DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

DAVID, MICHAELENE A

000745895

(573) 581-7410

1350 MARGRETTA
MEXICO
MO  65265

DAVID, MICHAELENE ANN



 

DAVID, MICHAELENE ANN

nanadavid7@gmail.com


CYNTHIA D MADDOX

BIRTH - 13 YEARS

10

FAMILY HOME

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
 
Inspection Information

03/26/2019

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2353162584


DocumentDocument-Date
ASSISTANT REFERENCES 02/22/2010
CHILD CARE/DISCIPLINE POLICIES 05/11/2000
DAILY SCHEDULE 05/11/2000
DIAGRAM/OUTDOOR 05/11/2000
DIAGRAM/INDOOR 05/11/2000
OWNER/PROVIDER REFERENCES 05/11/2000
POLICIES 05/11/2000
SAMPLE WEEKLY MENU 05/11/2000
SANITATION INSPECTION 02/04/2019
ASSISTANT APPROVAL REQUEST 02/26/2018
APPLICATION 02/26/2018
EQUIPMENT LIST 02/26/2018
FIRE/SAFETY INSPECTION 03/21/2019




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
Violation
 Provider Comments
Violation
The facility has not met the requirements for fire and safety as evidenced by an annual fire safety inspection has not been conducted as of the time of this compliance monitoring inspection.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 1 (B) states: The premises shall conform to the fire and safety requirements of the State Fire Marshal or his/her designee.
Correction Required
The facility shall comply with fire and safety requirements.

Correction Verification
Submit Documentation

Compliance Date
3/21/2019
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
Compliance
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 12-10-18 for 2 children.
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
3/26/2019
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by a statement, certificate or record from a physician or other recognized health facility or personnel was not on file for 2 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
3/26/2019
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 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules.
Compliance
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance