DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

BLUE GOOSE CHILD CARE, LLC

002320349

(314) 704-0683

598 VIRGINIA AVE
WEBSTER GROVES
MO  63119-4211

BLUE GOOSE CHILD CARE, LLC



 

GOBER, KAREN A

karengober@sbcglobal.net


SAMPLE, ERIKA M

6 WEEKS - 12 YEARS

8

FAMILY HOME

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

07/24/2019

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2360496185


DocumentDocument-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
FIRE/SAFETY INSPECTION 08/16/2018
SANITATION INSPECTION 08/08/2018
EQUIPMENT LIST 09/13/2018
APPLICATION 08/31/2018




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
Stairways in the facility did not meet requirements as evidenced by there was no safety gate.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 1 (H) states: Approved safety gates at stairways and doors shall be provided and used as needed.
Correction Required
Stairways shall meet safety standards as required.

Correction Verification
Submit Documentation

Compliance Date
5/29/2019
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by broken siding tiles with sharp edges are observed on the bottom of the garage side; children walk past this space to access the play area.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
5/29/2019
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by the gate surrounding the steps that lead to the cellar stairwells/stairs was not secure. There were multiple bags of trash sitting on the steps. On 03.01.19 the trash has been removed but the gates have not been corrected.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
5/29/2019
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by there is a rope used to tie up the dogs hanging from the back porch railing accessible to children.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
5/29/2019
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by splintering rail road ties were observed near the shed with an exposed nail.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
5/29/2019
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by there are 3 sump pump poles exposed in the outside play area, causing a tripping hazard.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
5/29/2019
Violation
The ceilings located in the kitchen was/were not in good condition as evidenced by there are areas of unfinished /damaged ceilings.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 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
5/29/2019
Violation
The floors located in the kitchen was/were not in good condition as evidenced by there are areas of loose, broken and missing tile.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 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
5/29/2019
Violation
The walls located in the kitchen was/were not in good condition as evidenced by they are unfinished in the area near the cabinets on the wall shared with the bathroom.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 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
5/29/2019
Violation
The bathroom was not clean and odor free as evidenced by there is a pile of wet towels on the floor by the toilet. Karen Gober states the toilet began leaking lastr night. The toilet is still working but is leaking.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 2 (C) 1 E states: Bathrooms shall be clean and odor free.
Correction Required
Bathrooms shall be clean and odor free.

Correction Verification
Submit Documentation

Compliance Date
5/29/2019
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
Violation
 Provider Comments
Violation
Requirements for an approved assistant were not met as evidenced by the assistant present was not approved.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel 3 (A) states: An approved assistant shall be available. If there is a change of assistants, the provider shall notify the Child Care Licensing Unit immediately.
Correction Required
An approved assistant shall be available as required.

Correction Verification
Submit Documentation

Compliance Date
5/31/2019
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
 Provider Comments
Violation
1 child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
19 CSR 30-61.210 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
5/29/2019
19 CSR 30-63.040 Background Screening Findings
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 requests/results of a criminal background check. A child care staff member(s), Karen Gober, Brian Gober, Heather Gober (all need FCSR) and Arlene Segur (needs FCSR and fingerprints), was/were employed/present prior to the provider requesting the results of a criminal background check.
Licensing Rule Reference
RSMo 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules. 2. (1) states: Prior to the employment or presence of a child care staff member in a family child care home, group child care home, child care center, or license-exempt child care facility, the child care provider shall request the results of a criminal background check for such child care staff member from the department of health and senior services.
Correction Required
Required requests/results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
7/1/2019
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance