PURPOSE: The purpose of this rule is to implement the provisions of sections 210.025 and 210.027, RSMo, for the purpose of registering child care providers and defining eligibility for providers to receive state or federal funds for providing child care services.

1. (1) Requirements for Registration. To receive a certificate of registration as a registered child care provider, the child care provider applicant shall meet the requirements set forth in this section.

   1. (A) The child care provider applicant must have attained eighteen (18) years of age.
   2. (B) The child care provider shall not care for more than four

2. (4) unrelated children.

   1. (C) A child care provider applicant shall—

      1. 1. Pass a background check as defined in 13 CSR 35-32.050.

Passing a background check shall include:

1. A. The child care provider shall not have received a

substantiated child abuse and neglect report;

1. B. The child care provider shall not have been previously

refused licensure or have experienced licensure suspension or revocation;

1. C. The child care provider cannot appear on the

Department of Mental Health’s Disqualification Registry pursuant to section 630.170, RSMo;

1. D. The child care provider shall not be a registered sex

offender or required to register as a sex offender in any state;

1. E. The child care provider applicant shall not have had

a certificate of registration denied or revoked within the past six (6) months; and

1. F. A child care provider applicant shall not have pled

guilty or nolo contendere to or been found guilty of—

1. (I) Any felony for an offense against the person

as defined in Chapter 565, RSMo, or any other offense (misdemeanor or felony) against the person involving the endangerment of a child as prescribed by law;

1. (II) Any misdemeanor or felony for sexual offense

as defined in Chapter 566, RSMo, for an offense against the family as defined in Chapter 568, RSMo, with the exception of the sale of fireworks to a child under the age of eighteen (18), for pornography or related offense as defined by Chapter 573, RSMo, for an offense relating to public assistance including, but not limited to, unlawful receipt, conversion or transfer of public benefits pursuant to sections 578.377 through 578.381, RSMo, (sections 570.400 through 570.404, RSMo, after January 1, 2017), perjury committed when obtaining public assistance pursuant to section 578.385, RSMo, (section 570.408, RSMo, after January 1, 2017); or

1. (III) Any similar crime in any federal, state, municipal,

or other court of similar jurisdiction or any offenses or reports which will disqualify an applicant from receiving state or federal funds, including the following:

1. (a) The following crimes, in any degree, if considered

a felony in the jurisdiction in which it was filed: murder, manslaughter, assault, kidnapping, felonious restraint, false imprisonment, interference with child custodial rights, adult abuse or stalking, burglary; or

1. (b) The following crimes, in any degree, if considered

a felony or misdemeanor in the jurisdiction in which it was filed: rape, sodomy, prostitution, child molestation, bigamy, child abandonment, child endangerment, criminal nonsupport of a child, child abuse, elder abuse, robbery, arson, armed criminal action, unlawful possession/use/transfer of a firearm or weapon, unlawful promotion/possession/furnishing of obscene or pornographic material (including, but not limited to, child pornography), or human trafficking;

1. (c) The following crimes, in any degree, if considered

a felony or misdemeanor in the jurisdiction in which it was filed and if involving the endangerment of a child or a child victim: assault, kidnapping, felonious restraint or false imprisonment, interference with child custodial rights; or

1. (d) The following crimes, in any degree, if considered

a felony or misdemeanor in the jurisdiction in which it was filed and if filed within the past ten (10) years: unlawful possession, sale, transfer, or trafficking of a controlled substance or any similar crime;

1. (e) The following crimes, in any degree, if considered

a felony in the jurisdiction in which it was filed and if committed against the Department of Social Services or any division thereof: fraud, stealing, or forgery; or

1. (f) Any municipal court offense for conduct which,

if prosecuted in a court of general jurisdiction, would be an offense described in subparagraph (1)(C)1.F. above.

1. (D) The child care provider shall submit a “Risk Assessment for Tuberculosis” form, to be completed, signed, and dated by a medical professional no more than ninety (90) days prior to submission. If a child care provider has active, contagious tuberculosis, the child care provider must submit documentation showing that a medical professional has certified that the child care provider is non-infectious before the child care provider may become registered.
2. (E) Child care provider shall submit a statement completed, signed, and dated by a medical professional no more than ninety (90) days prior to submission on a prescribed form, regarding his/her opinion of the physical and mental health of the child care provider applicant and certifying that a physical examination was completed within the past ninety

1. (90) days, that the child care provider applicant was free from communicable disease, and is not a threat to the health of children.

   1. (F) Child care provider applicant and anyone residing with the child care provider applicant shall be legally allowed in the presence of children.

   2. (G) All individuals residing with the child care provider applicant over the age of seventeen (17) shall pass—

      1. 1. A search of the Family Care Safety Registry as described

in sections 210.903 through 210.936, RSMo; and

1. 2. State-based child abuse and neglect registries and

databases in Missouri and in the state where the child care provider household member resides, and each state where such person resided during the preceding five (5) years;

1. 3. State-based sex offender registry or repository in Missouri

and in the state where the child care provider household member resides, and each state where such person resided during the preceding five (5) years;

1. 4. No individual residing with the child care provider

applicant over the age of seventeen (17) shall have received a substantiated child abuse and neglect report, appear on the Department of Mental Health employee disqualification list, or be a registered sex offender or required to register as a sex offender in any state.

1. (H) The department shall not pay for any costs associated with the requirements of registration.

2. (I) The child care provider applicant must cooperate and allow for an unannounced on-site inspection by the division or designee at initial application. The on-site inspections shall ensure that the child care provider applicant’s home is in compliance with the following health, safety, fire, and other requirements:

   1. 1. Local ordinances, codes, and regulations.

      1. A. The child care provider applicant’s home shall meet

local ordinances, codes, and regulations, particularly with regard to fire safety and smoke or carbon monoxide detectors.

1. B. If there are no local ordinances or regulations

regarding smoke and carbon monoxide detectors that apply to the child care provider applicant’s home, the child care provider applicant shall—

1. (I) Install and maintain operable smoke and carbon

monoxide detectors in accordance with the manufacturer’s instructions;

1. (II) Install and maintain all detectors on the ceiling

or wall at a point centrally located in a corridor or other area giving access to rooms used for providing child care services in the home unless the manufacturer’s instructions provide otherwise; and

1. (III) Ensure that when activated, the detectors shall

provide an alarm in the structure or room;

1. 2. Physical Space: The physical space of the child care

provider applicant’s home must meet the following criteria:

1. A. It must be clean, free of insects and vermin;
2. B. It must have working heating and cooling systems;
3. C. It must have potable, running water, at least one (1)

flushable toilet and one (1) sink for hand washing accessible to children;

1. D. Hygiene items such as toilet paper, soap, hand drying

towels (paper or cloth) must be accessible to children;

1. E. The food preparation area clean and equipped to

prepare snacks and meals;

1. F. It must have inside space for play and napping;
2. G. Hazardous materials must be inaccessible to children;
3. H. Smoking in the home is prohibited while children are

present;

1. I. Weapons and ammunition stored in locked cabinets

inaccessible to children; and

1. J. Smoke detectors and fire extinguisher present;
2. 3. Outdoor play area: The outdoor play area must meet the

following criteria:

1. A. It must be an area safe, maintained, and no hazards;
2. B. The outdoor area must either be continuously fenced

to ensure that the children cannot leave and others cannot enter the premises without supervision; or, if not fenced, child care provider must have a division approved, supervision plan for when children are in outdoor play area;

1. C. Pools and open water areas are not accessible to

children without adult supervision; and

1. D. Play equipment is well-constructed and free from

hazards;

1. 4. Emergency preparedness and response plan available

and posted;

1. 5. Animals: Any animals present on the premises must

meet the following criteria:

1. A. They must be non-threatening to children;
2. B. None of the animals may have a history of attacking

or injuring human beings or other animals;

1. C. The animals must be disease free and have all

required vaccinations according to state and local law;

1. D. Indoor and outdoor areas used by children are free of

animal excrement; and

1. E. Litter boxes are not located in food preparation or

serving area and inaccessible to children;

1. 6. The child care provider applicant’s home must be free of

illegal substances and criminal activity.

1. (J) The child care provider applicant shall register with Opportunities in a Professional Education Network (OPEN) and secure a Missouri Professional Development Identifier (MOPD-ID) to track and successfully complete all required trainings as approved by the division. The child care provider shall provide satisfactory, written documentation of successful completion to the division. The child care provider applicant shall successfully complete training which includes, but is not limited to:

   1. 1. First Aid and Cardiopulmonary Resuscitation (CPR);
   2. 2. Child Care Subsidy Orientation;
   3. 3. Prevention of Sudden Infant Death Syndrome and Safe

Sleeping;

1. 4. Prevention of Shaken Baby Syndrome and Abusive Head

Trauma;

1. 5. Emergency Disaster Response and Planning;
2. 6. Mandatory Child Abuse and Neglect (CA/N) Reporting;
3. 7. Prevention and Control of Infectious Diseases (including

immunizations);

1. 8. Administration of Medication, consistent with standards

for parental consent;

1. 9. Prevention and Response to Food Allergy Emergencies;
2. 10. Building and Physical Premises Safety; including

identification of and protection from hazards that can cause bodily injury;

1. 11. Handling and Storage of Hazardous Materials and the

Appropriate Disposal of Bio-Contaminants; and

1. 12. Transportation of Children.
2. (K) If a child care provider applicant has an outstanding debt owed to the state due to a previous child care overpayment, the child care provider applicant must participate in a repayment plan pursuant to 13 CSR 35-32.050 to become registered with the division.

1. (2) Providing Care for Related Child. If a child care provider applicant wishes to provide child care to a related child, the child care provider applicant must meet the requirements listed in section (1) and must sign an attestation of relationship to child on a form provided by the division.
2. (3) Providing Care in the Child’s Home. If a child care provider applicant wishes to provide child care in the child’s home, the child care provider applicant must meet the requirements listed in section (1), with the exception of the on-site inspection listed in subsection (1)(I).

3. (4) Processing of Application.

   1. (A) Upon receipt of an initial application for registration and completion of on-site inspection, the division shall review all information to make a determination as to whether the child care provider applicant is eligible to receive a certificate of registration. The division, in its discretion, may request additional documentation if concerns arise regarding the child care provider applicant’s ability to provide for the health and safety of children, ability to follow generally accepted accounting practices (GAAP), or to address other concerns as noted by the division. The child care provider applicant shall provide all requested documentation.
   2. (B) If the division determines the child care provider applicant meets all eligibility requirements, the division shall issue a certificate of registration good for one (1) year to the child care provider applicant.

   3. (C) If the division determines the child care provider applicant fails to meet eligibility requirements, the division may, in its discretion, give the child care provider a reasonable opportunity to cure any defect. The division may specify a reasonable time frame for the provider to cure the deficiency, not to exceed ninety (90) days. The division shall take into account the severity of any defect and whether such defect is likely to be cured in a reasonable amount of time. If the division determines that a defect cannot be cured or the applicant is otherwise ineligible, the division shall provide written notice of the denial of registration. The notice shall—

      1. 1. Inform the child care provider applicant of the nature

of the decision;

1. 2. State generally the factual and legal basis for the

division’s decision; and

1. 3. Notify the child care provider applicant of his/her right

to seek an administrative review.

1. (5) Renewal of Child Care Provider Registration.

   1. (A) A child care provider shall renew registration annually. The child care provider shall adhere to the time frames listed below for every subsequent renewal.

   2. (B) To renew a certificate of registration as a registered child care provider, the child care provider shall—

      1. 1. Within ten (10) days of circumstance, incident, or

occurrence which would alter any information provided in the child care provider’s original application for registration, the child care provider shall notify the division in writing;

1. 2. Perform the following annually:

   1. A. Cooperate and allow for an unannounced on-site

inspection by the division or designee prior to renewal. The on-site inspections shall ensure that the registered child care provider is in compliance with the health, safety, fire, and other requirements listed in subsection (1)(I);

1. 3. Perform the following every two (2) years:

   1. A. Submit a “Risk Assessment for Tuberculosis” form, to

be completed, signed, and dated by a medical professional no more than ninety (90) days prior to submission. If a registered child care provider has active, contagious tuberculosis, the registered child care provider must submit documentation showing that a medical professional has certified that the registered child care provider is non-infectious before the registered child care provider may become renewed; and

1. B. Submit a statement completed, signed, and dated no

more than ninety (90) days prior to submission by a medical professional on a prescribed form, regarding his/her opinion of the physical and mental health of the registered child care provider and certifying that a physical examination was completed no more than ninety (90) days prior to submission, that the registered child care provider was free from communicable disease and is not a threat to the health of children;

1. 4. Perform the following every five (5) years:

   1. A. Pass a background check as defined in 13 CSR 35-

32.050. Passage of a background check shall be determined as defined in paragraph (1)(C)1. above;

1. B. All individuals residing with the registered child care

provider over the age of seventeen (17) shall adhere to the requirements listed in subsection (1)(G) above; and

1. C. Upon receipt of registration renewal request, the

division shall make a determination as to whether the registered child care provider is eligible to receive a renewed certificate of registration. The division shall follow the same process for the renewal of a registration as that followed to process an initial application as described in section (2) above.

1. (6) Corrective Action. The division may require the child care provider to submit and implement a corrective action plan to resolve any health or safety concerns, regulatory violations, or contractual violations. The division shall provide written notification to the child care provider of the requirement to submit and implement a corrective action plan, identifying the specific performance, regulatory requirements, or contractual requirements not being met, and the expected corrective resolution.

   1. (A) The child care provider shall submit a written corrective action plan to the division within ten (10) days of notice.
   2. (B) The corrective action plan must include the actions the child care provider proposes to take to remedy concerns, time frames for achieving such, the staff responsible for the necessary action, the improvement that is expected, a description of how progress will be measured, and a description of the actions to be taken to prevent the situation from recurring.
   3. (C) The division shall notify the child care provider in writing if the corrective action plan is approved or if modifications are required. In the event the division requires changes to the corrective action plan, the child care provider shall submit a revised corrective action plan, within ten (10) days of notice that changes are required.

2. (7) Registration Revocation.

   1. (A) The division shall revoke a child care provider’s registration if—

      1. 1. Health or safety issues exist which place children at risk

of immediate harm;

1. 2. Child care provider or anyone over the age of seventeen

1. (17) living in the child care provider’s home has a substantiated child abuse or neglect report;

   1. 3. Child care provider committed an intentional violation;
   2. 4. Child care provider failed to report child abuse and

neglect when required by law to do so;

1. 5. Child care provider is not mentally, emotionally, or

physically fit to care for children as determined by a medical professional or mental health professional;

1. 6. Child care provider is not legally allowed in the presence

of children;

1. 7. Child care provider failed to cooperate in a Welfare

Investigative Unit investigation, a law enforcement investigation, a Child Abuse and Neglect investigation, compliance review, or audit; or

1. 8. The Department of Health and Senior Services determines

the child care provider is operating in violation of law.

1. (B) The division may revoke a child care provider’s registration if—

   1. 1. Child care provider failed to disclose all household

members subject to a check of the Family Care Safety Registry;

1. 2. Health and safety issues exist that negatively impact

the safety and well-being of the children in the child care provider’s care, and the child care provider fails or is unable to rectify the issues;

1. 3. Child care provider fails to successfully submit or

complete the requirements of a corrective action plan within time period specified in the plan; or

1. 4. Child care provider is non-compliant with registration

requirements.

1. (C) If any health or safety issues exist which place children at immediate risk of harm, the division shall immediately revoke the child care provider’s registration. In the case of immediate revocation, the child care provider shall promptly be granted an administrative review under section (9).

2. (D) If the division determines the child care provider’s registration is subject to revocation and no health or safety issues exist which place children at immediate risk of harm, the division shall provide written notice of the revocation. The notice shall—

   1. 1. Inform the child care provider applicant of the nature

of the decision;

1. 2. State generally the factual and legal basis for the

division’s decision; and

1. 3. Notify the child care provider of his/her right to seek an

administrative review.

1. (8) Contract. To be eligible to contract to receive state or federal funds as a registered child care provider, the child care provider shall meet the following requirements:

   1. (A) Obtain a certificate of registration which shall be maintained throughout the duration of the contract;

   2. (B) The child care provider shall sign a contract issued by the state, agreeing to all terms including, but not limited to:

      1. 1. All records of children shall be confidential, protected

from unauthorized examination and available to the parent(s) and division upon request unless otherwise allowed by law;

1. 2. Child care provider shall care for no more than four (4)

or fewer unrelated children;

1. 3. Child care provider shall not be engaged in any other

employment while providing child care services;

1. 4. Child care provider shall maintain records pursuant to

13 CSR 35-32.130;

1. 5. Child care provider shall notify all custodial parents and

legal guardians of the child care provider’s—

1. A. Phone number;
2. B. Discipline policy; and
3. C. Emergency preparedness and response plan;
4. 6. Child care provider shall notify custodial parents and

legal guardians if the child care provider does not have immediate access to a telephone and provide parents with an alternative, effective method of communication;

1. 7. Child care provider shall ensure custodial parents and

legal guardians have access to their child(ren);

1. 8. Child care provider shall report child deaths and serious

injuries to the division within twenty-four (24) hours of the incident, using a form provided by the division. This includes, but is not limited to:

1. A. The death of a child if the child died while at the child

care provider;

1. B. The death of a child enrolled at the child care provider

if the child died of a contagious disease; or

1. C. A “serious injury” to a child that occurs while the

child is at the child care provider or away from the child care provider’s facility but still in the care of the child care provider, if an injury results in the child being treated by a medical professional or admitted to a hospital;

1. 9. Child care provider shall cooperate with any

investigations, audits, or other requests of the division;

1. 10. Child care provider shall follow all statutes, regulations,

and policies of the division;

1. 11. Child care providers must report the following changes

to the division in writing within ten business (10) days: physical address, mailing address, telephone number, email address, the addition of any new household members seventeen (17) years of age or older, or current household member turns seventeen (17) years of age;

1. 12. Child care provider shall not utilize physical or corporal

punishment including, but not limited to, spanking, slapping, shaking, biting, or pulling hair;

1. 13. Child care provider shall submit to monitoring by

division or its designee for compliance with contractual or regulatory obligations. Such monitoring may include, but is not limited to—

1. A. Providing attendance records at the request of the

division or its designee;

1. B. Submitting to unannounced or announced on-site

inspections; or

1. C. Other monitoring as determined necessary by the

division;

1. 14. Child care provider shall attend annual training as

approved by the division, and provide documentation of the successful completion of all training to the division through the Opportunities in a Professional Education Network (OPEN).

1. (C) If the child care provider is providing care for a child in the child’s own home, the child care provider shall sign a contract issued by the state, agreeing to all terms listed in subsection (8)(B), except for the requirement listed in subparagraph (8)(B)13.B. The child care provider shall further agree in the contract that he/she shall not provide child care in the child’s home to any child who does not reside in the child’s home;
2. (D) A child care provider may not be eligible for a contract if the child care provider was denied a contract or a previous contract was terminated for cause and the underlying issues causing denial or termination of the contract have not been resolved. A child care provider may not be eligible for a contract if the child care provider was the owner, director, board member, officer, shareholder, agent, agent registered with the secretary of state’s office, or had decision making authority over a licensed or licensed exempt child care facility, and was denied a contract or a previous contract was terminated for cause;

3. (E) Termination of Contract. If a child care provider fails to adhere to the terms of the contract, the division may terminate the contract by providing written notice to the child care provider. The notice shall—

   1. 1. Inform the child care provider of the date upon which

the contract shall be terminated;

1. 2. State generally the factual and legal basis for the

division’s decision; and

1. 3. Notify the child care provider of his/her right to seek

administrative review.

1. (9) Administrative Review.

   1. (A) The child care provider/applicant may request an administrative review of the decision to deny registration, deny registration renewal, revoke registration, deny a contract, or terminate a contract by providing a written request for an administrative review within ten (10) days of the notification. The child care provider/applicant may submit additional documentation for consideration with the request for an administrative review. The division may, in its discretion, review any information received after the request for review, but is not required to do so. In no circumstances shall the division be required to review information provided after the division has conducted its administrative review.
   2. (B) The child care provider/applicant may request the opportunity to present additional information via telephone conference call by making such a request in writing with the request for administrative review. If the child care provider/ applicant timely requests a telephone conference call, the division shall notify the child care provider/applicant in writing of the date, time, and telephone number at which the child care provider/applicant may present information. In such circumstances, the child care provider/applicant is responsible for ensuring that he/she is able to present information via telephone on the date/time provided, and that he/she has a working telephone and stable connection. The division shall not be responsible for any technical difficulties the child care provider/applicant may experience.

   3. (C) The division shall—

      1. 1. Review the denial of registration, denial of registration

renewal, registration revocation, contract denial, or contract termination, and any written materials provided by the child care provider;

1. 2. Conduct a telephone conference call, if requested by the

child care provider/applicant; and

1. 3. Upon completion of the administrative review, notify

the child care provider of the results of the administrative review in writing. (10) Direct Appeal to the Director. If, after conducting the administrative review, the division upholds the denial of registration, denial of registration renewal, or registration revocation, the child care provider/applicant may appeal the decision directly to the director pursuant to section 208.080, RSMo. The child care provider/applicant must submit a request for direct appeal to the director within ten (10) days of notification of the results of the administrative review. (A) If the child care provider/applicant timely makes a direct appeal to the director, the director shall designate the Administrative Hearings Unit of the Division of Legal Services of the Department of Social Services to hear all cases. The Administrative Hearings Unit shall hear cases under the procedures outlined in 13 CSR 40-2.160. (B) The burden shall be on the child care provider/applicant to prove the denial of registration, denial of registration renewal, or registration revocation was inconsistent with all applicable laws and regulations. (C) Upon completion of the hearing, the Administrative Hearings Unit shall issue a written decision as approved by the director, except in default cases or cases disposed of by stipulation, consent order, or agreed settlement. The decision shall include or be accompanied by findings of fact and conclusions of law. The findings of fact shall be stated separately from the conclusions of law and shall include a concise statement of the findings on which the agency bases its order. The Administrative Hearings Unit shall deliver or mail its decision, findings of fact, and conclusions of law to each party, or his/her attorney of record. The decision of the Administrative Hearings Unit shall be the final decision of the department.

AUTHORITY: sections 207.020, 210.025, and 210.027, RSMo 2016,* 42 U.S.C. section 9858, et. seq., Executive Order 03-03. This rule originally filed as 13 CSR 35-32.070. Original rule filed Jan. 3, 2017, effective Aug. 30, 2017. Moved to 5 CSR 25-200.070, effective Aug. 28, 2021. *Original authority: 207.020, RSMo 1945, amended 1961, 1965, 1977, 1981, 1982, 1986, 1993, 2014; 210.025, RSMo 1999, amended 2004; and 210.027, RSMo 1999, amended 2014.