DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

INDEPENDENCE SCHOOL DISTRICT

000952536

(816) 521-5477

4300 PHELPS RD
INDEPENDENCE
MO  64055

INDEPENDENCE SCHOOL DISTRICT

201 N FOREST AVE
INDEPENDENCE
MO  64050-2513

GILLMAN, NICHOLE

NICHOLE_GILMAN@ISDSCHOOLS.ORG


ROMENA FOX

36 MONTHS - 5 YEARS

40

GROUP HOME AND CENTER

 
Inspection Information

10/04/2019

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2365940059


DocumentDocument-Date
DIAGRAM/OUTDOOR 03/24/1999
DIAGRAM/INDOOR 07/23/1997
DAILY SCHEDULE 12/17/1998
CHILD CARE PRACTICES 12/17/1998
DISCIPLINE POLICIES 12/17/1998
JOB RESPONSIBILITIES 12/17/1998
SAMPLE WEEKLY MENU 12/23/1997
LINES OF ADMINISTRATIVE AUTHORITY 08/06/1997
POLICIES 12/17/1998
SAMPLE FORMS 12/17/1998
DIRECTOR'S QUALIFICATIONS 10/15/2013
SANITATION INSPECTION 01/15/2019
APPLICATION 02/01/2019
EQUIPMENT LIST 02/19/2019
STAFF SHEET 02/19/2019
FIRE/SAFETY INSPECTION 01/17/2019




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 walls located in classroom one (1) was/were not in good condition as evidenced by chipping paint on February 19, 2019 (corrected 3/27/19). On September 9, 2019, the walls located in classroom one (1) were not in good condition as evidenced by chipping paint.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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
10/4/2019
19 CSR 30-62.087 Fire Safety
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials
Violation
 Provider Comments
Violation
Sleeping equipment was not arranged to provide required spacing as evidenced by there was no aisle on the long side of the napping equipment.
Licensing Rule Reference
19 CSR 30-62.092 Furniture, Equipment and Materials (1) (B) 1. D. states: Sleeping equipment shall be arranged to provide at least a two foot (2') aisle on one (1) long side of the equipment.
Correction Required
Caregivers shall provide a two foot (2') aisle on one long side of the napping equipment.

Correction Verification
Submit Documentation

Compliance Date
10/4/2019
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 did not include a completed Risk Assessment for Tuberculosis form for Janelle Harris on February 19, 2019 (corrected March 27, 2019). On September 9, 2019, medical examination report did not include a completed Risk Assessment for Tuberculosis form for Keisha Reece.
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
10/4/2019
19 CSR 30-62.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider's policies.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (8) (E) 8. A. states: They have received a copy of the provider's policies pertaining to the admission, care and discharge of children;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
10/4/2019
19 CSR 30-62.142 Nighttime Care
Compliance
19 CSR 30-62.152 Hourly Care Facilities
Compliance
19 CSR 30-62.162 Overlap Care of Children
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
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 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance