MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
BLUE GOOSE CHILD CARE, LLC

Facility DVN
002320349

Phone
(314) 704-0683

Physical Address
598 VIRGINIA AVE
WEBSTER GROVES
MO 63119-4211

Owner
BLUE GOOSE CHILD CARE, LLC

Mailing Address

Provider/Director
GOBER, KAREN A

E-mail Address
karengober@sbcglobal.net

Incorporated

Child Care Specialist
KATHERINE D SIMS

Age Range
6 WEEKS - 12 YEARS

Capacity
8

Facility Type
FAMILY HOME

Limitations
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

Date
02/25/2019

Arrival Time
1:30 PM

Departure Time
3:45 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2351160748

Document	Document-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

Staff	Child	Class Age	Note
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
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
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel Violation
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
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
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance