Missouri Code of State Regulations › Title 5 - DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION › Division 25 - Office of Childhood › Chapter 500 - Licensing Rules for Group Child Care Homes and Child Care Centers › Section 5 CSR 25-500.122 - Medical Examination Reports

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment replaces the term "day care"
				  with "child care," removes incorporated forms and replaces them with updated
				  forms incorporated by reference, and updates references to the Missouri
				  Department of Health and Senior Services.
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.
The Medical Examination Report for Caregivers and Staff form
				  that is incorporated by reference has been updated based on the comment.
(1) Staff and Volunteers.
(A) All persons working in a child 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, on file at the facility at the time of initial licensure or
				within thirty (30) days following employment.
(B) Medical examination reports shall include
				either a Tuberculosis (TB) Risk Assessment form, completed and signed by a
				health care professional, or a negative tuberculin skin test (TST) completed
				not more than twelve (12) months before beginning work in the facility. The
				Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by
				reference in this rule, as published by the Missouri Department of Health and
				Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the
				Missouri Department of Health and Senior Services at
https://health.mo.gov/living/healthcondis-eases/communicable/tuberculosis/tbmanual/pdf/RiskAssessment
				form.pdf
. This rule does not incorporate any subsequent amendments or
				additions. If the person has signs or symptoms of tuberculosis, or risk factors
				for tuberculosis, then testing for tuberculosis shall occur.
1. If the person has no documented history of
				ever receiving a tuberculin skin test (TST), and elects to receive a TST, then
				a two-(2-) step TST is required. A history of bacilli Calmette-Guerin
				vaccination (BCG) shall not exempt a person from receiving a tuberculin
				test.
2. Persons that have a newly
				positive tuberculin test(s) shall not be allowed to work until a medical
				evaluation is performed to determine if the person has active contagious
				tuberculosis.
3. Persons with
				active contagious tuberculosis shall be excluded from employment until deemed
				non-infectious by the Missouri Department of Health and Senior Services or the
				local public health agency. The person may return to work once the above
				criteria have been met, as long as the person adheres to his/her prescribed
				treatment regimen.
4. All positive
				tuberculin tests shall be reported to the Missouri Department of Health and
				Senior Services or local public health agency as required by
				19 CSR
				20-20.020.
(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 child 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.
				The Medical Examination Report for Caregivers and Staff form, revised 2021, is
				incorporated by reference in this rule, as published by the Missouri Department
				of Elementary and Secondary Education, PO Box 480, Jefferson City, MO
				65102-0480 and available by the department at
https://dese.mo.gov/childhood/forms
.
				This rule does not incorporate any subsequent amendments or
				additions.
(E) A child care
				employee, who is identified as a contact to an active tuberculosis case, shall
				be evaluated for tuberculosis to determine if the person has active contagious
				tuberculosis, or be excluded from work.
(F) If at any time the department has reason
				to question the physical or emotional health of any person 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.