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
WEBSTER GROVES
MO  63119-4211

BLUE GOOSE CHILD CARE, LLC



 

GOBER, KAREN A

karengober@sbcglobal.net


KATHERINE D SIMS

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 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; UP TO 8 CHILDREN NO MORE THAN 2 CHILDREN UNDER 2 WITH 1 ADULT
 
Inspection Information

02/25/2019

1:30 PM

3:45 PM

UNANNOUNCED

COMPLIANCE MONITORING

2351160748


DocumentDocument-Date
CERTIFICATE OF GOOD STANDING 10/25/2018
ARTICLES OF INCORPORATION 02/19/2010
CERTIFICATE OF INCORPORATION 02/19/2010
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/25/2018
SAFE SLEEP POLICY 10/01/2018
LLC ARTICLES OF ORGANIZATION 11/07/2011
LLC OPERATING AGREEMENT 10/25/2018
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: 15
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 4
Total Children 5
StaffChildClass AgeNote
3 5 MIXED Heather Gober, Karen Gober, and Brian Gober present with 6 children, ages 11m-5yrs (1 child under age 2yrs, 1 related chid)
1 0 NO CHILDREN IN ATTENDANCE Arlene Segur also present with no children in attendance

 
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
Violation
 Provider Comments
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by there was a broken garage window in the outdoor play space.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 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
Return Inspection

Compliance Date

Violation
Hazardous items as follows were accessible to children: cold medication, alka seltzer and ibuprofen. The item(s) was/were located in the upstairs bedroom to the right.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 1 (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Return Inspection

Compliance Date

Violation
Hazardous items as follows were accessible to children: an antibiotic. The item(s) was/were located at the top of the steps on the desk.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 1 (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Return Inspection

Compliance Date

Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by the gate surrounding the steps that lead to the down stairs was not secure. There were multiple bags of trash sitting on the steps.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 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
Return Inspection

Compliance Date

Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by there is a rope used to tie up the dogs hanging from the back porch railing accessible to children.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 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
Return Inspection

Compliance Date

Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by splintering rail road ties were observed near the shed with an exposed nail.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 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
Return Inspection

Compliance Date

Violation
Hazardous items as follows were accessible to children: Clorox wipes. The item(s) was/were located in the children's inside play area.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 1 (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
2/25/2019
Violation
Animal excrement was observed in an outdoor area used by children; the location of the excrement was dog excrement in the outdoor play area.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 4 (D) states: Areas used by children shall be free of animal excrement.
Correction Required
No animal excrement shall be in areas used by children.

Correction Verification
Return Inspection

Compliance Date

Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by there are 3 sump pump poles exposed in the outside play area, causing a tripping hazard.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 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
Return Inspection

Compliance Date

Violation
Hazardous items as follows were accessible to children: lighters, butane fuel, medications, unlabeled pills in a pill box, jar of catnip. The item(s) was/were located located in the upstairs bedroom located at the top of the steps. The bedroom does not have a door, and there is a sheet hanging in the doorway.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 1 (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Return Inspection

Compliance Date

Violation
Children were not restricted to approved space as evidenced by the stair case that leads upstairs did not have a gate giving children access to the upstairs.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 1 (E) states: Children shall have no access to areas not approved for child care.
Correction Required
Caregivers shall restrict children to approved space.

Correction Verification
Return Inspection

Compliance Date

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
Violation
 Provider Comments
Violation
The requirements for equipment to be clean, in good condition and accessible were not met as evidenced by there was one purple toy bin in the main play area observed with a pencil eraser dot sized red substance.
Licensing Rule Reference
19 CSR 30-61.095 Furniture, Equipment and Materials 2 (A) 1 states: Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children.
Correction Required
Indoor play equipment, clean and in good repair, shall be accessible to children.

Correction Verification
Return Inspection

Compliance Date

19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel
Violation
 Provider Comments
Violation
Requirements for an approved assistant were not met as evidenced by the assistant present was not approved.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel 3 (A) states: An approved assistant shall be available. If there is a change of assistants, the provider shall notify the Child Care Licensing Unit immediately.
Correction Required
An approved assistant shall be available as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Requirements for safe sleep training were not met as evidence by the provider did not complete safe sleep training in that Karen Gober's safe sleep certification expired on 2.6.19.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel 5 . states: Every three (3) years the provider and assistant(s) in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment, by Moon RY, which is incorporated by reference in this rule and published in PEDIATRICS Volume 128, No. 5, November 1, 2011, and available from the University of Vermont College of Medicine, Given Building S261, 89 Beaumont Avenue, Burlington, Vermont 05405-0068, telephone number 802-656-2505, fax number 802-656-4844, or at www.pediatrics.aapublications.org/content/128/5/1030.full. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Provider and assistant shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-61.115 Day Care Family and Household
Compliance
19 CSR 30-61.125 Medical Examination Reports
Compliance
19 CSR 30-61.135 Admission Policies and Procedures
Compliance
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
1 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

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), Karen Gober, Brian Gober, Heather Gober (all need FCSR) and Arlene Segur (needs FCSR and fingerprints), 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

Violation
The provider did not meet requirements for requests/results of a criminal background check. A child care staff member(s), Anthony Gober, 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
Corrected on Site

Compliance Date
2/25/2019
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance