DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

KIDS VILLAGE WEST LLC

002471034

(573) 860-2900

36 TAYLOR ST
SULLIVAN
MO  63080-1934

KIDS VILLAGE WEST LLC



 

JOHNSTON, CASSANDRA MARIE

kidsvillagewest@att.net


LEATRICE L DIXON

BIRTH - 12 YEARS

69

GROUP HOME AND CENTER

18 CHILDREN IN THE INFANT/TODDLER UNIT; 8 CHILDREN UNDER 12 MONTHS
 
Inspection Information

02/27/2019

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2351339397


DocumentDocument-Date
SAMPLE FORMS 07/21/2014
CHILD CARE PRACTICES 05/19/2014
DISCIPLINE POLICIES 05/19/2014
POLICIES 07/21/2014
SAMPLE WEEKLY MENU 06/20/2014
DAILY SCHEDULE 07/21/2014
JOB RESPONSIBILITIES 08/06/2014
LINES OF ADMINISTRATIVE AUTHORITY 05/19/2014
LOCAL BUILDING APPROVAL 07/21/2014
LOCAL ZONING APPROVAL 07/21/2014
LLC ARTICLES OF ORGANIZATION 08/06/2014
LLC OPERATING AGREEMENT 08/06/2014
DIAGRAM/OUTDOOR 07/21/2014
DIAGRAM/INDOOR 05/12/2014
DIRECTOR'S QUALIFICATIONS 09/08/2015
SANITATION INSPECTION 05/22/2018
EQUIPMENT LIST 06/08/2018
STAFF SHEET 06/08/2018
APPLICATION 06/08/2018
SAFE SLEEP POLICY 06/28/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 07/31/2018
CERTIFICATE OF GOOD STANDING 06/06/2018
FIRE/SAFETY INSPECTION 12/10/2018




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 30-62.032 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 ceilings located the 2 year old room was/were not in good condition as evidenced by there is a crack in the ceiling 18 feet by approx 1/4 inch.
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
1/9/2019
Violation
Diapering requirements were not met as evidenced by the diapering table did not have a waterproof washable surface.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (4) (A) states: A safe diapering table with a waterproof washable surface shall be used for changing diapers. The diapering table shall be located within or adjacent to the group space so the caregiver using the diapering table can maintain supervision of his/her group of children at all times.
Correction Required
The facility shall provide a safe and clean diapering table as required.

Correction Verification
Submit Documentation

Compliance Date
1/9/2019
19 CSR 30-62.087 Fire Safety
Violation
 Provider Comments
Violation
water heater was accessible to children as evidenced by an infant room closet that has no lock on the door is where the water heater is located.
Licensing Rule Reference
19 CSR 30-62.087 Fire Safety (10) (D) states: The rooms or areas listed in 19 CSR 30-62.087(10)(C)1.–5. Fire Safety shall be inaccessible to children by use of a locked doorknob or latch.
Correction Required
Rooms or areas listed in 19 CSR 30-62.87(10)(C )1.-5. shall be inaccessible to children by use of a locked doorknob or latch.

Correction Verification
Submit Documentation

Compliance Date
1/9/2019
19 CSR 30-62.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials
Violation
 Provider Comments
Violation
Furniture/equipment, a feeding chair, in the infant/toddler room was not in good condition as evidenced by straps are crusted with debris, seat was full f debris.
Licensing Rule Reference
19 CSR 30-62.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and 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
The facility shall provide safe and clean furniture/equipment as required.

Correction Verification
Submit Documentation

Compliance Date
1/9/2019
Violation
Outdoor equipment, a little tykes playhouse and a sensory table , in in the preschool playground was not in good condition as evidenced by there is a crack in the playhouse corner and the wooden top of the sensory table has a surface that is splintering.
Licensing Rule Reference
19 CSR 30-62.092 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 play equipment shall be safe and in good repair.

Correction Verification
Submit Documentation

Compliance Date
1/9/2019
Violation
Stationary equipment, red airplane in the preschool playground, was unsafe as evidenced by the equipment had exposed footings.
Licensing Rule Reference
19 CSR 30-62.092 Furniture, Equipment and Materials (3) (D) states: Stationary equipment such as swings, slides and climbers shall be securely anchored, have no exposed footings and be placed to avoid accidents or collisions.
Correction Required
Stationary equipment shall be safely installed, stable and securely anchored.

Correction Verification
Submit Documentation

Compliance Date
1/9/2019
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
The provider did not meet requirements for requests/results of background reviews. Reviews were missing/out of date for the following volunteers counted in staff/child ratio, caregivers or other personnel: Shelby Wood.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (K) states: Volunteers counted in staff/child ratios, caregivers, and other personnel shall be screened for child abuse/neglect. The screening shall be requested by the provider within ten (10) days of any individual beginning employment or volunteering in the facility. Any investigated allegation of child abuse or neglect involving these persons in which the investigator finds reasonable cause to believe that the individual is the alleged perpetrator of child abuse or neglect shall be evaluated by the department. After review, the department may prohibit the person from being present in the facility during child care hours. A copy of the screening request and the response shall be filed in the employee's record.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
1/9/2019
Violation
The provider did not meet requirements for requests/results of background reviews. Reviews were missing/out of date for the following owner(s), board president or chairperson, center director or group day care home provider, employees or volunteers counted in staff/child ratio: Shelby Wood.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (L) . states: The child care provider shall request and have on file the results of a criminal record review from the Missouri State Highway Patrol as defined by 19 CSR 30-62.042 Initial Licensing Information and 19 CSR 30-62.052 License Renewal. The child care provider shall request a criminal record review within ten (10) days following a change of the facility owner(s), board president or chairperson, the center director or group day care home provider, employees of the provider, or volunteers counted in staff/child ratios. The department may request a criminal record review from the Missouri State Highway Patrol for any adult present in the facility when child care children are present. The criminal record reviews shall include records of criminal convictions, pending criminal charges, and suspended imposition of sentence during the term of probation. Requests for criminal record reviews shall be made on a form provided by the highway patrol.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
1/9/2019
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 Shelby Wood 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
1/9/2019
Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Shelby Wood.
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
1/9/2019
19 CSR 30-62.132 Admission Policies and Procedures
Compliance
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 Child 1 and Child 6 are missing doses 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
2/20/2019
19 CSR 30-62.202 Nutrition and Food Service
Violation
 Provider Comments
Violation
The provider did not meet requirements for a written diet plan for each infant and toddler as evidenced by the written diet plan was not updated for a child in that Child 1 nd Child 5 need to have diet plans updated to reflect parent authorization for table food.
Licensing Rule Reference
19 CSR 30-62.202 Nutrition and Food Service (2) (B) states: The written diet plan for each infant/toddler shall be followed. The parent(s) shall update the plan according to the individual needs of the child until they grant permission in writing for the child to eat table foods.
Correction Required
A written diet plan shall be on file for each infant/toddler, updated as needed and followed by caregivers.

Correction Verification
Submit Documentation

Compliance Date
1/9/2019
Violation
Infant formulas and special baby foods provided by parents were not labeled.
Licensing Rule Reference
19 CSR 30-62.202 Nutrition and Food Service (2) (C) states: If preferred, formulas and special baby foods may be provided by the parent(s) with individual identification on each container.
Correction Required
Formula and food, provided by parents, shall be appropriately identified.

Correction Verification
Submit Documentation

Compliance Date
1/9/2019
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Violation
 Provider Comments
Violation
1 (Child 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
Submit Documentation

Compliance Date
1/9/2019
Violation
1 (Child 2) child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-62.222 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
1/9/2019
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
1/16/2019
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.
Compliance