Operation Breakthrough, Inc.

5 CSR 25-500.052 (2) (A) · Annual Requirements

The annual fire safety inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.192 (4) (D) · Health Care · Correction due May 11, 2026

Facility did not submit the 2026 annual summary report showing immunization status of each child enrolled by January 15.

Required correction: Facility shall submit an annual summary report by January 15 showing the immunization status of each child enrolled.

5 CSR 25-500.192 (4) (D) · Health Care

Facility did not submit the 2026 annual summary report showing immunization status of each child enrolled by January 15.

Required correction: Facility shall submit an annual summary report by January 15 showing the immunization status of each child enrolled.

5 CSR 25-500.092 (1) (A) 1. · Furniture, Equipment and Materials · Correction due April 27, 2026

Furniture/equipment, wicker chair, in in central area was not in good condition as evidenced by the front left chair leg was bent inward so that only the edge of the foot touched the floor.

Required correction: The facility shall provide safe and clean furniture/equipment as required.

5 CSR 25-500.092 (1) (A) 1. · Furniture, Equipment and Materials

Furniture/equipment, wicker chair, in in central area was not in good condition as evidenced by the front left chair leg was bent inward so that only the edge of the foot touched the floor.

Required correction: The facility shall provide safe and clean furniture/equipment as required.

5 CSR 25-500.052 (2) (A) · Annual Requirements · Correction due October 20, 2025

The annual fire safety inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.052 (2) (C) · Annual Requirements · Correction due November 7, 2025

The Family Care Safety Registry check was not conducted for M.G., L.R., S.M., A.T., B.F., R.D., K.C., K.R. and mary Esselman within thirty (30) days prior to the anniversary date.

Required correction: Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

5 CSR 25-500.082 (1) (I) · Physical Requirements of Group Day Care Homes and Day Care Centers · Correction due November 7, 2025

Hazardous items as follows were accessible to children: black box mouse traps. The item(s) was/were located on the floor in the multipurpose room along the walls.

Required correction: Hazardous items shall be inaccessible to children.

5 CSR 25-500.082 (2) (A) 6. · Physical Requirements of Group Day Care Homes and Day Care Centers · Correction due November 7, 2025

The walls located next to the door to the director's offices was/were not in good condition as evidenced by a hole in the wall was present with a thin plastic covering that was not flush with the wall and held to the wall by neon green tape. The tape was coming off the wall at the edges and the plastic plate was able to be easily lifted from the wall.

Required correction: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

5 CSR 25-500.102 · Personnel (1) (K) . · Correction due November 7, 2025

A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: S.M., A.T., K.R. and M.G.

Required correction: The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

5 CSR 25-500.122 (1) (A) · Medical Examination Reports · Correction due November 7, 2025

Medical examination report(s) was/were not on file for A.T., K.R. and M.G. as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Required correction: Medical reports shall be on file as required.

5 CSR 25-500.122 · Medical Examination Reports (1) (B) . · Correction due November 7, 2025

A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: S.M., A.T., K.R. and M.G.

Required correction: Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberculin skin test (TST) as required.

5 CSR 25-500.052 (1) (D) · Annual Requirements · Correction due October 8, 2025

The staff sheet was not submitted.

Required correction: The facility shall submit a current staff sheet as required.

5 CSR 25-500.052 (2) (A) · Annual Requirements · Correction due October 10, 2025

The annual fire safety inspection was not conducted.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.052 (2) (C) · Annual Requirements

The Family Care Safety Registry check was not conducted for M.G., L.R., S.M., A.T., B.F., R.D., K.C., K.R. and mary Esselman within thirty (30) days prior to the anniversary date.

Required correction: Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

5 CSR 25-500.052 (2) (A) · Annual Requirements

The annual fire safety inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.082 (1) (I) · Physical Requirements of Group Day Care Homes and Day Care Centers

Hazardous items as follows were accessible to children: black box mouse traps. The item(s) was/were located on the floor in the multipurpose room along the walls.

