DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

MIM'S JUST LIKE HOME, LLC

002664308

(573) 701-3208

10405 STATE HIGHWAY P
POTOSI
MO  63664-8352

MIM'S JUST LIKE HOME, LLC



 

ADAMS, KIMBERLY SUE

MimsKids18@yahoo.com


LEATRICE L DIXON

24 MONTHS - 13 YEARS

77

GROUP HOME AND CENTER

 
Inspection Information

02/07/2019

11:00 AM

1:08 PM

UNANNOUNCED

COMPLIANCE MONITORING

2350070234


DocumentDocument-Date
APPLICATION 06/25/2018
ARTICLES OF INCORPORATION 06/25/2018
CERTIFICATE OF GOOD STANDING 09/05/2018
FIRE/SAFETY INSPECTION 08/06/2018
LLC ARTICLES OF ORGANIZATION 09/05/2018
DIAGRAM/INDOOR 08/21/2018
DIAGRAM/OUTDOOR 08/21/2018
LOCAL ZONING APPROVAL 09/05/2018
LOCAL BUILDING APPROVAL 09/05/2018
LOCAL FIRE DEPARTMENT NOTIFICATION 09/05/2018
STAFF SHEET 08/29/2018
EQUIPMENT LIST 09/17/2018
DIRECTOR'S QUALIFICATIONS 09/27/2018
SAMPLE WEEKLY MENU 09/19/2018
JOB RESPONSIBILITIES 09/27/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 09/27/2018
DAILY SCHEDULE 09/27/2018
DISCIPLINE POLICIES 09/27/2018
LINES OF ADMINISTRATIVE AUTHORITY 10/04/2018
CHILD CARE PRACTICES 10/02/2018
POLICIES 10/02/2018
LLC OPERATING AGREEMENT 10/16/2018
SANITATION INSPECTION 09/18/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 18
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 5
Total Children 33
StaffChildClass AgeNote
2 20 MIXED Tracy Wilson and Sherry Portell with children ages 2 to 5 years (one is age 2 years)
2 12 MIXED Lisa Ward, Joanne Skaggs and Lisa Fargo with children ages 2 to 5 years
1 1 TWO YEAR OLDS Kim Adams with a child age 2 years

 
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
Violation
 Provider Comments
Violation
The premises were not safe and suitable as evidenced by there are hole around an electrical outlet in the 2 year old rom allowing children to have access to electrical wires if they would put their fingers in the holes.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.
Correction Required
The premises shall be safe and suitable for the care of children.

Correction Verification
Submit Documentation

Compliance Date

Violation
The walls located preschool room was/were not in good condition as evidenced by there are areas of chipped paint behind the stacked toy containers.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility's outdoor space was not safe for children's activities as evidenced by Fabric is sticking through the pea gravel causing a tripping hazard. Kim Adams sent a photo on 01.04.19 which put this violation from the December post licensing visit into compliance. However, it is again noted as a violation today.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Bathroom supplies were not available and accessible to children as evidenced by there were no paper towels.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 4. states: Paper towels, soap and toilet paper shall be provided and easily accessible so the children can reach them without assistance.
Correction Required
The facility shall provide paper towels, soap and toilet paper, accessible for children's use.

Correction Verification
Corrected on Site

Compliance Date
2/7/2019
Violation
The facility's outdoor space was not safe for children's activities as evidenced by the area around the climbing equipment on the preschool playground has not been well maintained. The landscaping fabric is sticking through the pea gravel in many areas creating a tripping hazard. Although there is sufficient pea gravel still in place at this time, it was discussed that since there is no edging in the area, constant maintainence is required to keep the fabric under the pea gravel and to keep enough pea gravel in the areas needed .
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
1/4/2019
Violation
The facility did not provide at least 35 square feet of usable floor space for each preschool and school-age child coming into the facility for day care as evidenced by previously approved required space was not being used.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (B) 1. A. states: At least thirty-five (35) square feet of usable floor space shall be provided for each preschool and school-age child coming into the facility for day care.
Correction Required
The facility shall provide thirty-five square feet of usable space per child.

Correction Verification
Return Inspection

Compliance Date
2/7/2019
Violation
The walls located in the 2 year old room was/were not in good condition as evidenced by the red painted corners have chipping paint, the blue wall under the tv has chipping paint, the gray wall by the rocker has chipping paint, the yellow wall has peeling paint. The blu door to the outside has chipping paint. There are holes around the outlet in the gray wall under the kitchen window.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that multiple outlets in every room were uncovered.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.
Correction Required
The facility shall use outlet covers or twist-lock outlets as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Children were not restricted to approved space as evidenced by the door from the 2 year old room to the kitchen was open allowing children access to the unattended kitchen.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.
Correction Required
Caregivers shall restrict children to approved space.

Correction Verification
Corrected on Site

Compliance Date
2/7/2019
Violation
The premises were not safe and suitable as evidenced by plug in dispensers full of oil are being used throughout the facility. Discussed that the oil is an ingestion hazard as they are located within reach of children.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.
Correction Required
The premises shall be safe and suitable for the care of children.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.087 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.
Licensing Rule Reference
19 CSR 30-62.087 Fire Safety (2) (F) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date
1/31/2019
Violation
Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by the disaster and tornado drill was not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-62.087 Fire Safety (2) (F) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date
1/31/2019
19 CSR 30-62.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials
Violation
 Provider Comments
Violation
The requirements for sleeping materials were not met as evidenced by 1 children 12 months or older was/were sleeping/napping on a mat on the floor.
Licensing Rule Reference
19 CSR 30-62.092 Furniture, Equipment and Materials (1) (B) 1. A. states: An individual cot or bed shall be provided for each child who naps or sleeps. An individually assigned sheet and blanket shall be provided for each child twelve (12) months and older who naps or sleeps. Upper levels of bunk beds shall not be used.
Correction Required
The facility shall provide sleeping equipment and bedding as required.

Correction Verification
Return Inspection

Compliance Date
2/7/2019
Violation
Sleeping equipment was not arranged to provide required spacing as evidenced by there was no aisle on the long side of the napping equipment.
Licensing Rule Reference
19 CSR 30-62.092 Furniture, Equipment and Materials (1) (B) 1. D. states: Sleeping equipment shall be arranged to provide at least a two foot (2') aisle on one (1) long side of the equipment.
Correction Required
Caregivers shall provide a two foot (2') aisle on one long side of the napping equipment.

Correction Verification
Return Inspection

Compliance Date
2/7/2019
Violation
The requirements for sleeping materials were not met as evidenced by 2 children 12 months or older was/were sleeping/napping on couches.
Licensing Rule Reference
19 CSR 30-62.092 Furniture, Equipment and Materials (1) (B) 1. A. states: An individual cot or bed shall be provided for each child who naps or sleeps. An individually assigned sheet and blanket shall be provided for each child twelve (12) months and older who naps or sleeps. Upper levels of bunk beds shall not be used.
Correction Required
The facility shall provide sleeping equipment and bedding as required.

Correction Verification
Return Inspection

Compliance Date
2/7/2019
Violation
The requirements for sleeping materials were not met as evidenced by 33 children 12 months or older, who nap or sleep, did not have a sheet.
Licensing Rule Reference
19 CSR 30-62.092 Furniture, Equipment and Materials (1) (B) 1. A. states: An individual cot or bed shall be provided for each child who naps or sleeps. An individually assigned sheet and blanket shall be provided for each child twelve (12) months and older who naps or sleeps. Upper levels of bunk beds shall not be used.
Correction Required
The facility shall provide sleeping equipment and bedding as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
The requirements for documentation of 12 clock hours of annual training were not met as evidenced by there were insufficient training documents on file. The staff listed need the following documentation: Tracy Wilson needs 1 hour, Joyce (Joann) Skaggs needs 1 hour, Sherry Portell needs 3 hours, Lisa Ward needs 1 hour, Lisa Fargo needs 3 hours.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (A) states: The center director, group day care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each year of employment in training which is approved by the department in - health, safety, nutrition, guidance and discipline, appropriate activities and learning experiences for children, positive communication and interaction with parents, planning and setting up an appropriate environment for children, professional and administrative practices, or other child related areas.
Correction Required
Required training hours shall be documented for each employee.

Correction Verification
Submit Documentation

Compliance Date

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 Lisa Fargo 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

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 11.06.18 (Child 1).
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
1/10/2019
Violation
Medical examination report form did not contain all required information as evidenced by Megan Arnold.
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

Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Lisa Fargo.
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

19 CSR 30-62.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.
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

Violation
The facility did not meet requirements for child enrollment and health information as evidenced by Child 9 did not have emergency care authorization.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (8) (E) 4. 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
2/7/2019
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 required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for 2 (Child 1 and Child 4) child(ren).
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

Violation
Requirements for immunization reports on file were not met as evidenced by 1 (Child 3) 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

Violation
Facility did not submit the 2019 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

19 CSR 30-62.202 Nutrition and Food Service
Violation
 Provider Comments
Violation
The provider did not supply and serve food according to the Meal and Snack Food Chart as evidenced by the lunch meal consisted of 2 small pizza rolls, a banana, cheetos and koolaid (not juice). There is insufficient or missing meal components. Pizza rolls must contain the required meat/meat alternate serving. There must be 2 servings from the fruit/vegetable component (only bananas were served and Kool aid is not 100% fruit juice). Cheetos, can be served as a n extra food but do not count as a grain component,. Koolaid (not fruit juice) was served instead of milk.
Licensing Rule Reference
19 CSR 30-62.202 Nutrition and Food Service (1) (A) states: The provider shall supply and serve nourishing food according to the Meal and Snack Food Chart provided in this rule.
Correction Required
Nourishing food shall be provided as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
One serving of fluid milk was not served with each meal.
Licensing Rule Reference
19 CSR 30-62.202 Nutrition and Food Service (1) (E) states: One (1) serving of fluid milk shall be served with each meal.
Correction Required
Milk shall be served as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Violation
 Provider Comments
Violation
3 (Children 4, 5, 7) 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
1/31/2019
Violation
1 (Child 3) 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
1/10/2019
Violation
Daily attendance records were not maintained on file as required as evidenced by there was no caregiver/volunteer attendance record.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (7) states: Daily staff and volunteer attendance records shall be maintained and kept on file a minimum of one (1) year.
Correction Required
Caregiver/volunteer attendance records shall be maintained/retained as required.

Correction Verification
Submit Documentation

Compliance Date
1/31/2019
Violation
3 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
Corrected on Site

Compliance Date
2/7/2019
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance
RSMo 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules.
Violation
 Provider Comments
Violation
The provider did not meet requirements for requests/results of a criminal background check. A child care staff member(s), Kim Adams, Traci Wilson, Joyce (Joann) Skaggs, Sherry Portell, Lisa Ward, Megan Arnold and Lisa Fargo, was/were employed/present prior to the provider requesting the results of a criminal background check.
Licensing Rule Reference
RSMo 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules. 2. (1) states: Prior to the employment or presence of a child care staff member in a family child care home, group child care home, child care center, or license-exempt child care facility, the child care provider shall request the results of a criminal background check for such child care staff member from the department of health and senior services.
Correction Required
Required requests/results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date