DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

CANCIENNE, SHANNON

002020959

(636) 464-2691

5512 LEHIGH LN
IMPERIAL
MO  63052-1718

CANCIENNE, SHANNON



 


shancan7@gmail.com


CARON AHLEMEYER

6 WEEKS - 12 YEARS

10

FAMILY HOME

IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 2 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER
 
Inspection Information

01/09/2017

8:18 AM

10:55 AM

ANNOUNCED

RENEWAL

2297750567


DocumentDocument-Date
SAMPLE WEEKLY MENU 03/04/2009
SAMPLE FORMS 03/04/2009
POLICIES 03/04/2009
OWNER/PROVIDER REFERENCES 03/04/2009
LOCAL FIRE DEPARTMENT NOTIFICATION 03/04/2009
DIAGRAM/OUTDOOR 03/04/2009
DIAGRAM/INDOOR 03/04/2009
DAILY SCHEDULE 03/04/2009
CHILD CARE/DISCIPLINE POLICIES 03/04/2009
ASSISTANT REFERENCES 03/24/2015
ASSISTANT APPROVAL REQUEST 03/24/2015
APPLICATION 12/08/2016
EQUIPMENT LIST 12/08/2016
FIRE/SAFETY INSPECTION 12/05/2016
SANITATION INSPECTION 11/15/2016

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:45PM   5:45PM   12/14/2010



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 7
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 3
Total Children 9
StaffChildClass AgeNote
2 9 MIXED Elizabeth Stevens and Melissa Wright-Dillon with children aged 23 months to age 5 years old
1 0 NO CHILDREN IN ATTENDANCE Shannon Cancienne, director with no children

 
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
Violation
 Provider Comments
Violation
The provider did not meet requirements for requests/results of background reviews. Reviews were missing/out of date for the following provider/employees/adult household members: Shannon Cancienne, Brad Cancienne, Elizabeth Stevens, and Melissa Wright-Dillon.
Licensing Rule Reference
19 CSR 30-61.055 License Renewal 3 states: After the child care provider applies for renewal of the license, the child care provider shall request the results of a criminal record review (CRR) from the Missouri State Highway Patrol for the child care provider, all persons employed by the child care provider, and all adult household members. The child care provider shall request a criminal record review within ten (10) days following the employment of any person and within ten (10) days after any adult becomes a household member. The department may request a criminal record review for any adult present in the family day care home when child care children are present. The criminal record reviews shall include records of criminal convictions, pending criminal charges, and suspended imposition of sentence during the term of probation. Requests for criminal record reviews shall be made on a form provided by the highway patrol.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not meet requirements for requests/results of background reviews. Reviews were missing/out of date for the following provider/other personnel/other household members: Shannon Cancienne, Brad Cancienne, Elizabeth Stevens, and Melissa Wright-Dillon.
Licensing Rule Reference
19 CSR 30-61.055 License Renewal 2 states: The child care provider, other personnel and other household members shall be screened for child abuse/neglect prior to renewal of the license.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
The ceilings located in the classroom space was/were not in good condition as evidenced by brown water stains from upstairs dishwasher and ice maker leaks.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 2 (A) 6 states: 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.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
A medical examination report was not on file for the assistant and/or volunteer.
Licensing Rule Reference
19 CSR 30-61.125 Medical Examination Reports 1 (D) states: 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.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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 on file as evidenced by child(s) file(s) did not have the parental acknowledgement they have been notified that they may request whether there are children for whom an immunization exemption has been filed for currently enrolled in or attending the facility.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 6 (E) 7 F. states: They have been notified that they may request notice at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for three child(ren).
Licensing Rule Reference
19 CSR 30-61.185 Health Care 4 (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Two child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports 2 (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance