DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

SUCCESS R-VI SCHOOL DISTRICT

002491469

(417) 967-2597

10341 HIGHWAY 17
SUCCESS
MO  65570-9605

SUCCESS RVI SCHOOL DISTRICT



 

WILSON, RAYLENE REE

cwilson@success.k12.mo.us


DAYNEEN GLASTETTER

36 MONTHS - 5 YEARS

20

GROUP HOME AND CENTER

 
Inspection Information

08/17/2017

1:00 PM

1:35 PM

UNANNOUNCED

COMPLIANCE MONITORING

2298973150


DocumentDocument-Date
SANITATION INSPECTION 12/14/2016
FIRE/SAFETY INSPECTION 11/07/2016
APPLICATION 12/05/2016
CHILD CARE PRACTICES 03/13/2015
DISCIPLINE POLICIES 03/13/2015
POLICIES 03/13/2015
DIAGRAM/INDOOR 03/13/2015
DIAGRAM/OUTDOOR 03/13/2015
DAILY SCHEDULE 03/13/2015
SAMPLE WEEKLY MENU 03/13/2015
OWNER/PROVIDER REFERENCES 03/26/2015
LINES OF ADMINISTRATIVE AUTHORITY 03/20/2015
JOB RESPONSIBILITIES 03/13/2015




Inspection determined facility to be in compliance with licensing rules.
Open Violations: NA
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 2
Total Children 13
StaffChildClass AgeNote
2 13 PRESCHOOL Raylene Wilson and Julia Pounds were present

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Initial Licensing Information
Compliance
19 CSR 30-62.052 License Renewal
Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
19 CSR 30-62.087 Fire Safety
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Compliance
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Compliance
19 CSR 30-62.132 Admission Policies and Procedures
Compliance
19 CSR 30-62.142 Nighttime Care
Compliance
19 CSR 30-62.152 Hourly Care Facilities
Compliance
19 CSR 30-62.162 Overlap Care of Children
Compliance
19 CSR 30-62.172 Emergency School Closings
Compliance
19 CSR 30-62.182 Child Care Program
Compliance
19 CSR 30-62.192 Health Care
Violation
 Provider Comments
Violation
Facility did not submit the required annual summary report showing immunization status of each child enrolled by January 15.
Licensing Rule Reference
19 CSR 30-62.192 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 (see 19 CSR 40-61.185). 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
3/9/2017
19 CSR 30-62.202 Nutrition and Food Service
Compliance
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance