Missouri childcare licensing is administered by the Section for Child Care Regulation within DHSS. Facilities providing care for 5 or more children for more than 4 hours per day must be licensed. Missouri uses a tiered quality system called Quality Counts Missouri. SB 710 (2026) created a new "Provisional License" pathway allowing new centers to open while completing full compliance requirements within 6 months.
| Age Group | Staff : Children | Max Group Size |
|---|---|---|
| Infants (under 12 months) | 1:4 | 8 |
| Toddlers (12–24 months) | 1:5 | 10 |
| 2 years | 1:8 | 16 |
| Preschool (3–5 years) | 1:10 | 20 |
| School age | 1:16 | 32 |
Enrollment Form
Complete enrollment with child information and emergency contacts.
Immunization Records
Current immunization records per Missouri Department of Health schedule required on file.
Medical/Health Assessment
Physician-signed health report required within 30 days of enrollment.
Emergency Contact Information
Names and phone numbers of emergency contacts and authorized pickup persons.
Emergency Medical Authorization
Parental consent for emergency medical care.
Allergy and Dietary Information
Documentation of any food allergies or special dietary needs.
Medication AuthorizationConditional
Written parental authorization for any medication to be administered.
Exemption Policy
Medical and religious exemptions are permitted. Contact the Missouri Department of Health and Senior Services for current exemption procedures.
Minimum Age
18 years
Background Check
State and federal fingerprint-based criminal background check and Family Care Safety Registry check required for all staff.
Lead Teacher Education
Child Development Associate (CDA) credential or relevant ECE coursework required.
Assistant Education
High school diploma or GED required. Pre-service training required before working independently with children.
CPR / First Aid
Pediatric CPR and First Aid certification required. At least one certified staff member on-site at all times.
Continuing Education
Annual professional development training required per DHSS standards.
Director Qualifications
Director qualification requirements set by DHSS Section for Child Care Regulation.
Inspection Frequency
At least two unannounced inspections annually.
License Renewal
Annual license renewal required.
Application Process
Contact DHSS Section for Child Care Regulation to begin the application process.
Licensing Fee
Varies by capacity. Contact DHSS for current fee schedule.
See exactly what's missing for every child. Compliance checklists, automated parent reminders, phone document scanning. $99/month, unlimited staff.