DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

GOLDEN VALLEY DAY CARE CENTER

000186025

(660) 885-8016

408 W ROGERS
CLINTON
MO  64735

GOLDEN VALLEY DAY CARE CENTER



 

MYERS, TIFFANY LEIGH

GOLDENVALLEYDAYCARE@YAHOO.COM

Incorporated

LAUREN R RAYWARNKE

BIRTH - 12 YEARS

99

GROUP HOME AND CENTER

16 CHILDREN IN THE INFANT/TODDLER UNIT; 8 CHILDREN UNDER 12 MONTHS
 
Inspection Information

06/11/2020

1:30 PM

2:32 PM

ANNOUNCED

SUPPLEMENTAL

2381213996


DocumentDocument-Date
LINES OF ADMINISTRATIVE AUTHORITY 09/20/2003
JOB RESPONSIBILITIES 09/20/1993
DIRECTOR'S QUALIFICATIONS 09/01/2006
CHILD CARE PRACTICES 04/30/1982
SAMPLE WEEKLY MENU 09/20/1993
DAILY SCHEDULE 09/06/1994
POLICIES 09/06/1994
DIAGRAM/OUTDOOR 09/20/1993
DIAGRAM/INDOOR 12/01/1993
CERTIFICATE OF GOOD STANDING 07/27/2009
ARTICLES OF INCORPORATION 10/11/1972
LOCAL ZONING APPROVAL 09/20/1993
LOCAL BUILDING APPROVAL 09/20/1993
APPLICATION 11/07/2019
STAFF SHEET 11/07/2019
EQUIPMENT LIST 11/07/2019
SANITATION INSPECTION 10/21/2019
FIRE/SAFETY INSPECTION 12/05/2019




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 3
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 9
Total Children 47
StaffChildClass AgeNote
2 6 INFANTS AND TODDLERS Christy Ballew and Kelsey Ballew with 7 children, one 12 month old, one 10 month old, one 9 month old, one 6 month old, one 5 months old, and one 2 months old.
2 8 MIXED Rhonda Reese and Madison Ballew with 8 children, seven children age 1 and one child age 2.
1 7 MIXED Joyce Baumgarden with 7 children, two children age 2 and five children age 2.
2 13 PRESCHOOL Kloe Cummings and Taylor Storey with 13 children, eight 3 year olds, four 4 year olds and 1 child age 5.
2 13 SCHOOL AGE Kiara Parks and Kammi Yates with 13 children ages 5 through 12.

 
19 CSR 30-62.032 Organization and Administration
Not Observed
19 CSR 30-62.042 Initial Licensing Information
Not Observed
19 CSR 30-62.052 License Renewal
Not Observed
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Not Observed
19 CSR 30-62.087 Fire Safety
Not Observed
19 CSR 30-62.090 Disaster and Emergency Preparedness
Not Observed
19 CSR 30-62.092 Furniture, Equipment and Materials
Not Observed
19 CSR 30-62.102 Personnel
Not Observed
19 CSR 30-62.112 Staff/Child Ratios
Not Observed
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Taylor Story.
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
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.
Correction Required
An individualized plan from a professional source shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.142 Nighttime Care
Not Observed
19 CSR 30-62.152 Hourly Care Facilities
Not Observed
19 CSR 30-62.162 Overlap Care of Children
Not Observed
19 CSR 30-62.172 Emergency School Closings
Not Observed
19 CSR 30-62.182 Child Care Program
Not Observed
19 CSR 30-62.192 Health Care
Not Observed
19 CSR 30-62.202 Nutrition and Food Service
Not Observed
19 CSR 30-62.212 Transportation and Field Trips
Not Observed
19 CSR 30-62.222 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 30-62.222 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
Not Observed
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. —
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed