DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

BOYS AND GIRLS CLUB OF JEFFERSON CITY

001834939

(573) 634-2582

1105 LAFAYETTE ST
JEFFERSON CITY
MO  65101

BOYS & GIRLS CLUB OF JEFFERSON CITY

PO BOX 105558
JEFFERSON CITY
MO  65110-5558

MCGOWAN, CONNIE ANN

sjohnson@bgcjc.com


SHELBY N KOETTING

5 YEARS - 16 YEARS

250

GROUP HOME AND CENTER

 
Inspection Information

02/26/2020

1:00 PM

5:13 PM

UNANNOUNCED

COMPLIANCE MONITORING

2376373340


DocumentDocument-Date
CERTIFICATE OF GOOD STANDING 07/11/2017
ARTICLES OF INCORPORATION 07/11/2017
JOB RESPONSIBILITIES 07/11/2017
LINES OF ADMINISTRATIVE AUTHORITY 07/11/2017
SAMPLE WEEKLY MENU 07/11/2017
DIAGRAM/INDOOR 07/12/2017
DIAGRAM/OUTDOOR 07/12/2017
REGISTERING FICTITIOUS NAMES 07/11/2017
DAILY SCHEDULE 07/12/2017
CHILD CARE PRACTICES 07/11/2017
DISCIPLINE POLICIES 07/11/2017
POLICIES 07/11/2017
LLC OPERATING AGREEMENT 05/17/2017
LLC ARTICLES OF ORGANIZATION 05/17/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 08/09/2017
DIRECTOR'S QUALIFICATIONS 08/25/2017
LOCAL ZONING APPROVAL 06/02/2017
LOCAL BUILDING APPROVAL 06/02/2017
APPLICATION 07/03/2019
EQUIPMENT LIST 07/03/2019
STAFF SHEET 07/03/2019
SANITATION INSPECTION 10/04/2019
FIRE/SAFETY INSPECTION 09/16/2019




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 21
Total Children 158
StaffChildClass AgeNote
5 0 NO CHILDREN IN ATTENDANCE Shelby Bopp, Cavos Phauls, Paris Lewis, Connie McGowan, and Stephanie Johnson in the office with 0 children.
3 0 NO CHILDREN IN ATTENDANCE Tai-Reece Basey and Wade Middaugh in the kitchen with 0 children.
2 26 SCHOOL AGE Shakya Walters and Timberly Woods with 26 school age children.
2 25 SCHOOL AGE Cameron Blair and Cheyenne Ross with 25 school age children.
2 22 SCHOOL AGE Christopher Sawyer and Castrele Hoy with 22 school age children.
2 26 SCHOOL AGE Donna Horton-Taylor and Rachelle Montgomery with 26 school age children.
3 25 SCHOOL AGE Cardasia Futrell, Kendall Coffelt, and Colin Richardson with 25 school age children.
2 34 SCHOOL AGE John Schaefferkoetter, Sabria Hendricks, and Justin Adams with 34 teen school age children.

 
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 facility's outdoor space was not safe for children's activities as evidenced by white jagged pieces of broken toys strewn through the John & Sharon Cowley Court.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. 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
Corrected on Site

Compliance Date
2/26/2020
Violation
The facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence had openings that were between 3.5 and 9 inches and allow entrapment - the openings measured 7 inches near the planters on the John & Sharon Crowley court.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.
Correction Required
The outdoor play area shall be accessible without hazard.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
Hazardous items as follows were accessible to children: employee purse. The item(s) was/were located on a table accessible to children in the Westhues Learning Center.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by an electrical plate was missing in that an electrical outlet on the mirrored wall in the Teen Center was missing and outlet wiring was exposed.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.
Correction Required
The facility shall use outlet covers or twist-lock outlets as required.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
Children were not restricted to approved space as evidenced by children are using an old office room converted to a tutoring space without measurements.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.
Correction Required
Caregivers shall restrict children to approved space.

