DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

CANCIENNE, SHANNON MARIA

002020959

(636) 464-2691

5512 LEHIGH LN
IMPERIAL
MO  63052-1718

CANCIENNE, SHANNON MARIA



 

CANCIENNE, SHANNON MARIA

shancan7@gmail.com


MICHELLE WILLIAMS

6 WEEKS - 12 YEARS

10

FAMILY HOME

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

08/22/2019

12:45 PM

1:36 PM

UNANNOUNCED

COMPLIANCE MONITORING

2362626542


DocumentDocument-Date
SAMPLE WEEKLY MENU 03/04/2009
SAMPLE FORMS 03/04/2009
POLICIES 03/04/2009
OWNER/PROVIDER REFERENCES 03/04/2009
LOCAL FIRE DEPARTMENT NOTIFICATION 03/04/2009
DIAGRAM/OUTDOOR 03/04/2009
DIAGRAM/INDOOR 03/04/2009
DAILY SCHEDULE 03/04/2009
CHILD CARE/DISCIPLINE POLICIES 03/04/2009
ASSISTANT REFERENCES 03/24/2015
ASSISTANT APPROVAL REQUEST 03/24/2015
APPLICATION 01/31/2019
EQUIPMENT LIST 02/01/2019
FIRE/SAFETY INSPECTION 12/13/2018
SANITATION INSPECTION 11/30/2018
SAFE SLEEP POLICY 02/01/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 02/01/2019

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:45PM   5:45PM   12/14/2010



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 8
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.
Attendance at Time of Inspection
Total Staff 3
Total Children 9
StaffChildClass AgeNote
3 9 MIXED Shannon Cancienne, Morgan Cancienne, and Elizabeth Stevens with 9 Children. 1 Related child not counted. (1) 1 year old, (7) 2 year olds, (1) 3 year old.

 
19 CSR 30-61.025 Organization and Administration
Compliance
19 CSR 30-61.045 Initial Licensing Information
Violation
 Provider Comments
Violation
Posting requirements were not met as evidenced by the posted license was outdated.
Licensing Rule Reference
19 CSR 30-61.045 Initial Licensing Information 3 (N) states: The official license shall be granted for up to two (2) years and may be renewed upon reapplication and reinvestigation. Until the official license is received, the temporary license shall be posted near the entrance of the home where it may be seen easily by parents or others who visit. Thereafter, the official license shall be posted near the entrance of the home.
Correction Required
The facility's license number shall be posted.

Correction Verification
Submit Documentation

Compliance Date

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

Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by trash, a broken drain, and a BBQ pit with tools and a propane tank observed in the backyard play space on a wooden deck. There is a dumpster in the backyard that was being used to dump trash and materials.
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

Violation
There was evidence of dirt/debris in bathroom of the basement, an air vent on the ceiling was hanging with observed dust and dirt.
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

19 CSR 30-61.086 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by the disaster and tornado drill was not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-61.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.
Licensing Rule Reference
19 CSR 30-61.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

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
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 employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-61.210 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

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

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.
Compliance
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance