DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

JACKSON, JACQUELINE

001425934

(314) 531-4959

3814 PENROSE ST
ST LOUIS
MO  63107-1636

JACKSON, JACQUELINE MARIE



 

JACKSON, JACQUELINE MARIE

JTRJJ@AOL.COM


SHALINDA WALLACE

6 WEEKS - 12 YEARS

10

FAMILY HOME

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

09/26/2018

8:30 AM

10:01 AM

UNANNOUNCED

COMPLIANCE MONITORING

2340410180


DocumentDocument-Date
APPLICATION 01/17/2017
EQUIPMENT LIST 01/17/2017
LLC OPERATING AGREEMENT 12/28/2015
ASSISTANT REFERENCES 01/05/2011
ASSISTANT APPROVAL REQUEST 01/05/2011
SAMPLE WEEKLY MENU 10/31/2002
SAMPLE FORMS 10/31/2002
POLICIES 10/31/2002
DIAGRAM/OUTDOOR 10/31/2002
DIAGRAM/INDOOR 10/31/2002
CHILD CARE/DISCIPLINE POLICIES 10/31/2002
DAILY SCHEDULE 10/31/2002
FIRE/SAFETY INSPECTION 01/23/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 03/27/2018
SAFE SLEEP POLICY 09/26/2018

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:30PM   4:30PM   2/6/2015
  7:30AM   8:30AM   2/6/2015



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 14
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 5
StaffChildClass AgeNote
2 5 MIXED Ms. Jacqueline Jackson and Teina Evans is present with 5 children. One- 6 month old. Two- One year olds. Two- Two year olds.

 
19 CSR 30-61.025 Organization and Administration
Compliance
19 CSR 30-61.045 Initial Licensing Information
Compliance
19 CSR 30-61.055 License Renewal
Compliance
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Compliance
19 CSR 30-61.086 Fire Safety
Compliance
19 CSR 30-61.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-61.095 Furniture, Equipment and Materials
Compliance
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel
Compliance
19 CSR 30-61.115 Day Care Family and Household
Compliance
19 CSR 30-61.125 Medical Examination Reports
Violation
 Provider Comments
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 both unknown.
Licensing Rule Reference
19 CSR 30-61.125 Medical Examination Reports 2 (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of 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

19 CSR 30-61.135 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information as evidenced by the providers name was not documented on the enrollment form .
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 6 (E) 3 states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
9/26/2018
Violation
The provider did not have parental acknowledgement on file indicating the parent understands and agrees that the child may not be accepted for care when ill.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 6 (E) 7 D states: They understand and agree that the child may not be accepted for care when ill.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider's policies.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 6 (E) 7 A states: They have received a copy of the provider's policies pertaining to the admission, care and discharge of children.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not have parental acknowledgement on file indicating the parent has been informed that Licensing Rules for Family Day Care Homes in Missouri are available for review.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 6 (E) 7 B states: They have been informed that the Licensing Rules for Family Day Care Homes in Missouri are available in the home for their review.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not have parental acknowledgement on file indicating the parent and provider have agreed on a plan for continuing communication.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 6 (E) 7 C states: They and the provider have agreed on a plan for continuing communication regarding the child’s development, behavior and individual needs.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider’s safe sleep policy when enrolling children less than 1 year of age.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 6 (E) 7 E states: They have received a copy of the provider’s safe sleep policy when enrolling children less than one (1) year of age.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by one child(s) file(s) did not have the parental acknowledgement they have been notified that they may request whether there are children for whom an immunization exemption has been filed for currently enrolled in or attending the facility.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures 6 (E) 7 F. states: They have been notified that they may request notice at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-61.145 Nighttime Care
Compliance
19 CSR 30-61.155 Overlap Care of Children
Compliance
19 CSR 30-61.165 Emergency School Closings
Compliance
19 CSR 30-61.175 Child Care Program
Compliance
19 CSR 30-61.185 Health Care
Compliance
19 CSR 30-61.190 Nutrition and Food Service
Compliance
19 CSR 30-61.200 Transportation and Field Trips
Compliance
19 CSR 30-61.210 Records and Reports
Violation
 Provider Comments
Violation
One child(ren) records did not include name of individual authorized to take the child from the home.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports 2 (E) states: Name of the individual(s) authorized to take the child from the home.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
One child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
19 CSR 30-61.210 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

Violation
Two child(ren) records did not include date care begins and ends.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports 2 (A) states: The child’s full name, address, birth date and the date care begins and ends.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Two child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-61.210 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

Violation
One child(ren) records did not include name, address and telephone number of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports 2 (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
One child(ren) records did not include name and phone number of the family physician or hospital.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports 2 (D) states: Name and phone number of the family physician, or hospital, or both, to be used in an emergency.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Violation
 Provider Comments
Violation
Requirements for sanitation inspection were not met as evidenced by the inspection has not been conducted
Licensing Rule Reference
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. 1 states: All buildings and premises used by a child-care facility to care for more than four children except those exempted from the licensing provisions of the department of health and senior services pursuant to subdivisions (1), (2), (3), (4) and (6) of section 210.211, shall be inspected annually for fire and safety by the state fire marshal, the marshal's designee or officials of a local fire district and for health and sanitation by the department of health and senior services or officials of the local health department. Evidence of compliance with the inspections required by this section shall be kept on file and available to parents of children enrolling in the child-care facility.
Correction Required
An approved sanitation and fire/safety inspection shall be kept on file and be available as required.

Correction Verification
Submit Documentation

Compliance Date