DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

BELBEN, ALLISON

002212126

(417) 315-1621

3934 W YOUNG ST
SPRINGFIELD
MO  65803-5404

BELBEN, ALLISON



 


mrsbelben@gmail.com


ANGEL DONSON

6 WEEKS - 5 YEARS

10

FAMILY HOME

2 CHILDREN UNDER 12 MONTHS; IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 2 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER
 
Inspection Information

04/08/2019

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2354467108


DocumentDocument-Date
ASSISTANT REFERENCES 06/27/2012
OWNER/PROVIDER REFERENCES 04/05/2012
ASSISTANT APPROVAL REQUEST 06/27/2012
SAMPLE FORMS 11/18/2011
SAMPLE WEEKLY MENU 11/18/2011
DAILY SCHEDULE 11/18/2011
CHILD CARE/DISCIPLINE POLICIES 11/18/2011
DIAGRAM/OUTDOOR 11/18/2011
DIAGRAM/INDOOR 11/18/2011
APPLICATION 04/25/2018
FIRE/SAFETY INSPECTION 02/22/2018
EQUIPMENT LIST 07/25/2018




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 30-61.025 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
Hazardous items as follows were accessible to children: plugged candle warmer with wax dripping . The item(s) was/were located in the bathroom.
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
Submit Documentation

Compliance Date
12/12/2018
Violation
Hazardous items as follows were accessible to children: unlocked small refrigerator has alcohol beverages. The item(s) was/were located outside in the play yard.
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
Submit Documentation

Compliance Date
12/12/2018
Violation
Hazardous items as follows were accessible to children: cigarettes butts, power tools plugged in (drill) and open rabbit food. The item(s) was/were located outside in the play yard.
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
Submit Documentation

Compliance Date
12/12/2018
Violation
There was evidence of dirt/debris in living room evidenced by dirty fish tanks.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 2 (A) 9 states: The home shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.
Correction Required
The facility shall be clean and pest free.

Correction Verification
Submit Documentation

Compliance Date
12/12/2018
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
Child's medical examination report did not contain evidence that child’s current health is satisfactory for participation in a day care program.
Licensing Rule Reference
19 CSR 30-61.125 Medical Examination Reports 2 (B) states: Examination reports shall determine if a child's medical history and current state of health is satisfactory for participation in a day care program.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
4/5/2019
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
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
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