DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

FODERBERG, MICHELLE E

002379439

(816) 507-0503

2008 NE 91ST ST
KANSAS CITY
MO  64155

FODERBERG, MICHELLE E



 


foderberg@hotmail.com


ROMENA FOX

BIRTH - 5 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

05/15/2017

3:00 PM

3:39 PM

UNANNOUNCED

COMPLIANCE MONITORING

2298711796


DocumentDocument-Date
EQUIPMENT LIST 11/11/2016
APPLICATION 11/01/2016
ASSISTANT REFERENCES 11/29/2012
ASSISTANT APPROVAL REQUEST 01/22/2013
SAMPLE WEEKLY MENU 01/22/2013
POLICIES 01/23/2013
OWNER/PROVIDER REFERENCES 12/04/2012
DAILY SCHEDULE 01/22/2013
CHILD CARE/DISCIPLINE POLICIES 01/23/2013
DIAGRAM/OUTDOOR 01/22/2013
DIAGRAM/INDOOR 01/22/2013
FIRE/SAFETY INSPECTION 09/27/2016
SANITATION INSPECTION 08/31/2016




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 5
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 6
StaffChildClass AgeNote
1 6 MIXED One under one year old One one year old Two two year olds One three year old One five year old

 
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
Compliance
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
Violation
 Provider Comments
Violation
The requirements for first aid and CPR training were not met as evidenced by there was no documentation on file showing completion of first aid certification.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel 1 (N) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.
Correction Required
Required certification in first aid/CPR shall be on file. At least one caregiver with the certification shall be on site as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for documentation of 12 clock hours of annual training were not met as evidenced by there were insufficient training documents on file. The staff listed needs the following information: Michelle Foderberg is missing eleven hours of training.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel 4 (A) states: The provider shall obtain at least twelve (12) clock hours of child care-related training during each year of employment in training which is approved by the department in health, safety, nutrition, guidance and discipline, appropriate activities and learning experiences for children, positive communication and interaction with parents, planning and setting up an appropriate environment for children, professional and administrative practices, or other child-related areas. Any assistant working more than five (5) hours per week shall meet the same training requirements.
Correction Required
Required training hours shall be documented for each employee.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid and CPR training were not met as evidenced by there was no documentation on file showing completion of CPR certification.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel 1 (N) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.
Correction Required
Required certification in first aid/CPR shall be on file. At least one caregiver with the certification shall be on site as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid and CPR training were not met as evidenced by at least one caregiver certified in first aid/CPR was not on site.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel 1 (N) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.
Correction Required
Required certification in first aid/CPR shall be on file. At least one caregiver with the certification shall be on site as required.

Correction Verification
Submit Documentation

Compliance Date

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's file did not include information about the child's behaviors.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 6 (E) 2 states: Information regarding a child's personal development, behavior patterns, habits and individual needs.
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
Not Observed
19 CSR 30-61.175 Child Care Program
Compliance
19 CSR 30-61.185 Health Care
Violation
 Provider Comments
Violation
Facility did not submit the Bureau of Immunizations annual summary report showing immunization status of each child enrolled by January 15.
Licensing Rule Reference
19 CSR 30-61.185 Health Care 4 (D) states: The administrator of each day care facility shall prepare a record of immunization of each child enrolled in or attending the facility. An annual summary report shall be made by January 15 showing the immunization status of each child enrolled, using forms provided by the department. The immunization records shall be available for review by department personnel upon request.
Correction Required
Facility shall submit an annual summary report by January 15 showing the immunization status of each child enrolled.

Correction Verification
Submit Documentation

Compliance Date
5/15/2017
19 CSR 30-61.190 Nutrition and Food Service
Not Observed
19 CSR 30-61.200 Transportation and Field Trips
Not Observed
19 CSR 30-61.210 Records and Reports
Compliance
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