PURPOSE: This rule defines admission policies and procedures for children in care.

PUBLISHER’S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here.

1. (1) The provider shall establish, implement, and maintain written policies pertaining to the program goals, admission, safe sleep practices for children less than one (1) year of age, care, and discharge of children, and shall provide a copy to the parent(s) at the time of enrollment.

2. (2) The provider’s infant safe sleep policy shall comply with section 210.223, RSMo, and shall include, but not be limited to:

   1. (A) The following safe sleep practices:

      1. 1. The policy shall list the licensee’s expectations regarding

how and when caregivers are to be trained on safe sleep;

1. 2. A requirement that children less than one (1) year of age

be placed on their backs to sleep;

1. 3. A requirement that the facility shall receive a written

statement from the infant’s licensed health care provider stating that the infant requires alternative sleep positions or special sleeping arrangements that differ from those set forth in 19 CSR 30-62.182(2)(C) prior to allowing the infant to be placed in a sleep position that is not on his or her back; and

1. 4. Supervision of infants during nap/sleep times, to in-

clude:

1. A. Positioning of staff;
2. B. Lighting in the nap room;
3. C. Physical checks of the child to ensure he or she is not

overheated or in distress; and

1. D. Prohibitions against the use of any equipment such as

a sound machine that may interfere with the caregiver’s ability to see or hear a child who may be distressed; and

1. (B) The following requirements for safe sleep environments:

   1. 1. The policy shall state that cribs and playpens must have

a firm mattress and tight fitting sheets, be free of loose bedding, bumper pads, pillows, and soft toys;

1. 2. Shall require infants’ heads be uncovered during nap/

sleep times;

1. 3. Shall prohibit covering cribs or playpens with blankets

or bedding;

1. 4. Shall prohibit smoking in the child care home during

the hours children are in care; and

1. 5. Shall require giving the parent(s) or guardian(s) of each

infant in care a copy of the provider’s safe sleep policy upon the child’s enrollment.

1. (3) 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.
2. (4) 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.

3. (5) If infant/toddler care is provided in a unit auxiliary to a licensed facility for older children, the following shall apply:

   1. (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
   2. (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.
4. (6) 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.
5. (7) The provider shall assess his/her ability to provide care for the special needs child while also meeting the needs of the other children.

6. (8) The provider shall develop and implement a procedure for admitting children which shall include:

   1. (A) A personal interview with the parent(s) and child to exchange information and arrive at a mutual decision about admitting a child;
   2. (B) A plan for continuing communication between the child care provider and the parent(s);
   3. (C) Discussion of the plan for providing for the care of the ill child as required by 19 CSR 30-62.192 Health Care;
   4. (D) Discussion of the parental plan for providing for the care of the school-age child on scheduled days of school closings; and

   5. (E) Completion by the parent(s) of the following written information which shall be on file before the child is accepted for care:

      1. 1. All information required by 19 CSR 30-62.222 Records and

Reports;

1. 2. Information regarding a child’s personal development,

behavior patterns, habits, and individual needs;

1. 3. A diet plan for each infant/toddler signed by the

parent(s);

1. 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;

1. 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 30-62.192 Health Care;

1. 6. Permission for field trips, transportation to and from

school, and other transportation;

1. 7. Permission for school-age children to leave the facil-

ity 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

1. 8. Acknowledgement by the parent(s) that—

   1. A. They have received a copy of the provider’s policies

pertaining to the admission, care, and discharge of children;

1. 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;

1. C. They and the provider have agreed on a plan for con-

tinuing communication regarding the child’s development, behavior, and individual needs;

1. D. They understand and agree that the child may not be

accepted for care when ill;

1. E. They have received a copy of the provider’s safe sleep

policy when enrolling children less than one (1) year of age; and

1. F. They have been notified that they may request notice

at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility.

1. (9) 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 30-61.135). 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:

   1. (A) Each child’s name, address, birthdate, and date of admission;
   2. (B) Each child’s relationship to the center owner(s) or group day care home provider; and
   3. (C) The parent’s(s’) name(s), address(es), and telephone number(s).
2. (10) 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.
3. (11) 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.
4. (12) Care of a child may be discontinued if the provider and the parent(s) cannot establish a mutually satisfactory working relationship.
5. (13) Parents shall have access to the facility at any time during child care hours.

AUTHORITY: sections 210.221 and 210.223, RSMo Supp. 2015.* 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. Emergency amendment filed Nov. 10, 2015, effective Nov. 20, 2015, expired May 17, 2016. Amended: Filed Nov. 10, 2015, effective April 30, 2016. Moved to 5 CSR 25-500.132, effective Aug. 30, 2021. *Original authority:210.221.1(3), RSMo 1949, amended 1955, 1987, 1993, 1995, 1999, 2015 and 210.223, RSMo 2015.