DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

POTTS, PATRICIA ANN

000194963

(573) 642-9587

810 ST EUNICE RD
FULTON
MO  65251

POTTS, PATRICIA ANN



 




ANGELA EVELYN EASLEY

36 MONTHS - 12 YEARS

10

FAMILY HOME

 
Inspection Information

04/20/2015

8:30 AM

9:23 AM

UNANNOUNCED

COMPLIANCE MONITORING

2251828299


DocumentDocument-Date
ASSISTANT APPROVAL REQUEST 04/20/2010
SAMPLE WEEKLY MENU 12/30/1985
DAILY SCHEDULE 08/04/1986
CHILD CARE/DISCIPLINE POLICIES 05/05/1992
DIAGRAM/OUTDOOR 12/30/1985
DIAGRAM/INDOOR 09/24/1985
SANITATION INSPECTION 03/31/2014
EQUIPMENT LIST 03/31/2014
APPLICATION 03/31/2014
FIRE/SAFETY INSPECTION 04/14/2014

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:30PM   4:30PM   7/28/2010
  6:30AM   7:30AM   7/28/2010



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 3
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.
Attendance at Time of Inspection
Total Staff 1
Total Children 5
StaffChildClass AgeNote
1 5 PRESCHOOL

 
19 CSR 30-61.025 Organization and Administration
Compliance
19 CSR 30-61.045 Initial Licensing Information
Compliance
19 CSR 30-61.055 License Renewal
Compliance
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
The provider did not provide resilient material necessary for the protection of children as evidenced by dirt exposed under two yellow swing.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 7 states: The provider shall be responsible for the type, depth and fall-zone area of resilient material necessary for the protection of children.
Correction Required
Appropriate type, depth and fall zone area of resilient material shall be provided for the protection of children.

Correction Verification
Submit Documentation

Compliance Date

Violation
The premises were not safe and suitable as evidenced by a shaving razor on the floor of the standing shower.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 1 (A) states: The premises shall be safe and suitable for the care of children.
Correction Required
The premises shall be safe and suitable for the care of children.

Correction Verification
Corrected on Site

Compliance Date
4/20/2015
19 CSR 30-61.086 Fire Safety
Compliance
19 CSR 30-61.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-61.095 Furniture, Equipment and Materials
Compliance
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel
Compliance
19 CSR 30-61.115 Day Care Family and Household
Compliance
19 CSR 30-61.125 Medical Examination Reports
Compliance
19 CSR 30-61.135 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information as evidenced by one child needs authorization for emergency medical completed on enrollment form.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 5 (E) 3 states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-61.145 Nighttime Care
Compliance
19 CSR 30-61.155 Overlap Care of Children
Compliance
19 CSR 30-61.165 Emergency School Closings
Compliance
19 CSR 30-61.175 Child Care Program
Compliance
19 CSR 30-61.185 Health Care
Compliance
19 CSR 30-61.190 Nutrition and Food Service
Compliance
19 CSR 30-61.200 Transportation and Field Trips
Compliance
19 CSR 30-61.210 Records and Reports
Violation
 Provider Comments
Violation
one child(ren) records did not include name and phone number of the family physician or hospital.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports 2 (D) states: Name and phone number of the family physician, or hospital, or both, to be used in an emergency.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance