DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

BLUE GOOSE CHILD CARE, LLC

002320349

(314) 704-0683

598 VIRGINIA AVE
ST LOUIS
MO  63119-4211

BLUE GOOSE CHILD CARE, LLC



 

GOBER, KAREN A

karengober@sbcglobal.net


LEATRICE L DIXON

6 WEEKS - 12 YEARS

8

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 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 8 CHILDREN IN CARE, ALL CHILDREN MAY BE UNDER AGE 2 WITH 2 ADULT CAREGIVERS
 
Inspection Information

10/31/2018

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2343173822


DocumentDocument-Date
SAFE SLEEP POLICY 10/01/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/25/2018
LLC ARTICLES OF ORGANIZATION 11/07/2011
LLC OPERATING AGREEMENT 01/10/2013
OWNER/PROVIDER REFERENCES 04/24/2012
ASSISTANT REFERENCES 02/01/2013
SAMPLE FORMS 10/21/2011
SAMPLE WEEKLY MENU 10/21/2011
POLICIES 10/21/2011
DAILY SCHEDULE 10/21/2011
CHILD CARE/DISCIPLINE POLICIES 10/21/2011
DIAGRAM/OUTDOOR 10/21/2011
ASSISTANT APPROVAL REQUEST 10/21/2011
DIAGRAM/INDOOR 10/21/2011
EQUIPMENT LIST 09/13/2018
APPLICATION 08/31/2018
FIRE/SAFETY INSPECTION 08/16/2018
SANITATION INSPECTION 08/08/2018




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 30-61.025 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
Violation
 Provider Comments
Violation
The facility's disaster and emergency plan was not available in each room used for child care as evidenced by there is no emergency plan onsite.
Licensing Rule Reference
19 CSR 30-61.090 Disaster and Emergency Preparedness 2 (A) states: At all times, a copy of the facility's disaster emergency plan is readily available in the office area and in each room used for care of children.
Correction Required
The facilities disaster and emergency plan must be available in required locations.

Correction Verification
Submit Documentation

Compliance Date
10/25/2018
Violation
The facility has not developed, implemented or maintained policies and procedures for responding to a disaster emergency.
Licensing Rule Reference
19 CSR 30-61.090 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
10/25/2018
19 CSR 30-61.095 Furniture, Equipment and Materials
Violation
 Provider Comments
Violation
Outdoor equipment, large wooden play structure, in the new playground area was unsafe as evidenced by the slats on the top of the climber are constructed to allow climbing by the children. There is insufficient railing/barrier on the top sides to prevent children from going over the side. .
Licensing Rule Reference
19 CSR 30-61.095 Furniture, Equipment and Materials 3 (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.
Correction Required
Outdoor equipment shall have no exposed hazards.

Correction Verification
Submit Documentation

Compliance Date
10/25/2018
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 01.04.07 (Child 2 has no medical exam form).
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
10/1/2018
19 CSR 30-61.135 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 30-61.135 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
10/1/2018
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for 1 (Child 6 is missing multiple doses) child(ren).
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
10/1/2018
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
Compliance
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.
Compliance