Required correction: Hazardous items shall be inaccessible to children.

5 CSR 25-500.082 (2) (A) 6. · Physical Requirements of Group Day Care Homes and Day Care Centers

The walls located next to the door to the director's offices was/were not in good condition as evidenced by a hole in the wall was present with a thin plastic covering that was not flush with the wall and held to the wall by neon green tape. The tape was coming off the wall at the edges and the plastic plate was able to be easily lifted from the wall.

Required correction: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

5 CSR 25-500.102 · Personnel (1) (K) .

A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: S.M., A.T., K.R. and M.G.

Required correction: The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

5 CSR 25-500.122 (1) (A) · Medical Examination Reports

Medical examination report(s) was/were not on file for A.T., K.R. and M.G. as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Required correction: Medical reports shall be on file as required.

5 CSR 25-500.122 · Medical Examination Reports (1) (B) .

A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: S.M., A.T., K.R. and M.G.

Required correction: Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberculin skin test (TST) as required.

5 CSR 25-500.052 (1) (C) · Annual Requirements · Correction due October 7, 2025

The equipment list was not submitted.

Required correction: The facility shall submit an equipment list as required.

5 CSR 25-500.052 (1) (D) · Annual Requirements

The staff sheet was not submitted.

Required correction: The facility shall submit a current staff sheet as required.

5 CSR 25-500.052 (1) (A) · Annual Requirements · Correction due October 7, 2025

The Annual Declaration was not submitted.

Required correction: The facility shall submit the Annual Declaration as required.

5 CSR 25-500.052 (2) (A) · Annual Requirements

The annual fire safety inspection was not conducted.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.052 (2) (B) · Annual Requirements · Correction due October 7, 2025

The annual sanitation inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual sanitation requirements.

5 CSR 25-500.052 (2) (C) · Annual Requirements

The Family Care Safety Registry check was not conducted for M.G., L.R., S.M., A.T., B.F., R.D., K.C., K.R. and mary Esselman within thirty (30) days prior to the anniversary date.

Required correction: Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

5 CSR 25-500.082 (1) (I) · Physical Requirements of Group Day Care Homes and Day Care Centers

Hazardous items as follows were accessible to children: black box mouse traps. The item(s) was/were located on the floor in the multipurpose room along the walls.

Required correction: Hazardous items shall be inaccessible to children.

5 CSR 25-500.082 (2) (A) 6. · Physical Requirements of Group Day Care Homes and Day Care Centers

The walls located next to the door to the director's offices was/were not in good condition as evidenced by a hole in the wall was present with a thin plastic covering that was not flush with the wall and held to the wall by neon green tape. The tape was coming off the wall at the edges and the plastic plate was able to be easily lifted from the wall.

Required correction: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

5 CSR 25-500.102 · Personnel (1) (K) .

A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: S.M., A.T., K.R. and M.G.

Required correction: The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

5 CSR 25-500.102 (2) (A) 3. · Personnel · Correction due October 7, 2025

The facility does not have an approved director on staff.

Required correction: The facility shall have an approved director/group home provider.

5 CSR 25-500.122 (1) (A) · Medical Examination Reports

Medical examination report(s) was/were not on file for A.T., K.R. and M.G. as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.

Required correction: Medical reports shall be on file as required.

5 CSR 25-500.122 · Medical Examination Reports (1) (B) .

A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: S.M., A.T., K.R. and M.G.

Required correction: Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberculin skin test (TST) as required.

5 CSR 25-500.052 (2) (B) · Annual Requirements

The annual sanitation inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual sanitation requirements.

5 CSR 25-500.102 (2) (A) 3. · Personnel

The facility does not have an approved director on staff.

Required correction: The facility shall have an approved director/group home provider.

5 CSR 25-500.102 (2) (A) 3. · Personnel

The facility does not have an approved director on staff.

Required correction: The facility shall have an approved director/group home provider.

5 CSR 25-500.102 (2) (A) 3. · Personnel

The facility does not have an approved director on staff.

Required correction: The facility shall have an approved director/group home provider.

5 CSR 25-500.052 (2) (A) · Annual Requirements · Correction due May 13, 2024

The annual fire safety inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.052 (1) (A) · Annual Requirements · Correction due November 4, 2024

The Annual Declaration was not submitted.

Required correction: The facility shall submit the Annual Declaration as required.

5 CSR 25-500.052 (2) (A) · Annual Requirements · Correction due May 13, 2024

The annual fire safety inspection was not conducted.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.052 (2) (B) · Annual Requirements · Correction due October 17, 2024

The annual sanitation inspection was not conducted.

Required correction: The facility shall submit evidence of compliance with annual sanitation requirements.

5 CSR 25-500.090 (3) (A) · Disaster and Emergency Preparedness · Correction due November 4, 2024

Requirements of facilities participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.

Required correction: Fire, tornado, and other disaster drills shall be completed and recorded as required.

5 CSR 25-500.090 (3) (B) 2. · Disaster and Emergency Preparedness · Correction due November 4, 2024

The facility did not review with staff disaster procedures in the various possible emergency situations.

Required correction: Facility must review emergency plan with staff as required.

5 CSR 25-500.102 (3) (A) · Personnel · Correction due February 26, 2025

The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2023, the staff listed need the following information: R.M. (needs 2hours).

Required correction: Required training hours shall be documented for each caregiver.

Violation substantiated · 5 CSR 25-500.182(1)(C)3.

Only constructive, age-appropriate methods of discipline shall be used to help children develop self-control and assume responsibility for their own actions.

Required correction: The facility shall notify all staff members of the violations which were substantiated, and specify the actions to be taken by all staff in order to comply with all violations cited. A copy of the memo, letter, or staff meeting agenda shall be submitted to the Office of Childhood.

Violation substantiated · 5 CSR 25-500.182(1)(C)6.

Firm, positive statements or redirection of behavior shall be used with infants and toddlers.

Required correction: The facility shall notify all staff members of the violations which were substantiated, and specify the actions to be taken by all staff in order to comply with all violations cited. A copy of the memo, letter, or staff meeting agenda shall be submitted to the Office of Childhood.

Violation substantiated · 5 CSR 25-500.182(1)(C)7.

Physical punishment including, but not limited to, spanking, slapping, shaking, biting, or pulling hair shall be prohibited.

Required correction: The facility shall notify all staff members of the violations which were substantiated, and specify the actions to be taken by all staff in order to comply with all violations cited. A copy of the memo, letter, or staff meeting agenda shall be submitted to the Office of Childhood.

5 CSR 25-500.052 (1) (C) · Annual Requirements · Correction due October 1, 2024

The equipment list was not submitted.

Required correction: The facility shall submit an equipment list as required.

5 CSR 25-500.052 (1) (D) · Annual Requirements · Correction due October 1, 2024

The staff sheet was not submitted.

Required correction: The facility shall submit a current staff sheet as required.

5 CSR 25-500.052 (1) (A) · Annual Requirements

The Annual Declaration was not submitted.

Required correction: The facility shall submit the Annual Declaration as required.

5 CSR 25-500.052 (2) (A) · Annual Requirements

The annual fire safety inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.052 (2) (B) · Annual Requirements

The annual sanitation inspection was not conducted.

Required correction: The facility shall submit evidence of compliance with annual sanitation requirements.

5 CSR 25-500.052 (2) (A) · Annual Requirements

The annual fire safety inspection was not conducted.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.090 (3) (A) · Disaster and Emergency Preparedness

Requirements of facilities participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.

Required correction: Fire, tornado, and other disaster drills shall be completed and recorded as required.

5 CSR 25-500.090 (3) (B) 2. · Disaster and Emergency Preparedness

The facility did not review with staff disaster procedures in the various possible emergency situations.

Required correction: Facility must review emergency plan with staff as required.

5 CSR 25-500.102 (3) (A) · Personnel

The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2023, the staff listed need the following information: R.M. (needs 2hours).

Required correction: Required training hours shall be documented for each caregiver.

5 CSR 25-500.052 (2) (A) · Annual Requirements

The annual fire safety inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.052 (2) (A) · Annual Requirements · Correction due May 3, 2024

The annual fire safety inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.082 (2) (A) 6. · Physical Requirements of Group Day Care Homes and Day Care Centers · Correction due April 8, 2024

The walls located located behind door to offices was/were not in good condition as evidenced by hole in the wall.

Required correction: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

5 CSR 25-500.052 (2) (A) · Annual Requirements

The annual fire safety inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.052 (2) (B) · Annual Requirements · Correction due March 15, 2023

The annual sanitation inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual sanitation requirements.

5 CSR 25-500.082 (2) (A) 6. · Physical Requirements of Group Day Care Homes and Day Care Centers

The walls located located behind door to offices was/were not in good condition as evidenced by hole in the wall.

Required correction: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

5 CSR 25-500.102 (3) (A) · Personnel · Correction due March 4, 2024

The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: M.B. needs 12 hours, R.M.D. needs 12 hours,Veda WIlliams needs 12 hours,June Gilkey needs 7 hours, L.R. needs 12 hours and Coura Thiam needs 12 hours.

Required correction: Required training hours shall be documented for each caregiver.

5 CSR 25-500.102 · Personnel (4) (A) . · Correction due March 4, 2024

Safe sleep training was not completed within the past 3 years for the following staff J.F., J.G., L.R., T.T., and C.T.

Required correction: The director, group home provider, other caregivers, and those volunteers counted in staff/child ratio, shall complete department-approved safe sleep training as required.

5 CSR 25-500.052 (1) (C) · Annual Requirements · Correction due November 20, 2023

The equipment list was not submitted.

Required correction: The facility shall submit an equipment list as required.

5 CSR 25-500.052 (1) (D) · Annual Requirements · Correction due November 17, 2023

The staff sheet was not submitted.

Required correction: The facility shall submit a current staff sheet as required.

5 CSR 25-500.052 (1) (A) · Annual Requirements · Correction due November 17, 2023

The Annual Declaration was not submitted.

Required correction: The facility shall submit the Annual Declaration as required.

5 CSR 25-500.052 (2) (A) · Annual Requirements

The annual fire safety inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.052 (2) (B) · Annual Requirements · Correction due February 2, 2024

The annual sanitation inspection was not conducted.

Required correction: The facility shall submit evidence of compliance with annual sanitation requirements.

5 CSR 25-500.052 (2) (B) · Annual Requirements

The annual sanitation inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual sanitation requirements.

5 CSR 25-500.082 (2) (A) 6. · Physical Requirements of Group Day Care Homes and Day Care Centers

The walls located located behind door to offices was/were not in good condition as evidenced by hole in the wall.

Required correction: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

5 CSR 25-500.102 (3) (A) · Personnel

The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: M.B. needs 12 hours, R.M.D. needs 12 hours,Veda WIlliams needs 12 hours,June Gilkey needs 7 hours, L.R. needs 12 hours and Coura Thiam needs 12 hours.

Required correction: Required training hours shall be documented for each caregiver.

5 CSR 25-500.102 (2) (A) 2. · Personnel · Correction due November 20, 2023

The director is not routinely on duty, as evidenced by there is no approved director.

Required correction: The director/group home provider shall be routinely on duty, as required.

5 CSR 25-500.102 (2) (A) 3. · Personnel · Correction due November 20, 2023

The facility does not have an approved director on staff.

Required correction: The facility shall have an approved director/group home provider.

5 CSR 25-500.102 · Personnel (4) (A) .

Safe sleep training was not completed within the past 3 years for the following staff J.F., J.G., L.R., T.T., and C.T.

Required correction: The director, group home provider, other caregivers, and those volunteers counted in staff/child ratio, shall complete department-approved safe sleep training as required.

5 CSR 25-500.122 (2) (A) · Medical Examination Reports · Correction due November 20, 2023

Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were for RF and RD.

Required correction: Child medical requirements shall be completed and on file as required.

5 CSR 25-500.192 (4) (A) · Health Care · Correction due November 20, 2023

Requirements for immunization reports on file were not met as evidenced by for RF and RD immunization record(s) was/were not on file.

Required correction: Child immunization requirements shall be on file as required.

5 CSR 25-500.222 (2) (A) · Records and Reports · Correction due November 20, 2023

One child(ren) records did not include date care begins and ends.

Required correction: Child enrollment information shall be completed and on file as required.

5 CSR 25-500.222 (2) (C) · Records and Reports · Correction due November 20, 2023

One child(ren) records did not include address of another individual who might be reached in an emergency.

Required correction: Child enrollment information shall be completed and on file as required.

5 CSR 25-500.052 (1) (C) · Annual Requirements

The equipment list was not submitted.

Required correction: The facility shall submit an equipment list as required.

5 CSR 25-500.052 (1) (D) · Annual Requirements

The staff sheet was not submitted.

Required correction: The facility shall submit a current staff sheet as required.

5 CSR 25-500.052 (1) (A) · Annual Requirements

The Annual Declaration was not submitted.

Required correction: The facility shall submit the Annual Declaration as required.

5 CSR 25-500.052 (2) (A) · Annual Requirements

The annual fire safety inspection was not approved.

Required correction: The facility shall submit evidence of compliance with annual fire safety requirements.

5 CSR 25-500.052 (2) (B) · Annual Requirements

The annual sanitation inspection was not conducted.

Required correction: The facility shall submit evidence of compliance with annual sanitation requirements.

5 CSR 25-500.082 (2) (A) 6. · Physical Requirements of Group Day Care Homes and Day Care Centers

The walls located located behind door to offices was/were not in good condition as evidenced by hole in the wall.

Required correction: Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

5 CSR 25-500.102 (3) (A) · Personnel

The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: M.B. needs 12 hours, R.M.D. needs 12 hours,Veda WIlliams needs 12 hours,June Gilkey needs 7 hours, L.R. needs 12 hours and Coura Thiam needs 12 hours.

Required correction: Required training hours shall be documented for each caregiver.

5 CSR 25-500.102 · Personnel (2) (A) 1. .

The director was not responsible for the daily planning, monitoring and managing of the facilities program as evidenced by there is no approved director.

Required correction: The director or group home provider shall be responsible for the daily program.

5 CSR 25-500.102 (2) (A) 2. · Personnel

The director is not routinely on duty, as evidenced by there is no approved director.

Required correction: The director/group home provider shall be routinely on duty, as required.

5 CSR 25-500.102 (2) (A) 3. · Personnel

The facility does not have an approved director on staff.

Required correction: The facility shall have an approved director/group home provider.

5 CSR 25-500.102 · Personnel (4) (A) .

Safe sleep training was not completed within the past 3 years for the following staff J.F., J.G., L.R., T.T., and C.T.

Required correction: The director, group home provider, other caregivers, and those volunteers counted in staff/child ratio, shall complete department-approved safe sleep training as required.

5 CSR 25-500.122 (2) (A) · Medical Examination Reports

Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were for RF and RD.

Required correction: Child medical requirements shall be completed and on file as required.

5 CSR 25-500.192 (4) (A) · Health Care

Requirements for immunization reports on file were not met as evidenced by for RF and RD immunization record(s) was/were not on file.

Required correction: Child immunization requirements shall be on file as required.

5 CSR 25-500.222 (2) (A) · Records and Reports

One child(ren) records did not include date care begins and ends.

Required correction: Child enrollment information shall be completed and on file as required.

5 CSR 25-500.222 (2) (C) · Records and Reports

One child(ren) records did not include address of another individual who might be reached in an emergency.

Required correction: Child enrollment information shall be completed and on file as required.