DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

CALIFORNIA KIDS LLC

002553204

(573) 796-2058

800 LAKE DR
CALIFORNIA
MO  65018-2022

CALIFORNIA KIDS LLC



 

WOLFORD, ANNY NICOLE

californiakidsllc@gmail.com


ALISON MICHELE EVANS

6 WEEKS - 12 YEARS

38

GROUP HOME AND CENTER

12 CHILDREN IN THE INFANT/TODDLER UNIT
 
Inspection Information

06/22/2018

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2334618518


DocumentDocument-Date
APPLICATION 07/12/2017
STAFF SHEET 07/12/2017
LLC OPERATING AGREEMENT 09/01/2015
LLC ARTICLES OF ORGANIZATION 09/01/2015
LINES OF ADMINISTRATIVE AUTHORITY 09/01/2015
DIRECTOR'S QUALIFICATIONS 09/11/2015
DIAGRAM/INDOOR 09/18/2015
DIAGRAM/OUTDOOR 09/18/2015
SAMPLE WEEKLY MENU 10/08/2015
SANITATION INSPECTION 07/26/2017
DISCIPLINE POLICIES 10/26/2015
CHILD CARE PRACTICES 10/26/2015
POLICIES 10/26/2015
SAMPLE FORMS 10/28/2015
FIRE/SAFETY INSPECTION 06/26/2017
JOB RESPONSIBILITIES 11/02/2015
DAILY SCHEDULE 11/04/2015
EQUIPMENT LIST 07/12/2017
OWNER/PROVIDER REFERENCES 11/04/2015
LOCAL FIRE DEPARTMENT NOTIFICATION 11/04/2015

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:00PM   5:00PM   11/4/2015



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.

 
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
The provider did not meet requirements for requests/results of background reviews. Reviews were missing/out of date for the following owner(s), board president or chairperson, center director or group day care home provider, employees or volunteers counted in staff/child ratio: Caitlin Halsley.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (L) . states: The child care provider shall request and have on file the results of a criminal record review from the Missouri State Highway Patrol as defined by 19 CSR 30-62.042 Initial Licensing Information and 19 CSR 30-62.052 License Renewal. The child care provider shall request a criminal record review within ten (10) days following a change of the facility owner(s), board president or chairperson, the center director or group day care home provider, employees of the provider, or volunteers counted in staff/child ratios. The department may request a criminal record review from the Missouri State Highway Patrol for any adult present in the facility 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
6/22/2018
Violation
The provider did not meet requirements for requests/results of background reviews. Reviews were missing/out of date for the following volunteers counted in staff/child ratio, caregivers or other personnel: Caitlion Halsley.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (K) states: Volunteers counted in staff/child ratios, caregivers, and other personnel shall be screened for child abuse/neglect. The screening shall be requested by the provider within ten (10) days of any individual beginning employment or volunteering in the facility. Any investigated allegation of child abuse or neglect involving these persons in which the investigator finds reasonable cause to believe that the individual is the alleged perpetrator of child abuse or neglect shall be evaluated by the department. After review, the department may prohibit the person from being present in the facility during child care hours. A copy of the screening request and the response shall be filed in the employee's record.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
6/22/2018
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 Caitlin Halsley 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
6/22/2018
Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Caitlin Halsley.
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
6/22/2018
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
Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file .
Licensing Rule Reference
19 CSR 30-62.192 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 immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the 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 on file as required.

Correction Verification
Submit Documentation

Compliance Date
3/23/2018
Violation
Facility did not submit the Immunization 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
3/23/2018
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
Violation
 Provider Comments
Violation
1 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 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
3/23/2018
Violation
1 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 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
3/23/2018
Violation
1 child(ren) records did not include employers' name of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 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
3/23/2018
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Violation
 Provider Comments
Violation
Parent and/or guardian was not notified upon request of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.
Licensing Rule Reference
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when. 7. states: All public, private, and parochial day care centers, preschools, and nursery schools shall notify the parent or guardian of each child at the time of initial enrollment in or attendance at the facility that the parent or guardian may request notice of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed. Beginning December 1, 2015, all public, private, and parochial day care centers, preschools, and nursery schools shall notify the parent or guardian of each child currently enrolled in or attending the facility that the parent or guardian may request notice of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed. Any public, private, or parochial day care center, preschool, or nursery school shall notify the parent or guardian of a child enrolled in or attending the facility, upon request, of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.
Correction Required
Parent and/or guardian shall be notified upon request of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.

Correction Verification
Submit Documentation

Compliance Date
3/23/2018