Missouri daycare regulations

The six-child threshold

§ 210.211, RSMo CentersGroup child care homesFamily child care View rule § 210.211, RSMo

A license is required to care for more than six children, or more than three children under age 2, at the same address. School-age children who live in the caregiver's home don't count toward the six. Other exemptions include programs under the exclusive control of a religious organization, nursery schools, private and religious school systems, Montessori schools, day camps and short-term drop-in care at businesses where parents stay on site. Programs may file a Program Evaluation Questionnaire with DESE to document an exemption. Religious organization programs, nursery schools and private or religious school systems must file it (school systems every year), and religious and nursery school programs still get yearly fire, sanitation and health inspections (§ 210.252). This section was amended in 2024, so check the current text for the full exemption list.

License types

5 CSR 25-400.010; 5 CSR 25-500.010 Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-400.010; 5 CSR 25-500.010 (PDF)

A family child care home cares for no more than 10 children. A group child care home cares for no more than 20 and must be outside the provider's residence or separate from the living quarters. A child care center is any program outside the provider's permanent residence. A provider may hold only one family or group home license. For licensing, an infant is under 12 months, a toddler 12 to 24 months, a preschool child 2 through 5 and not in kindergarten, and a school-age child 5 or older and in kindergarten or above.

Getting licensed

5 CSR 25-500.042; 5 CSR 25-400.045 Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.042; 5 CSR 25-400.045 (PDF)

Applicants complete DESE's online licensing orientation, then apply. The licensing representative inspects the whole premises, and the facility must pass fire safety and sanitation before a license is issued. Centers and group homes also submit floor plans, parent policies, daily schedules, a sample menu, an equipment list, a staff sheet, a written disaster plan, a safe sleep policy if infants are served, and the director's verified education. Background screening must be complete before the license is issued. If the rules aren't met within 6 months, the application is void. After a denial or revocation, DESE won't accept a new application for that facility for 12 months.

Posting and capacity

5 CSR 25-500.042(12)–(18) Effective May 2022 CentersGroup child care homes View rule 5 CSR 25-500.042(12)–(18) (PDF)

Post the license near the entrance, along with the names, addresses and phone numbers of the provider, owners, board president or managers. The license isn't transferable and becomes void on a change of ownership. The number and ages of children on the license can't be exceeded except as the rules allow, such as approved overlap care or emergency school closings.

Yearly renewal

5 CSR 25-500.052; 5 CSR 25-400.055 Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.052; 5 CSR 25-400.055 (PDF)

At least 30 days before the license anniversary, send DESE an Annual Declaration, a current equipment list and a staff sheet (family homes: a list of household members and assistants). Keep proof of the yearly fire and sanitation inspections on file. Run a Family Care Safety Registry check on every staff member within 30 days before the anniversary date. A family home must also file a safety plan if a registered sex offender lives within 1,000 feet.

Overlap care and school closings

5 CSR 25-500.162; 5 CSR 25-500.172 Effective May 2022 CentersGroup child care homes View rule 5 CSR 25-500.162; 5 CSR 25-500.172 (PDF)

With DESE's written approval, a facility may go up to one-third over its licensed capacity for overlap periods such as shift changes or before and after school, for no more than 2 hours a day in total. On unscheduled school closings (bad weather, for example), enrolled school-age children may push attendance up to one-third over capacity for the day, but never more than one-third over in total. Ratios still apply, and the closing must be logged with the date, reason and number of children.

Center and group home ratios

5 CSR 25-500.112 Effective January 2024 CentersGroup child care homes View rule 5 CSR 25-500.112 (PDF)

One caregiver may care for at most 4 children in any group with children from birth to 36 months, 8 in a group made up only of 2-year-olds, 10 three- and four-year-olds, or 16 children aged 5 and older. Mixed groups of 2-year-olds and older children are 1:10 if there are no more than four 2-year-olds (Type 1) and 1:8 if there are more than four (Type 2). Ratios must be kept at all times.

SafePass tip: SafePass shows a live count for each room: children checked in against staff clocked in, with an alert to directors when a room goes over ratio. Set each room's ratio to Missouri's number for that room. SafePass's built-in defaults are not Missouri's. Its toddler default is 1:6, which is looser than Missouri's 1:4 for every group with a child under 2, and tighter than its 1:8 for groups of only 2-year-olds. SafePass does not work out Missouri's mixed-age group types or check group-size limits.

When the ratio changes

5 CSR 25-500.112(1)(C), (G), (2)–(4) Effective January 2024 CentersGroup child care homes View rule 5 CSR 25-500.112(1)(C), (G), (2)–(4) (PDF)

At naptime, groups of children 2 and older don't need the ratio inside the napping area, but the ratio must be met on the premises. Outdoors, ratios may be 1.5 times the indoor ratio if no children 2 or younger are present, as long as the indoor ratio is met on the premises. In a center with more than 50 children in attendance, the director doesn't count in the ratio except at naptime or as an emergency substitute. With more than 30 children at lunch or dinner, separate staff must prepare and serve the meal. Clerical, housekeeping and maintenance staff don't count while doing those jobs.

Who counts in the ratio

5 CSR 25-500.102(1)(C) Effective January 2024 CentersGroup child care homes View rule 5 CSR 25-500.102(1)(C) (PDF)

Caregivers 18 or older count. A Junior Aide (16 or 17) counts only under the direct supervision of an adult caregiver in the same group, never for infants and toddlers, and may never be the only caregiver with a group or on the premises. Caregivers attending clock-hour training don't count in the ratio while in training.

Family home ratios

5 CSR 25-400.105(2) Effective April 2023 Family child care View rule 5 CSR 25-400.105(2) (PDF)

A family home may be licensed for up to 10 children. One caregiver may care for up to 4 children (all 4 may be under age 2), 5 or 6 children with no more than 3 under 2, or 7 to 10 children with no more than 2 under 2. Two caregivers may care for up to 8 children who are all under 2, or up to 10 children with no more than 4 under 2. Up to two of the provider's related children aged 5 or older (or children in the provider's legal custody) don't count toward capacity. A home may run at full capacity for 18 consecutive hours a day and at one-third of capacity for the other 6.

SafePass tip: SafePass shows a live count for each room: children checked in against staff clocked in, with an alert to directors when a room goes over ratio. Set the ratio to the Missouri table that fits your mix of ages. SafePass's built-in defaults are not Missouri's. Its toddler default is 1:6, which is looser than Missouri's 1:4 for every group with a child under 2, and tighter than its 1:8 for groups of only 2-year-olds. SafePass does not apply Missouri's limits on the number of children under 2.

Ratios on outings

5 CSR 25-500.212(3)(C) CentersGroup child care homes View rule 5 CSR 25-500.212(3)(C) (PDF)

Staff-to-child ratios must be maintained whenever children are transported away from the facility.

Maximum group sizes

5 CSR 25-500.112 Effective January 2024 CentersGroup child care homes View rule 5 CSR 25-500.112 (PDF)

Groups with children from birth to 36 months: 8. Groups of only 2-year-olds: 16. Three- and four-year-olds: 20. Children 5 and older: 32. Mixed Type 1 (no more than four 2-year-olds): 20. Mixed Type 2 (more than four 2-year-olds): 16. Groups of 2-year-olds and older don't need to keep group sizes during outdoor play, gym time, meals, field trips, special events or transport. Small facilities (group homes licensed for no more than 4 infants/toddlers, or centers licensed for up to 20 children with no more than 4 infants/toddlers) and school-age-only programs may have several groups share one space.

Indoor space

5 CSR 25-500.082(2) Effective April 2016 CentersGroup child care homes View rule 5 CSR 25-500.082(2) (PDF)

Provide at least 35 square feet of usable floor space per preschool and school-age child, measured wall to wall, not counting kitchens, bathrooms, offices, hallways or permanently placed cribs and cots. Larger facilities that add infant/toddler space need 45 square feet per infant or toddler, no more than 24 infants, toddlers and 2-year-olds in one walled room, and floor-to-ceiling walls separating the infant/toddler unit from older children.

Family home space

5 CSR 25-400.085(2)–(3) Effective April 2016 Family child care View rule 5 CSR 25-400.085(2)–(3) (PDF)

A family home needs at least 35 square feet of usable floor space per child and 75 square feet of outdoor play space per child. An adult must be outside at all times with children under 3, and with any children if the play area isn't fenced and next to the exit (unless they are school-age with set boundaries).

Outdoor play area

5 CSR 25-500.082(6) Effective April 2016 CentersGroup child care homes View rule 5 CSR 25-500.082(6) (PDF)

Centers and group homes need a fenced outdoor play area (42-inch fence for new facilities or new fences) with at least 75 square feet per child using it at one time, enough for one-third of licensed capacity and never less than 750 square feet. Areas used only by school-age children don't need a fence.

Center director education by size

5 CSR 25-500.102(2) Effective January 2024 Centers View rule 5 CSR 25-500.102(2) (PDF)

A director must be on duty at least 40 hours a week during the hours of highest attendance (or half the operating hours if the program runs less than 40). Requirements by licensed capacity: up to 20 children, 30 college semester hours with 6 in child-related courses, or 12 months of experience plus 6 child-related hours, a CDA or a YDC. 21–60: 60 hours with 12 child-related, or 24 months of experience plus 12 child-related hours. 61–99: 90 hours with 18 child-related, or 36 months plus 18. 100 or more: 120 hours with 24 child-related (6 may be business or management), or 4 years plus 24. DESE must have official verification before the director starts.

SafePass tip: SafePass staff profiles store certifications and documents with expiration dates, so transcripts and director credentials are in one place for the licensing inspector.

Group home provider

5 CSR 25-500.102(2)(B)2. Effective January 2024 Group child care homes View rule 5 CSR 25-500.102(2)(B)2. (PDF)

A group child care home provider needs at least 30 college semester hours with 6 in child-related courses, or 12 months of experience plus 6 child-related hours, a Child Development Associate (CDA) or a Youth Development Credential (YDC).

All caregivers

5 CSR 25-500.102(1) Effective January 2024 CentersGroup child care homes View rule 5 CSR 25-500.102(1) (PDF)

Caregivers must be capable, know children's needs, and be able to handle emergencies. No one may be under the influence of alcohol or illegal drugs, or impaired by medication, on the premises or in program vehicles. Caregivers may not do major housekeeping during care hours. Staff and volunteers can't be in the same age range as the children on the license. A provider can't retaliate against an employee who reports licensing problems.

Family home provider and assistant

5 CSR 25-400.105(1), (3) Effective April 2023 Family child care View rule 5 CSR 25-400.105(1), (3) (PDF)

The provider must be on duty at least 40 hours a week during peak attendance and may not hold another job while on duty. Caregivers must be 18 or older. The provider must name at least one assistant who can substitute or help meet ratios, post the assistants' names and phone numbers with the emergency numbers, and tell parents when the provider is away and who is in charge.

First aid and CPR

5 CSR 25-500.102(1)(T); 5 CSR 25-400.105(1)(S) Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.102(1)(T); 5 CSR 25-400.105(1)(S) (PDF)

Centers and group homes need staff with current age-appropriate first aid and CPR certification equal to one caregiver for every 20 children of licensed capacity. In every facility, including family homes, at least one certified caregiver must be on site whenever children are present. The course must be from a nationally recognized organization and approved by DESE.

SafePass tip: SafePass tracks each staff certification's expiration date. Staff get a reminder 30 days out, and directors are alerted when one expires.

What the check includes

5 CSR 25-600.010(4); 5 CSR 25-600.020 Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-600.010(4); 5 CSR 25-600.020 (PDF)

Before a staff member starts work or is present, the provider requests a criminal background check from DESE. It includes an FBI fingerprint check, the National Sex Offender Registry, and the criminal, sex offender and child abuse/neglect registries (including Missouri's Family Care Safety Registry) for Missouri and every state the person lived in during the past 5 years. Staff members include volunteers with unsupervised access, and in family homes, household members 18 and older. A person may start under a temporary eligibility notice based on a fingerprint result but must be supervised at all times by someone with a qualifying check from the past 5 years.

SafePass tip: SafePass stores each staff member's background check date and flags checks more than five years old on the Compliance page, which matches Missouri's 5-year repeat. It doesn't request checks from DESE or track the yearly Family Care Safety Registry check.

Every 5 years, and portability

5 CSR 25-600.020(5); 5 CSR 25-600.010(4) Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-600.020(5); 5 CSR 25-600.010(4) (PDF)

Checks must be repeated every 5 years. A new employer doesn't need a new check if the person had a qualifying check within 5 years while working for another Missouri provider and has been out of child care for no more than 180 consecutive days. The staff member pays for the check unless the provider chooses to.

Who is disqualified

5 CSR 25-600.040 Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-600.040 (PDF)

A person is ineligible if they refuse the check, make a materially false statement, are on a sex offender registry, are listed as a perpetrator of child abuse or neglect, or have a plea or finding of guilt for listed offenses. These include felony offenses against the person, sexual offenses, offenses against the family, first-degree burglary, robbery, pornography, felony arson, listed weapons felonies, terrorist threats, and a felony drug offense in the past 5 years. Disqualified adult household members can't be present in a family home during care hours.

Family Care Safety Registry

5 CSR 25-500.102(1)(P); 5 CSR 25-500.052(2)(C) Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.102(1)(P); 5 CSR 25-500.052(2)(C) (PDF)

Run a Family Care Safety Registry screening before hiring anyone who has a qualifying background check, and again for every staff member within 30 days before each license anniversary. Keep background results in each person's file, confidentially, for review.

Appealing an ineligibility finding

5 CSR 25-600.050 Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-600.050 (PDF)

A staff member found ineligible may appeal in writing to DESE within 10 days of the mailing of the notice, as § 210.1080 allows.

12 clock hours a year

5 CSR 25-500.102(3); 5 CSR 25-400.105(4) Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.102(3); 5 CSR 25-400.105(4) (PDF)

The director or provider, every caregiver, and volunteers counted in ratio (in family homes, assistants who work more than 5 hours a week) need at least 12 clock hours of DESE-approved training each calendar year, or 1 hour per month for staff hired mid-year. Hours don't carry over. Each caregiver needs a Missouri Professional Development ID (MOPD ID), and hours are recorded in DESE's professional development system. One college credit in a child-related course equals 15 clock hours. Earning a CDA or YDC counts as the full 12 for that year.

SafePass tip: SafePass keeps dated training records in each staff profile, but DESE's professional development system is the official record.

Orientation within 7 days

5 CSR 25-500.102(1)(K)–(L); 5 CSR 25-400.105(1)(J) Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.102(1)(K)–(L); 5 CSR 25-400.105(1)(J) (PDF)

Within 7 days of starting, and before being left alone with children, each new caregiver gets a documented orientation: a facility tour; the licensing rules and the license's limits; policies for medication, illness and discipline; the daily schedule and assigned duties; the names, ages and special needs of the children in their care; where records are kept; the safe sleep policy; the disaster plan; and their duty to report suspected abuse or neglect.

Safe sleep training every 3 years

5 CSR 25-500.102(4); 5 CSR 25-400.105(5) Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.102(4); 5 CSR 25-400.105(5) (PDF)

In facilities licensed for infants under 1, the provider, staff and volunteers must complete DESE-approved training on the American Academy of Pediatrics safe sleep recommendations (2022 update) before licensure or within 30 days of starting, and again every 3 years.

SafePass tip: SafePass tracks training and certification expiration dates, so you can set the 3-year safe sleep renewal as an expiring certification for each caregiver.

Daily health observation and exclusion

5 CSR 25-500.192(2); 5 CSR 25-400.185 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.192(2); 5 CSR 25-400.185 (PDF)

Observe each child for illness on arrival and throughout the day. Send a child home for more than one loose stool, vomiting more than once, a fever over 100°F by mouth (99°F under the arm), severe coughing, difficult breathing, yellow skin or eyes, pinkeye, unusual rashes, sore throat, infected skin patches, a headache with stiff neck, or severe itching. Keep the child isolated and within earshot of a caregiver until the parent arrives. Record the parent contact and decision in the child's file. Report suspected reportable diseases to the local health department.

SafePass tip: SafePass can run an optional health check at check-in (temperature and symptoms) and notifies directors and parents when a child doesn't pass.

Accidents and injuries

5 CSR 25-500.192(5) CentersGroup child care homes View rule 5 CSR 25-500.192(5) (PDF)

Notify the parent immediately of any accident or injury. Follow the parent's written instructions if emergency care is needed, and note the date and circumstances in the child's record.

SafePass tip: SafePass incident reports record what happened, the action taken and first aid, notify the parent, and capture the parent's e-signature.

Diapering and handwashing

5 CSR 25-500.182(1)(E); 5 CSR 25-500.192(6) Effective January 2024 CentersGroup child care homes View rule 5 CSR 25-500.182(1)(E); 5 CSR 25-500.192(6) (PDF)

Use a diapering table with a washable surface, disinfect it after each use, and never leave a child on it. Wash hands with soap and running water after each diaper change, after toileting, and before preparing or serving food. Keep diapering away from food areas. Toilet training starts only when the parent and provider agree.

SafePass tip: SafePass daily logs record diaper changes with times, and parents see them in the app.

Staff health exams and TB

5 CSR 25-500.122; 5 CSR 25-400.125 Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.122; 5 CSR 25-400.125 (PDF)

Everyone working in the facility during care hours, including volunteers counted in ratio, needs a medical examination report signed by a physician (or a nurse under a physician's supervision) dated within 12 months before starting, on file within 30 days of hire. It must include a TB risk assessment or a negative TB skin test. A person with a newly positive TB test can't work until evaluated.

SafePass tip: SafePass staff profiles store documents with expiration dates, so medical reports and TB results are easy to find at inspection.

No tobacco

5 CSR 25-500.082(1)(K); 5 CSR 25-400.085(1)(L) Effective April 2016 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.082(1)(K); 5 CSR 25-400.085(1)(L) (PDF)

No one may smoke or use tobacco anywhere in the facility while children in care are present.

Hazards and weapons

5 CSR 25-500.082(1); 5 CSR 25-400.085(1) Effective April 2016 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.082(1); 5 CSR 25-400.085(1) (PDF)

Keep flammable liquids, matches, cleaning supplies, poisons, medicines, alcohol, hazardous personal care items and other hazards out of children's reach. Store guns, ammunition, hunting knives, bows and other weapons in a locked cabinet or closet. Use outlet covers or twist-lock outlets. Provide safety gates as needed, handrails on stairs with more than 3 steps, and railings on drop-offs over 24 inches.

Indoor conditions

5 CSR 25-500.082(2)(A) Effective April 2016 CentersGroup child care homes View rule 5 CSR 25-500.082(2)(A) (PDF)

Rooms must be 68°F to 85°F measured 2 feet off the floor, lit to at least 10 footcandles, clean and pest-free, and painted only with lead-free paint. Windows less than 24 inches from the floor need barriers unless they are safety glass. Indoor equipment over 24 inches high needs mats underneath (carpet alone doesn't count). A working phone with emergency numbers posted next to it is required.

Furniture and toys

5 CSR 25-500.092(1)–(2); 5 CSR 25-400.095 Effective April 2016 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.092(1)–(2); 5 CSR 25-400.095 (PDF)

Furniture and equipment must be safely built, in good repair, free of sharp or loose parts, and arranged to keep exits clear. Infant and toddler toys can't be small enough to swallow. Centers and group homes need at least 40 approved play items for every 10 children of capacity, with at least four from each of eight categories.

Outdoor equipment and surfacing

5 CSR 25-500.092(3); 5 CSR 25-500.082(6)(A) Effective April 2016 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.092(3); 5 CSR 25-500.082(6)(A) (PDF)

Swings, slides and climbers must be securely anchored with no exposed footings. New equipment may be no more than 6 feet high where a child could fall. Trampolines are banned (mini-trampolines only with close supervision). Cover fall zones with impact-absorbing material such as sand, pea gravel, wood chips or rubber matting, and keep it topped up. Concrete, asphalt, carpet, grass or bare soil is not acceptable under equipment at centers and group homes. Family homes may use grass while it stays thick (5 CSR 25-400.085).

Swimming and wading pools

5 CSR 25-500.082(7) Effective April 2016 CentersGroup child care homes View rule 5 CSR 25-500.082(7) (PDF)

Pools must be filtered and fenced (42 inches with a locked gate for new facilities). An adult with a current lifeguard certificate including infant/child CPR must be on duty when water is 48 inches deep or more. For shallower pools, an adult with basic water safety and infant/child CPR training must be on duty.

Smoke, CO and fire equipment

5 CSR 25-500.087(12) Effective August 2000 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.087(12) (PDF)

Install smoke detectors in every child care room, and a carbon monoxide detector if the facility has fuel-burning equipment or an attached garage. Have at least one 5-lb. 2A-10BC fire extinguisher, serviced yearly by an extinguisher company. Centers and group homes also need a manual fire alarm system with pull stations at exits (except a one-room facility whose exits all lead directly outside). Family homes have similar requirements in 5 CSR 25-400.086.

Monthly fire drills, quarterly disaster drills

5 CSR 25-500.087(2)(F); 5 CSR 25-400.086(2)(C) Effective August 2000 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.087(2)(F); 5 CSR 25-400.086(2)(C) (PDF)

Hold at least one fire drill each month and a disaster drill (including tornado drills) at least every 3 months. Keep a written record of the date, type of drill, time needed to evacuate and number of children present. Fire drills must sound the alarm, simulate a real fire, and gather children at a set location away from the building. Post an evacuation plan approved by the fire inspector, with special instructions for infants and children who can't walk.

SafePass tip: SafePass's checked-in list shows who is in care right now, which helps with headcounts during a drill. SafePass does not log drills, so keep the drill record separately.

Written disaster and emergency plan

5 CSR 25-500.090; 5 CSR 25-400.090 Effective October 2011 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.090; 5 CSR 25-400.090 (PDF)

The plan must cover fire, tornado, flood, chemical spill, carbon monoxide, power failure, bomb threat, a person whose behavior may be harmful, kidnapping or a missing child, evacuation (including from a vehicle) and lockdown. It names the responsible staff and includes where attendance records and emergency information are kept, exit diagrams, two off-site meeting places, and how parents will be contacted for reunification. Keep a copy in the office and every child care room, and post emergency numbers and evacuation routes in each room and by each phone.

SafePass tip: SafePass parent messaging can reach every family at once during a relocation or reunification, and the checked-in list shows who is on site.

Report any fire

5 CSR 25-500.087(2)(L) Effective August 2000 CentersGroup child care homes View rule 5 CSR 25-500.087(2)(L) (PDF)

Report any fire in the facility immediately to the Office of the State Fire Marshal and to the licensing agency. The rule text still names the old DHSS licensing bureau, which is now DESE's Office of Childhood.

Permission, containers and storage

5 CSR 25-500.192(3); 5 CSR 25-400.185(3) CentersGroup child care homesFamily child care View rule 5 CSR 25-500.192(3); 5 CSR 25-400.185(3) (PDF)

Give medication only with the parent's dated, written permission stating how long it may be given. Prescription medicine must be in the original container labeled with the child's name, dosing instructions and the physician's name. Over-the-counter medicine must be in the original container, labeled by the parent with the child's name and dosing instructions. Store medicine out of reach or locked, refrigerated medicine in a separate container away from food, and return or dispose of it when no longer needed.

SafePass tip: SafePass collects the parent's signed medication request electronically. Staff approve it, and the parent gets a notification at each dose.

Medication log

5 CSR 25-500.192(3)(I); 5 CSR 25-400.185(3)(I) CentersGroup child care homesFamily child care View rule 5 CSR 25-500.192(3)(I); 5 CSR 25-400.185(3)(I) (PDF)

Promptly record the date and time of each dose, the name of the person who gave it and the amount. File the record in the child's file once the medication is no longer needed.

SafePass tip: SafePass logs each dose with the time, amount and staff name.

Required vaccines and exemptions

5 CSR 25-500.192(4); 5 CSR 25-400.185(4) CentersGroup child care homesFamily child care View rule 5 CSR 25-500.192(4); 5 CSR 25-400.185(4) (PDF)

A child may not enroll in or attend a facility caring for 10 or more children unless adequately immunized on the ACIP schedule, shown by a record giving the vaccine type and the date of each dose. A child who has started the series may attend while staying on schedule. Exemptions are a medical exemption certified by a physician, or a parent or guardian exemption filed as a written objection on DESE's form. In an outbreak, follow the health authority's control measures. Parents may ask whether any enrolled children have immunization exemptions on file (5 CSR 25-500.132).

SafePass tip: SafePass lets parents upload vaccine records. Staff verify them, and the dashboard lists overdue and due-soon doses, with an exemption field.

Annual summary by January 15

5 CSR 25-500.192(4)(D) CentersGroup child care homesFamily child care View rule 5 CSR 25-500.192(4)(D) (PDF)

Keep an immunization record for each child, and send the state an annual summary report of every enrolled child's immunization status by January 15.

SafePass tip: SafePass's immunization dashboard gives you a current list of each child's status to start the January 15 summary.

Child health exams

5 CSR 25-500.122(2) Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.122(2) (PDF)

Within 30 days of admission, each infant, toddler and preschool child needs a medical examination report signed by a physician (or a nurse under a physician's supervision), completed within the 12 months before admission. School-age children need a parent-provided health history at enrollment. Parents may object to the exam on religious grounds in a signed statement.

Meals and snacks

5 CSR 25-500.202(1); 5 CSR 25-400.190 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.202(1); 5 CSR 25-400.190 (PDF)

Children in daytime care get breakfast or a mid-morning snack, lunch, and a mid-afternoon snack, with no more than 4 hours between meals or snacks. School-age children get an after-school snack. Serve milk with every meal, use only 100% juice, and follow the age-based portion chart. Powdered milk is for cooking only. No child may be forced to eat. Drinking water must be available near playrooms and the playground, and menus are available to parents on request.

SafePass tip: SafePass weekly menus and meal logs show parents what was served and how much their child ate.

Infant feeding

5 CSR 25-500.202(2) CentersGroup child care homes View rule 5 CSR 25-500.202(2) (PDF)

Feed infants according to a written diet plan from the parent, kept up to date until the parent approves table foods in writing. Hold infants for bottle feeding until they can hold the bottle comfortably. Never prop bottles. Parent-supplied formula and baby food must be labeled.

Infant sleep

5 CSR 25-500.182(2)(C)4.; 5 CSR 25-400.175 Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.182(2)(C)4.; 5 CSR 25-400.175 (PDF)

Place infants under 12 months on their backs to sleep, with the head and face uncovered and no more than one layer more than an adult would wear. Infants who can roll both ways may stay in the position they choose. A different position requires written instructions from the infant's health care provider. No pacifiers hung around the neck or clipped to clothing. An infant may stay in the crib after waking for up to 30 minutes. Home monitors and SIDS-prevention products can't replace supervision.

SafePass tip: SafePass nap logs record when each child went down and woke up, and parents see them. SafePass does not run timed sleep-check logs.

Cribs and bedding

5 CSR 25-500.092(1)(B); 5 CSR 25-400.095 Effective April 2016 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.092(1)(B); 5 CSR 25-400.095 (PDF)

Each infant and toddler gets an individually assigned crib, portable crib or playpen meeting the federal crib standards (16 CFR 1219/1220). No stacked cribs. Use a firm, well-fitting mattress and a fitted sheet only, and keep cribs free of bumpers, pillows, blankets, positioners and soft toys. Don't cover cribs. An infant who falls asleep in a car seat, swing, stroller or carrier must be moved to a crib. Toddlers 12 months and older may nap on cots with written parent consent.

Written safe sleep policy

5 CSR 25-500.132(2); § 210.223, RSMo Effective April 2016 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.132(2); § 210.223, RSMo (PDF)

Facilities serving infants must have a written safe sleep policy covering staff training, back-to-sleep, health-provider exceptions, how infants are supervised while sleeping (staff positioning, lighting, physical checks, and no sound machines that block hearing a distressed child), and a safe crib environment. Give each infant's parents a copy at enrollment.

Nap supervision

5 CSR 25-500.182(1)(A)5.–6.; 5 CSR 25-400.175(1)(A)5.–7. Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.182(1)(A)5.–6.; 5 CSR 25-400.175(1)(A)5.–7. (PDF)

In centers and group homes, a caregiver stays in the room with napping preschool and school-age children and must be able to see and hear them. In family homes, caregivers check on sleeping children often and stay close enough to hear them; if no caregiver is in the room the door stays open, and all children nap on the same floor as a caregiver. Children who don't sleep rest at least 30 minutes but no more than 1 hour.

Discipline

5 CSR 25-500.182(1)(C); 5 CSR 25-400.175(1)(C) Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.182(1)(C); 5 CSR 25-400.175(1)(C) (PDF)

Use constructive, age-appropriate guidance with simple rules and praise. A brief supervised separation is allowed, about one minute for each year of the child's age. Physical punishment (spanking, slapping, shaking, biting, pulling hair) is prohibited, as are humiliating, threatening or frightening techniques, shaming, harsh language or profanity, punishment tied to food, rest or toilet training, and placing a child in a closet or a locked or dark room.

Supervision and abuse reporting

5 CSR 25-500.182(1)(A); 5 CSR 25-500.102(1)(J) Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.182(1)(A); 5 CSR 25-500.102(1)(J) (PDF)

Never leave a child without competent supervision. Infants and toddlers need constant care and supervision, and children under 3 need help in the bathroom. All staff must know the child abuse and neglect law and report suspected abuse or neglect to the Children's Division hotline, 1-800-392-3738.

Child files

5 CSR 25-500.222(2)–(4); 5 CSR 25-400.210 Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.222(2)–(4); 5 CSR 25-400.210 (PDF)

Each child's file includes the child's name, address, birth date, start and end dates; parents' names, addresses, employers, work schedules and phone numbers; another emergency contact; the physician and hospital; the people authorized to pick up the child; field trip and transportation permission; the medical exam or school-age health report; medication permissions and logs; and any accidents, injuries or emergency care. Keep child files at least 1 year after the child leaves. Records are confidential and open to the parent.

SafePass tip: SafePass registration packets collect guardians, emergency contacts, authorized pickups, physician and allergy information, with a parent signature.

Before a child starts

5 CSR 25-500.132(8) Effective April 2016 CentersGroup child care homes View rule 5 CSR 25-500.132(8) (PDF)

Before accepting a child, have the parent complete the enrollment record, information on development and habits, a diet plan for infants and toddlers, emergency care permission, immunization status, transportation and activity permissions, and a signed acknowledgment that they received the policies (and the safe sleep policy for infants). Parents may visit any time during care hours.

SafePass tip: SafePass registration packets collect these forms with the parent's e-signature before the child's first day.

Staff records

5 CSR 25-500.222(8); 5 CSR 25-500.102(1)(L) Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.222(8); 5 CSR 25-500.102(1)(L) (PDF)

Keep each staff member's qualifying background screening results (confidentially), orientation documentation, medical exam report, training and first aid/CPR certification on file for review.

SafePass tip: SafePass staff profiles hold certifications, training records and the background check date for each person.

Daily child and staff attendance

5 CSR 25-500.222(5)–(6); 5 CSR 25-400.210 Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.222(5)–(6); 5 CSR 25-400.210 (PDF)

Keep daily child attendance records and daily staff and volunteer attendance records (family homes: all caregivers) for at least 1 year. They must be in a place caregivers know, accessible at all times, and not locked away or removed from the facility while it is open.

SafePass tip: SafePass Kiosk records each check-in and check-out with a timestamp and who dropped off or picked up, and exports attendance reports as PDF. The SafePass staff time clock records when each staff member clocks in and out.

Personal arrival and release

5 CSR 25-500.182(1)(A)2.; 5 CSR 25-400.175(1)(A)2. Effective January 2024 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.182(1)(A)2.; 5 CSR 25-400.175(1)(A)2. (PDF)

A caregiver must personally admit each child on arrival and personally dismiss each child on departure. Release children only to a parent, guardian, legal custodian or someone they have approved.

SafePass tip: At check-out, SafePass shows staff the child's guardians and authorized pickups, with photos, and records who picked the child up.

Drivers, vehicles and consent

5 CSR 25-500.212; 5 CSR 25-400.200 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.212; 5 CSR 25-400.200 (PDF)

Keep written parental consent for field trips and transportation, and tell parents when trips are planned. Short unscheduled walks are fine if discussed at enrollment. Drivers must be 18 or older with a valid license. Vehicles must be licensed, and children may never ride in campers, trailers or truck beds. Every child must be in a permanent seat with a seat belt or child restraint as Missouri law requires. Carry each child's name and parent contact information in the vehicle.

Headcounts and never leaving a child

5 CSR 25-500.212(3) CentersGroup child care homesFamily child care View rule 5 CSR 25-500.212(3) (PDF)

Never leave a child unattended in a vehicle. Take headcounts before leaving, after boarding, during the trip, after bathroom stops, after returning to the vehicle and back at the facility. Check the whole vehicle, including under seats, after children get off. Load and unload at the curb, and hand children only to parents or people they have authorized.

SafePass tip: SafePass's checked-in list gives a running headcount by child. It doesn't keep transportation or vehicle-check logs.

Fire, safety and sanitation inspections

§ 210.252, RSMo; 5 CSR 25-500.087(2)(A) CentersGroup child care homesFamily child care View rule § 210.252, RSMo; 5 CSR 25-500.087(2)(A)

Every building used to care for more than six children (except most exempt programs) gets a yearly fire and safety inspection by the State Fire Marshal or a local fire district, and a yearly health and sanitation inspection. Keep proof of both on file and available to parents enrolling their children.

Licensing inspections at least twice a year

DESE inspection process CentersGroup child care homesFamily child care View rule DESE inspection process

DESE's Child Care Compliance section inspects licensed facilities at least twice a year, in addition to the fire and sanitation inspections. License-exempt religious programs and nursery schools are inspected once a year. Providers can comment on violations in an inspection or complaint report through DESE's Child Care Portal. Summaries of substantiated complaints are public in the Show Me Child Care Provider Search.

Discipline of a license

§ 210.221, RSMo; § 210.245, RSMo CentersGroup child care homesFamily child care View rule § 210.221, RSMo; § 210.245, RSMo

DESE may deny, suspend, place on probation or revoke a license for failing to follow the law or rules, and may deny a license for a location within 1,000 feet of where a registered sex offender lives. It may issue letters of censure or warning without a hearing. If children face a threat of imminent bodily harm, DESE may suspend a license at the same time it gives notice. The prosecuting attorney or Attorney General may seek a court order to oversee or close a facility.

Penalties

§ 210.245, RSMo CentersGroup child care homesFamily child care View rule § 210.245, RSMo

Violating the licensing law, or making false statements to get a license, is a class C misdemeanor for the first offense (fine up to $750), and a class A misdemeanor for later offenses (up to $2,000 a day, $10,000 total). Running an unlicensed, non-exempt facility after a 30-day notice can bring a civil penalty of $750 to $2,000.

Access for inspectors

5 CSR 25-500.042(20) Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.042(20) (PDF)

The provider must give DESE access to the facility, premises and records during every inspection, and records must be available at the facility on request.

SafePass tip: SafePass keeps attendance, medication and incident records with dates and times, and exports reports as PDF for a licensing inspector.

Appealing a license action

§ 210.245.2, RSMo; § 210.241, RSMo CentersGroup child care homesFamily child care View rule § 210.245.2, RSMo; § 210.241, RSMo

When DESE proposes to deny, suspend, place on probation or revoke a license, it sends written notice with the reasons and effective date. You have 30 days to ask, in writing to DESE, for a hearing before the Administrative Hearing Commission. Without a request, the action takes effect on the 31st day. An emergency suspension can be appealed to DESE within 10 days, and DESE must hold a hearing within 10 days. Final decisions can be reviewed in court under chapter 536, RSMo.

Variances

5 CSR 25-500.230; 5 CSR 25-400.220; § 210.221.2, RSMo Effective May 2022 CentersGroup child care homesFamily child care View rule 5 CSR 25-500.230; 5 CSR 25-400.220; § 210.221.2, RSMo (PDF)

Any provider may ask DESE in writing for a variance from a rule, naming the rule and the reason. DESE must approve any request that doesn't endanger children's health or safety. If it's denied, you can ask the Commissioner of Education to review it within 30 calendar days, and the Commissioner decides within 15 business days.