DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

BELBEN, ALLISON

002212126

(417) 315-1621

3934 W YOUNG ST
SPRINGFIELD
MO  65803-5404

BELBEN, ALLISON



 


mrsbelben@gmail.com


LEAH WHITE

6 WEEKS - 5 YEARS

10

FAMILY HOME

2 CHILDREN UNDER 12 MONTHS; 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

05/25/2018

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2335920923


DocumentDocument-Date
APPLICATION 04/25/2018
FIRE/SAFETY INSPECTION 02/22/2018
ASSISTANT REFERENCES 06/27/2012
OWNER/PROVIDER REFERENCES 04/05/2012
ASSISTANT APPROVAL REQUEST 06/27/2012
SAMPLE FORMS 11/18/2011
SAMPLE WEEKLY MENU 11/18/2011
DAILY SCHEDULE 11/18/2011
CHILD CARE/DISCIPLINE POLICIES 11/18/2011
DIAGRAM/OUTDOOR 11/18/2011
DIAGRAM/INDOOR 11/18/2011
EQUIPMENT LIST 04/25/2016




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 30-61.055 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 Reviews were missing/out of date for the following provider/employees/adult household members: David Belben.
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
5/15/2018
19 CSR 30-61.115 Day Care Family and Household
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 one child's immunization record(s) was/were not on file .
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
5/25/2018
19 CSR 30-61.200 Transportation and Field Trips
Compliance
19 CSR 30-61.210 Records and Reports
Compliance