DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

KIDS VILLAGE WEST LLC

002471034

(573) 860-2900

36 TAYLOR ST
SULLIVAN
MO  63080-1934

KIDS VILLAGE WEST LLC



 

PRATER, CHANDA TAMARA

kidsvillagewest@att.net


LEATRICE L DIXON

BIRTH - 12 YEARS

69

GROUP HOME AND CENTER

16 CHILDREN IN THE INFANT/TODDLER UNIT; 8 CHILDREN UNDER 12 MONTHS
 
Inspection Information

07/31/2018

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2336565209


DocumentDocument-Date
SAFE SLEEP POLICY 06/28/2018
CERTIFICATE OF GOOD STANDING 06/06/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 07/31/2018
SAMPLE FORMS 07/21/2014
CHILD CARE PRACTICES 05/19/2014
DISCIPLINE POLICIES 05/19/2014
POLICIES 07/21/2014
SAMPLE WEEKLY MENU 06/20/2014
DAILY SCHEDULE 07/21/2014
JOB RESPONSIBILITIES 08/06/2014
LINES OF ADMINISTRATIVE AUTHORITY 05/19/2014
LOCAL BUILDING APPROVAL 07/21/2014
LOCAL ZONING APPROVAL 07/21/2014
LLC ARTICLES OF ORGANIZATION 08/06/2014
LLC OPERATING AGREEMENT 08/06/2014
DIAGRAM/OUTDOOR 07/21/2014
DIAGRAM/INDOOR 05/12/2014
DIRECTOR'S QUALIFICATIONS 09/08/2015
SANITATION INSPECTION 05/22/2018
FIRE/SAFETY INSPECTION 06/06/2018
EQUIPMENT LIST 06/08/2018
STAFF SHEET 06/08/2018
APPLICATION 06/08/2018




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
Violation
 Provider Comments
Violation
The facility has not developed, implemented or maintained policies and procedures for responding to a disaster emergency.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (1) (A) states: The facility shall develop, implement, and maintain policies and procedures for responding to a disaster emergency, including a written plan for:
Correction Required
Facility must have plan on file as required.

Correction Verification
Submit Documentation

Compliance Date
7/31/2018
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
Violation
 Provider Comments
Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for , Allison West, Jordan Dahms, and Crystal Black.
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
6/28/2018
Violation
Medical examination report form did not contain all required information as evidenced by Cassandra Johnston's medical does not indicate if she is in good physical and mental health (box not checked by doctor's office).
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (D) states: The medical examination report form shall be supplied by the department or the facility may use its own form if it contains all the information on the department's form.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
6/28/2018
Violation
Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 10.30.17 (this child has a parent health report but needs a child medical exam-based on the age of the child).
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
6/28/2018
19 CSR 30-62.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The facility's written policies did not contain information pertaining to safe sleep practices for children less than 1 year of age.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (1) states: The provider shall establish, implement and maintain written policies pertaining to the program goals, admission, safe sleep practices for children less than one (1) year of age, care and discharge of children and shall provide a copy to the parent(s) at the time of enrollment.
Correction Required
The provider's written policies shall be provided to the parent(s) as required.

Correction Verification
Submit Documentation

Compliance Date
6/28/2018
Violation
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not met as evidenced by there was no plan on file for a child with special needs.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.
Correction Required
An individualized plan from a professional source shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
6/28/2018
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
Violation
 Provider Comments
Violation
1 child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (F) states: Field trip and transportation authorization.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
6/22/2018
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance