DHSS MO
MISSOURI DEPARTMENT OF HEALTH & SENIOR SERVICES

SECTION FOR CHILD CARE REGULATION

SCHOOL AGE INSPECTION REPORT
Facility Information

THE BOYS AND GIRLS CLUB OF POPLAR BLUFF

002373515

(573) 776-1690

1200 CAMP RD
POPLAR BLUFF
MO  63901

THE BOYS & GIRLS CLUB OF POPLAR BLUFF

PO BOX 55
POPLAR BLUFF
MO  63902-0055

TIPTON, JEANNA DAWN

ROLLAND, JEFFREY

lesley@bgcpb.org



JESSICA GRAHAM

5 YEARS - 7 YEARS

100

SCHOOL AGE

 
Inspection Information

04/09/2019

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2354291992


DocumentDocument-Date
DAILY SCHEDULE 12/04/2012
POLICIES 12/04/2012
LINES OF ADMINISTRATIVE AUTHORITY 12/04/2012
DIRECTOR'S JOB RESPONSIBILITIES 12/04/2012
JOB RESPONSIBILITIES 12/04/2012
CHILD CARE PRACTICES 12/04/2012
SAMPLE FORMS 12/04/2012
DIRECTOR'S QUALIFICATIONS 04/18/2013
ARTICLES OF INCORPORATION 03/18/2015
CERTIFICATE OF INCORPORATION 03/18/2015
DISCIPLINE POLICIES 12/04/2012
SAMPLE WEEKLY MENU 11/20/2015
APPLICATION 02/22/2019
EQUIPMENT LIST 03/06/2019
STAFF SHEET 03/06/2019




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 30-62.032 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 outlets were not covered.
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
3/19/2019
Violation
Hazardous items as follows were accessible to children: clorox wipes and germ x. The item(s) was/were located on the floor, in cabinets, and on desks.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) 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
Submit Documentation

Compliance Date
3/19/2019
19 CSR 30-62.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
The facility's disaster and emergency plan was not available in each room used for childcare as evidenced by the disaster plan was not placed in each room used for child care.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster and emergency plan is readily available in the office area and in each room used for care of children;
Correction Required
The facilities disaster and emergency plan must be available in required locations.

Correction Verification
Submit Documentation

Compliance Date
3/19/2019
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Compliance
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 Amy Baugus as evidenced by a medical examination was not on file at the facility at the time of initial licensure.
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
3/19/2019
Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Amy Baugus.
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
3/19/2019
19 CSR 30-62.132 Admission Policies and Procedures
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
Compliance
19 CSR 30-62.202 Nutrition and Food Service
Compliance
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 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.
Violation
 Provider Comments
Violation
The provider did not meet requirements for requesting a criminal background check. The provider did not request the results of a criminal background check for Jeff Rolland and Amy Baugus prior to January 31, 2019.
Licensing Rule Reference
RSMo 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules. 2. (3) states: A family child care home, group child care home, child care center, or license-exempt child care facility that has child care staff members at the time this section becomes effective* shall request the results of a criminal background check for all child care staff members by January 31, 2019, unless the requirements of subsection 5 of this section are met by the child care provider and proof is submitted to the department of health and senior services by January 31, 2019.
Correction Required
Required requests of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
4/9/2019