DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

GOODALL, TIFFANY

002793366

(417) 546-8581

174 PLYMOUTH RD
FORSYTH
MO  65653-5165

GOODALL, TIFFANY RAE

275 BARBS LN
FORSYTH
MO  65653-5327


trgoodall2015@gmail.com


BILLIE RUSSELL

BIRTH - 10 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 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER
 
Inspection Information

11/14/2019

11:00 AM

1:44 PM

ANNOUNCED

RENEWAL

2369836376


DocumentDocument-Date
SAMPLE WEEKLY MENU 11/14/2019
POLICIES 11/14/2019
EQUIPMENT LIST 11/14/2019
DIAGRAM/OUTDOOR 11/14/2019
DIAGRAM/INDOOR 11/14/2019
DAILY SCHEDULE 11/14/2019
CHILD CARE/DISCIPLINE POLICIES 11/14/2019
APPLICATION 09/12/2019
SAFE SLEEP POLICY 11/14/2019
SANITATION INSPECTION 11/08/2019
FIRE/SAFETY INSPECTION 09/30/2019




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 5
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 1
Total Children 7
StaffChildClass AgeNote
1 7 MIXED One child was under 24 months old.

 
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
Violation
 Provider Comments
Violation
The provider did not meet requirements for a criminal background check. Results were missing for: Kim Ever.
Licensing Rule Reference
19 CSR 30-61.055 License Renewal (3) 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 30-61.085 Physical Requirements of the Family Day Care Home
Compliance
19 CSR 30-61.086 Fire Safety
Compliance
19 CSR 30-61.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
The facility has not developed, implemented or maintained policies and procedures for responding to a disaster emergency.
Licensing Rule Reference
19 CSR 30-61.090 Disaster and Emergency Preparedness 1 (A) states: The facility shall develop, implement, and maintain policies and procedures for responding to a disaster emergency, including a written plan for:
Correction Required
Facility must have plan on file as required.

Correction Verification
Submit Documentation

Compliance Date

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 provider did not notify the department immediately of change of assistant.
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 department immediately.
Correction Required
An approved assistant shall be available as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Requirements for safe sleep training were not met as evidence by the assistant(s), Kim Evers, did not complete safe sleep training within the past three years.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel (5) . states: Safe Sleep Training. Every three (3) years the provider and assistant(s) in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 138, No. 5, November 1, 2016 and available at ttp://pediatrics.aappublications.org/content/pediatrics/early/2016/10/20/peds.2016- 2938.full.pdf. This rule does not incorporate any subsequent amendments or additions.
Correction Required
The child care provider and assistant(s) shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Requirements for safe sleep training were not met as evidence by the child care provider, Tiffany Goodall, did not complete safe sleep training within the past three years.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel (5) . states: Safe Sleep Training. Every three (3) years the provider and assistant(s) in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 138, No. 5, November 1, 2016 and available at ttp://pediatrics.aappublications.org/content/pediatrics/early/2016/10/20/peds.2016- 2938.full.pdf. This rule does not incorporate any subsequent amendments or additions.
Correction Required
The child care provider and assistant(s) shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date

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