DHSS MO
MISSOURI DEPARTMENT OF HEALTH & SENIOR SERVICES

SECTION FOR CHILD CARE REGULATION

INSPECTION REPORT
Facility Information






 




 










 
Inspection Information








DocumentDocument-Date
SAMPLE WEEKLY MENU 09/12/2016
POLICIES 09/12/2016
REGISTERING FICTITIOUS NAMES 09/12/2016
SAMPLE FORMS 09/12/2016
LLC ARTICLES OF ORGANIZATION 09/12/2016
LINES OF ADMINISTRATIVE AUTHORITY 09/12/2016
DIAGRAM/OUTDOOR 09/12/2016
LOCAL FIRE DEPARTMENT NOTIFICATION 09/12/2016
DISCIPLINE POLICIES 09/12/2016
CHILD CARE PRACTICES 09/12/2016
DAILY SCHEDULE 09/20/2016
APPLICATION 08/15/2016
LOCAL BUILDING APPROVAL 09/20/2016
LLC OPERATING AGREEMENT 09/20/2016
JOB RESPONSIBILITIES 09/20/2016
FIRE/SAFETY INSPECTION 10/04/2016
EQUIPMENT LIST 09/12/2016
DIAGRAM/INDOOR 09/12/2016
STAFF SHEET 10/17/2016
DIRECTOR'S QUALIFICATIONS 10/13/2016
SANITATION INSPECTION 10/06/2016

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:00PM   5:00PM   7/31/2017



Open Violations:
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

 
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
Violation
 Provider Comments
Violation
Breanna Robinson & Katie Kositzke did not complete safe sleep training within 30 days of employment or volunteering at the facility.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (4) (D) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall complete safe sleep training described in section (4) of this rule within thirty (30) days of employment or volunteering at the facility.
Correction Required
The department approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Breanna Robinson, Jessica Flores, & Katie Kositzke as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (A) states: All persons working in a day care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Katie Kositzke.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (B) states: Medical examination reports shall include a “Risk Assessment for Tuberculosis” form, included herein, completed and signed by a health care professional, as provided by the Missouri Department of Health and Senior Services (MDHSS). If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
TB reports shall be on file as required

Correction Verification
Submit Documentation

Compliance Date

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
Compliance
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