Missouri Code of State Regulations › Title 5 - DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION › Division 25 - Office of Childhood › Chapter 400 - Licensing Rules for Family Child Care Homes › Section 5 CSR 25-400.125 - Child Care Family and Household

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 that are incorporated by reference, and updates references to Missouri
				  Department of Health and Senior Services.
(1) Child Care Provider and Assistants.
(A) The child care provider shall be in good
				physical and emotional health with no physical or mental conditions which would
				interfere with child care responsibilities.
(B) The provider shall have a medical
				examination report on file at the time of initial licensure.
(C) All assistants shall be in good physical
				and emotional health with no physical or mental conditions which would
				interfere with child care responsibilities.
(D) Assistants who are employed or volunteer
				more than five (5) hours per week shall have a medical examination report on
				file within thirty (30) days of beginning work in the home.
(E) 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 to this publication. 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.
(F) Medical examination reports shall be
				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
				beginning work in the home. These reports may be transferable to another child
				care facility for subsequent employment.
(G) The medical examination report form shall
				be supplied by the department or the provider may use his/her 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.
(H) 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.
(I) If at any time the department has reason
				to question the physical or mental health of a provider or assistant, the
				department shall require a physical or mental examination of that
				person.
(J) No individual shall
				work when ill if the health or well-being of children is
				endangered.