Missouri Code of State Regulations
Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES
Division 30 - Division of Regulation and Licensure
Chapter 62 - Licensing Rules for Group Child Care Homes and Child Care Centers
Section 19 CSR 30-62.082 - Physical Requirements of Group Day Care Homes and Day Care Centers

Universal Citation: 19 MO Code of State Regs 30-62.082

Current through Register Vol. 49, No. 18, September 16, 2024

PURPOSE: This amendment specifies that smoking is prohibited in areas where children are cared for in a group child care home or child care center as recommended by the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome for a safe infant sleeping environment.

(1) General Requirements.

(A) The premises shall be safe and suitable for the care of children.

(B) The premises shall conform to the fire and safety requirements of the State Fire Marshal or his/her designee and requirements for state or local zoning, building and sanitation.

(D) Stairways in approved child care space shall be well-lighted and free of obstructions. Stairways in approved child care space having more than three (3) steps shall have a handrail the children can reach.

(E) Porches, decks, stairwells or other areas in approved child care space having a drop-off of more than twenty-four inches (24") from which children might fall and be injured shall have an approved railing or approved barrier. The railing or barrier shall be constructed to prevent the child from crawling or falling through or becoming entrapped.

(F) Approved safety gates at stairways and doors shall be provided and used as needed.

(G) Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.

(H) Heaters, floor furnaces, radiators, hot water heaters or other equipment which pose a threat to children shall meet the requirements of 19 CSR 30-62.087 Fire Safety.

(I) All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.

(J) Ammunition, guns, hunting knives, bows and arrows or other weapons shall be stored in a locked cabinet or locked closet.

(K) No person shall smoke or otherwise use tobacco products in any area of the child care facility during the period of time when children cared for under the license are present.

(2) Indoor Space.

(A) General Requirements.

1. Any floor of a building used for child care shall be approved by the State Fire Marshal or his/her designee.

2. Open windows and doors shall be screened securely. Barriers to prevent children from falling against windows or falling from windows shall be provided when windows are less than twenty-four inches (24") from the floor and not constructed of safety glass or other nonbreakable material.

3. Clear glass doors shall be marked plainly at varying heights to avoid impact.

4. Artificial or natural lighting shall supply at least ten (10) footcandles of light throughout each room used for child care.

5. The facility shall be dry, temperature controlled, well-ventilated and free of drafts. Children shall not be overheated or chilled. The temperature of the rooms shall be no less than sixty-eight degrees Fahrenheit (68oF) and no more than eighty-five degrees Fahrenheit (85oF) when measured two feet (2') from the floor.

6. Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

7. Concrete floors in areas counted as child care space shall be covered with carpet, tile, linoleum or other floor covering.

8. Floor surfaces under indoor equipment over twenty-four inches (24") in height, from which children might fall and be injured, shall be protected with pads or mats which will effectively cushion the fall of a child. Carpeting alone is not an acceptable resilient surface under indoor equipment.

9. The facility shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.

10. A telephone in working order shall be available for incoming and outgoing calls. If a telephone answering machine is used, it must be turned on so incoming messages can be heard and parents' calls can be returned promptly.

11. Telephone numbers for the police, fire department, ambulance and other emergency telephone numbers shall be posted near the telephone.

(B) Floor Space Calculations and Utilization.

1. General requirements.

A. At least thirty-five (35) square feet of usable floor space shall be provided for each preschool and school-age child coming into the facility for day care.

B. Floor space shall be measured wall-to-wall from the inside walls of areas used for children's activities.

C. Floor space shall not include kitchens, bathrooms, closets, staff lounges, office space, hallways used exclusively as passageways or floor space occupied by furniture or shelving not used by the children or for their activities.

D. Space occupied by permanently placed cots, cribs, beds or playpens used for napping cannot be counted as usable floor space. Cots shall not be set up early or left in place to interfere with children's play activities.

E. Storage space for play materials shall be provided. Some of the space shall be on low shelves and accessible to the children.

F. Each child shall be provided individual space, accessible to the child, for storage of each child's clothing and other personal belongings.

G. Space shall be provided for office equipment, the making and keeping of records and for transaction of business. This space shall not interfere with the children's play areas.

H. An area for staff breaks shall be provided in the facility separate from child care space.

I. In a facility located in a provider's permanent residence, the area used for child care, including play space and bathrooms, shall be separate from the family living quarters.

J. The family kitchen of a facility licensed for no more than twenty (20) children, located in a provider's permanent residence, may be used for food preparation with approval of the sanitarian.

K. If school-age children are in care, there shall be space apart from the preschool program equipped for their use.

2. Infant and toddler space.

A. For group day care homes licensed for a maximum of four (4) infants/toddlers or for day care centers licensed for a maximum of twenty (20) children, including no more than four (4) infant/toddlers, the following shall apply:

(I) At least thirty-five (35) square feet of usable floor space shall be provided for each infant and toddler. Space occupied by cribs and playpens used for napping shall be deducted from usable floor space; and

(II) A crawl area protected by stable dividers shall be provided. The area shall have a resilient and washable floor covering which shall be mopped and sanitized daily. Washable area rugs that are laundered daily may be used.

B. For all other group day care homes licensed for more than four (4) infant/toddlers and for all day care centers licensed for more than twenty (20) children or more than four (4) infant/toddlers, the following shall apply:

(I) For facilities initially licensed for infant/toddler care after the effective date of these rules or facilities adding new infant/toddler space, at least forty-five (45) square feet of usable floor space shall be provided in the facility for each infant and toddler. Space occupied by napping equipment does not have to be deducted from usable floor space;

(II) Two (2) year-old children may be cared for in an infant/toddler unit. At least thirty-five (35) square feet of usable floor space shall be provided for each child in groups composed solely of two (2) year olds;

(III) If a unit for infants and toddlers is auxiliary to a facility for older children, centers initially licensed for infant/toddler care after the effective date of these rules or facilities adding new infant/toddler space, shall have play, sleeping and bathroom space in the infant and toddler unit. This space shall be separated from the space used for older children by floor-to-ceiling walls;

(IV) No more than eight (8) infant/toddlers or sixteen (16) two (2) year olds shall be in a group;

(V) In facilities initially licensed for infant/toddler care after the effective date of these rules or facilities adding new infant/toddler space, no more than twenty-four (24) infants/toddlers and/or two (2) year olds shall be in a room. A room shall be defined as an area separated from other parts of the building by floor-to-ceiling walls. Stable partitions a minimum of four feet (4') in height shall be used to separate the infant/toddler or two (2) year old groups, or both, in a room;

(VI) Floors shall be tile, linoleum or wood and shall be mopped and sanitized daily. Washable area rugs that are laundered daily may be used. Centers initially licensed after the effective date of these rules or facilities adding new infant/toddler space shall not use carpet;

(VII) Facilities initially licensed after the effective date of these rules or facilities adding new infant/toddler space shall provide refrigeration for bottles and a method for heating bottles in the infant/toddler unit; and

(VIII) Infant/toddler areas may not be used by staff or older children as passageways to other areas of the building.

(3) Bathrooms.

(A) General Requirements.

1. One (1) flush toilet and one (1) adjacent handwashing facility with running water shall be available for every twenty (20) children.

2. Urinals may be substituted for up to one-half (1/2) the required number of toilets, with a minimum of one (1) toilet per bathroom.

3. Toilet and handwashing facilities shall be in working order and convenient for the children's use.

4. Paper towels, soap and toilet paper shall be provided and easily accessible so the children can reach them without assistance.

5. Locks or latches shall not be used on bathroom or bathroom stall doors used by children below the first grade.

6. Children shall be monitored while in the bathroom.

7. Bathrooms shall be clean and odor free.

8. If a center is licensed for more than fifty (50) children, a separate bathroom or bathroom stall shall be available for staff.

(B) School Age.

1. When a center offers care for school-age children in first grade or above, bathroom facilities shall be provided as follows:

A. Separate girls' and boys' bathrooms shall be provided; or

B. If twenty (20) or fewer school-age children are in care, one (1) bathroom may be designated for school-age children only.

1. One (1) flush toilet and one (1) adjacent handwashing facility with running water shall be available for every twenty-four (24) children in an infant/toddler unit.

2. One (1) potty chair, junior commode or toilet with an adapter seat shall be provided for every four (4) children being toilet trained. Potty chairs shall be located in the bathroom and shall be emptied, cleaned and disinfected after each use.

(4) Diapering Area.

(A) A safe diapering table with a waterproof washable surface shall be used for changing diapers. The diapering table shall be located within or adjacent to the group space so the caregiver using the diapering table can maintain supervision of his/her group of children at all times.

(B) Facilities initially licensed for infant/toddler care after the effective date of these rules or facilities adding new infant/toddler space shall have one (1) diapering table for every group of eight (8) infant/toddlers and one (1) diapering table for every group of sixteen (16) two (2) year olds.

(C) Facilities initially licensed after the effective date of these rules and accepting two (2) year olds for care in the preschool unit shall have a diapering table available in the preschool unit.

(D) Diapering supplies and warm, running water shall be adjacent to the diapering area.

(5) Kitchens.

(A) A kitchen shall be required for meal preparation unless meals are catered from a source approved by the local or state sanitarian, or both.

(B) Kitchens used for meal preparation shall have sufficient equipment to accommodate the licensed capacity of the facility. The equipment shall include a stove, sink, hot and cold running water, a refrigerator and storage space for food, dishes and cooking utensils.

(C) If meals are catered, a sink, hot and cold running water, a refrigerator and storage space for food, dishes and cooking utensils shall be provided.

(D) Kitchens shall be maintained in compliance with state or local rules, or both, governing food service sanitation.

(E) Kitchens shall not be used for children's play activities unless the activities are part of the learning program and the children are supervised by adults.

(F) Kitchens shall not be used for napping or as passageways for children.

(6) Outdoor Space.

(A) General Requirements.

1. A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.

2. A minimum of seventy-five (75) square feet of outdoor play area per child at the time of use shall be provided. A sufficient area shall be available to accommodate one-third (1/3) the licensed capacity of the facility at one (1) time, with no less than seven hundred fifty (750) square feet.

3. Adult supervision shall be provided at all times when children are outside. For children three (3) years of age and above, staff/child ratios may be one and one-half (1 1/2) times the indoor staff/child ratios. The required indoor staff/child ratios shall be maintained on the premises at all times.

4. The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

5. The fall-zone area under and around outdoor equipment where children might fall and be injured shall be covered with impact-absorbing materials which will effectively cushion the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.

6. The provider shall be responsible for the type, depth and fall-zone area of resilient material necessary for the protection of children.

7. Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.

8. Concrete, asphalt, carpet, grass or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.

(B) Infants and Toddlers.

1. Outdoor play space for infants and toddlers shall be separate from that used for older children or the same space shall be used at different times. (This rule does not apply to group day care homes with a maximum of four (4) infant/toddlers or to day care centers licensed for a maximum of twenty (20) children, including no more than four (4) infant/toddlers.)

2. Staff/child ratios for infant/toddlers and two (2) year olds shall be maintained at all times.

(7) Swimming and Wading Pools.

(A) Swimming and wading pools used by children shall be constructed, maintained and used in a manner which safeguards the lives and health of children.

(B) Swimming and wading pools shall have a water filtration system. The water in swimming and wading pools shall be treated, cleaned and maintained in accordance with health practices and rules as determined by the local or state health authority, or both.

(C) Swimming and wading pools shall be fenced to prevent access by children. For facilities initially licensed after the effective date of these rules, the fence shall be at least forty-two inches (42") high and shall have a locked gate. Above-the-ground pools may use a forty-two inch (42") fence around the top of the pool with barricades of the steps to the pool deck.

(D) Children using swimming or wading pools shall be instructed in water safety and supervised by an adult at all times.

(E) An adult with a current lifeguard training certificate, including infant/child cardiopulmonary resuscitation (CPR) training, shall be on duty at all times when a swimming or wading pool containing a depth of forty-eight inches (48") or more of water is being used.

(F) An adult who has completed a course in basic water safety, which includes infant/child CPR, shall be on duty when a swimming or wading pool containing less than forty-eight inches (48") of water is being used.

(8) Animals.

(A) Animals which may pose a threat to the health or safety of children shall not be permitted on the premises or shall be penned securely in an area which is inaccessible to the children.

(B) If an animal bites a child, the parent(s) shall be notified immediately. The provider shall contact a veterinarian to determine a course of action in the diagnosis of possible rabies in the animal. If possible, the provider shall restrain the animal for observation by a veterinarian.

(D) No animals shall be permitted in food preparation areas.

(E) Areas used by children shall be free of animal excrement.

(F) Litter boxes shall not be located in areas used by children or in food preparation areas.

(G) Food and water dishes used by animals shall not be accessible to the children.

*Original authority: 210.221.1(3), RSMo 1949, amended 1955, 1987, 1993, 1995.

Disclaimer: These regulations may not be the most recent version. Missouri may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.

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