for care unless the facility has been specifically licensed to include infant/toddler care. (4) If infant/toddler care is provided in a unit auxiliary to a licensed facility for older children, the following shall apply: (A) Placement of a two (2) year old in either the infant/toddler unit or the unit for older children shall be determined in consultation with the parent(s); and (B) The infant/toddler unit shall not care for children older than two (2) years unless the total number of children in attendance at the time is four (4) or fewer. (5) A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source. (6) The provider shall assess his/her ability to provide care for the special needs child while also meeting the needs of the other children. (7) The provider shall develop and implement a procedure for admitting children which shall include: (A) A personal interview with the parent(s) and child to exchange information and arrive at a mutual decision about admitting a child; (B) A plan for continuing communication between the child care provider and the parent(s); (C) Discussion of the plan for providing for the care of the ill child as required by 19 CSR 40-62.192 Health Care; (D) Discussion of the parental plan for providing for the care of the school-age child on scheduled days of school closings; and (E) Completion by the parent(s) of the following written information, which shall be on file before the child is accepted for care: 1. All information required by 19 CSR 40-62.222 Records and Reports; 2. Information regarding a child’s per- sonal development, behavior patterns, habits and individual needs; 3. A diet plan for each infant/toddler signed by the parent(s); 4. Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care; 5. Information indicating that the child has completed age-appropriate immunizations, is in the process of completing immunizations or is exempt from immunization requirements as defined by 19 CSR 40- 62.192 Health Care; 6. Permission for field trips, transporta- tion to and from school and other transportation; 7. Permission for school-age children to leave the facility to participate in classes, clubs or other activities, naming the activity, time of leaving and returning and the method of transportation to and from the activity (Permission for regular activities such as scouting may be given for the entire school term.); and 8. Acknowledgement by the parent(s) that— A. They have received a copy of the provider’s policies pertaining to the admission, care and discharge of children; B. They have been informed that the Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available in the facility for their review; C. They and the provider have agreed on a plan for continuing communication regarding the child’s development, behavior and individual needs; and D. They understand and agree that the child may not be accepted for care when ill. (8) If care is provided for children related to the center owner(s) or group day care home provider, the parent(s) shall complete and sign a form which is supplied by the department (see 19 CSR 40-61.135). The form shall be on file at the facility before children related to the center owner(s) or group day care home provider are accepted for care, and shall contain the following identifying information: (A) Each child’s name, address, birthdate and date of admission; (B) Each child’s relationship to the center owner(s) or group day care home provider; and (C) The parent’s(s’) name(s), address(es) and telephone number(s). (9) If a provider enrolls children for irregular or intermittent care, all procedures for admitting children shall be followed. Children enrolled on an irregular or intermittent basis shall be accepted only by appointment and shall not cause the facility to exceed its licensed capacity. (10) After attempts have been made to meet a child’s individual needs, any child who demonstrates an inability to benefit from the care offered by the child care provider or whose presence is detrimental to other children may be discharged from the facility. (11) Care of a child may be discontinued if the provider and the parent(s) cannot establish a mutually satisfactory working relationship. (12) Parents shall have access to the facility at any time during child care hours. AUTHORITY: section 210.221.1(3), RSMo Supp. 1993.* This rule previously filed as 13 CSR 40-62.120, 13 CSR 40-62.132 and 19 CSR 40-62.132. Original rule filed March 29, 1991, effective Oct. 31, 1991. Changed to 19 CSR 40-62.132, effective Dec. 9, 1993. Emergency amendment filed Aug. 18, 1993, effective Aug. 28, 1993, expired Dec. 25, 1993. Emergency amendment filed Jan. 4, 1994, effective Jan. 14, 1994, expired May 13, 1994. Amended: Filed Aug. 18, 1993, effective April 9, 1994. Changed to 19 CSR 30-62.132 July 30, 1998. *Original authority:210.221.1(3), RSMo 1949, amended 1955, 1987, 1993.