DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

GOOD SHEPHERD NURSING HOME DISTRICT

002609583

(573) 374-8263

610 HIGHWAY O
LAURIE
MO  65038

GOOD SHEPHERD NURSING HOME DISTRICT

PO BOX 1068
LAURIE
MO  65038-1068

HAMMONDS, SANDRA LYNN

smithlc1@yahoo.com


AMY BANNING

24 MONTHS - 12 YEARS

70

GROUP HOME AND CENTER

45 FULL DAY PRESCHOOL CHILDREN
 
Inspection Information

11/05/2019

9:20 AM

11:33 AM

ANNOUNCED

RENEWAL

2368616662


DocumentDocument-Date
DIAGRAM/OUTDOOR 07/14/2017
EQUIPMENT LIST 10/24/2019
STAFF SHEET 10/24/2019
JOB RESPONSIBILITIES 10/23/2017
LINES OF ADMINISTRATIVE AUTHORITY 10/23/2017
DIAGRAM/INDOOR 10/23/2017
CHILD CARE PRACTICES 10/18/2017
POLICIES 10/23/2017
DISCIPLINE POLICIES 10/23/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 12/12/2017
DIRECTOR'S QUALIFICATIONS 01/08/2011
APPLICATION 10/24/2019
FIRE/SAFETY INSPECTION 09/11/2019
SANITATION INSPECTION 09/20/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 11/09/2017
DAILY SCHEDULE 12/27/2017
SAMPLE WEEKLY MENU 10/23/2017
LOCAL BUILDING APPROVAL 01/11/2018
LOCAL ZONING APPROVAL 01/16/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 11
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 6
Total Children 16
StaffChildClass AgeNote
1 4 MIXED Cynthia with three children age two.
1 0 NO CHILDREN IN ATTENDANCE Ahdri, Kitchen
1 0 NO CHILDREN IN ATTENDANCE Sandy, Office
1 6 PRESCHOOL Riley
2 6 PRESCHOOL Dana & Megan

 
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
Violation
 Provider Comments
Violation
The facility did not meet requirements for a criminal background check. Results were not on file for chairperson: Amanda Huffman.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (3) states: The facility owner(s), board president or chairperson, and the center director or group day care home provider, shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not meet requirements for a criminal background check. Results were not on file for the following staff member(s): Lance Smith.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (4) states: Child care staff members shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
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
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 Valentena Shermeta as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
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

Violation
Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by the medical examination report was older than 12 months prior to admission - the admission date(s) and date(s) of medical was/were 9/2019.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.132 Admission Policies and Procedures
Compliance
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
Violation
 Provider Comments
Violation
One child(ren) records did not include employers' name of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 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
Two child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
One child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
One child(ren) records did not include telephone number of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Four child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 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
Four child(ren) records did not include work schedule of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 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
Four child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 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

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