Correction Verification
Submit Documentation

Compliance Date

Violation
Hazardous items as follows were accessible to children: hot glue gun. The item(s) was/were located in an unlocked cabinet accessible to children in the Hawthorn Bank Multipurpose Room.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
Hazardous items as follows were accessible to children: old food trash including chewed up spoons and Cheetos and chip bags. The item(s) was/were located in the Teen Center on the couch.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
Hazardous items as follows were accessible to children: Ziploc bags with "Keep Out of Reach of Children" label. The item(s) was/were located in an unlocked cabinet accessible to children in the Karen Gibbs Art & Music Room.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
Hazardous items as follows were accessible to children: cleaning supplies including Clorox wipes and hand sanitizer. The item(s) was/were located on a table accessible to children in the Westhues Learning Center.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
Hazardous items as follows were accessible to children: employee purse. The item(s) was/were located on a table accessible to children in the Hawthorn Bank Multipurpose Room.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
19 CSR 30-62.087 Fire Safety
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
The facility’s list of emergency numbers was not posted in each room.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;
Correction Required
Facility must post information as required.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
The facility's evacuation route diagram was not posted in each room.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (B) 2. states: A diagram of evacuation routes from the room;
Correction Required
Facility must post information as required.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
19 CSR 30-62.092 Furniture, Equipment and Materials
Violation
 Provider Comments
Violation
Furniture/equipment, black pleather gaming chair, in the Farmer Family Game Room A was not in good condition as evidenced by 12 inch piece of leather hanging from bottom of chair, unattached, with staples in it.
Licensing Rule Reference
19 CSR 30-62.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.
Correction Required
The facility shall provide safe and clean furniture/equipment as required.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. The staff listed need the following information: Rushonia Blanche (needs 12), Cory Bradley (needs 1.5), Sabria Hendricks (needs 10), David Hendrickson (needs 5), Cory Lee (needs 10), Rayvon Mallett (needs 12), Barbara Martin (needs 8.5), Connie McGowan (needs 7.5), Briana Oliver (needs 7.5), Cheyenne Ross (needs 3), Tyreesha Young (needs 5), Justin Adams (needs 3), Cameron Blair (needs 2), Jalesa Campbell (needs 3), Cardasia Futrell (needs 2), Castrele Hoy (needs 4), Paris Lewis (needs 7.5), Rachelle Montgomery (needs 3), Shianne Sheely (needs 2), Shakya Walters (needs 5), and Timberly Woods (needs 1) clock hour trainings for 2019 calendar year.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (A) states: The center director, group day care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each employee.

Correction Verification
Submit Documentation

Compliance Date

Violation
A caregiver exhibited behavior that did not show the individual to be of good character and intent and qualified to provide care to children as evidenced by an employee, Quincy Briggs, had an FCSR on file that stated that he had a guilty charge of endangering the welfare of a child in the second degree.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (A) states: Day care personnel shall be of good character and intent and shall be qualified to provide care conducive to the welfare of children.
Correction Required
Caregivers shall meet child care personnel requirements.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
Child care staff member(s), Quincy Briggs, has a disqualifying background screening result and is/was present on the premises of the facility during child care hours.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (N) states: Child care staff members with disqualifying background screening results as defined in 19 CSR 30-63.020 General Requirements, shall be prohibited from being present on the premises of the facility during child care hours.
Correction Required
Child care staff member(s) with disqualifying background screening results shall be prohibited from being present on the premises of the facility during child care hours.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Cameron Blair, Ashley Davis, Cardasia Futrell, Castrele Hoy, Kendall Coffelt, Kelly Marshall, Christopher Sawyer, Shianne Sheely, and Timberly Woods.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (J) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering and before being left alone with children that caregivers receive a facility orientation. The child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Shakya Walters, Paul Winn, Timberly Woods, Jalesa Campbell, Cardasia Futrell, Castrele Hoy, Paris Lewis, and Christopher Sawyer 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
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Paul Winn, Castrele Hoy, Paris Lewis, Rachelle Montgomery and Christopher Sawyer.
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

19 CSR 30-62.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information as evidenced by specialized care forms were not on file for 2 children within 30 days of enrollment.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (8) (E) 2. states: Information regarding a child's personal development, behavior patterns, habits and individual needs;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 2 immunization record(s) was/were not on file .
Licensing Rule Reference
19 CSR 30-62.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
Violation
Requirements for immunization reports on file were not met as evidenced by 2 immunization record(s) was/were not on file .
Licensing Rule Reference
19 CSR 30-62.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Corrected on Site

Compliance Date
2/26/2020
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
3 child(ren) records did not include name 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
Corrected on Site

Compliance Date
2/26/2020
Violation
1 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
1 child(ren) records did not include name 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
4 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

Violation
3 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
2 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
Corrected on Site

Compliance Date
2/26/2020
Violation
6 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
Corrected on Site

Compliance Date
2/26/2020
Violation
2 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

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 210.115. Reports of abuse, neglect, and under age eighteen deaths — persons required to report — supervisors and administrators not to impede reporting — deaths required to be reported to the division or child fatality review panel, when — report made to another state, when. —
Compliance
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance