DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

FOUR LEAF CLOVER PRESCHOOL

002168729

(573) 632-6400

3525 COUNTRY CLUB DR
JEFFERSON CITY
MO  65109

DANDELION PRESCHOOL LLC



 

WILLIAMS, MARCELLA JO

fourleafmarcella@gmail.com


ALISON MICHELE EVANS

6 WEEKS - 12 YEARS

120

GROUP HOME AND CENTER

8 CHILDREN UNDER 12 MONTHS; 16 CHILDREN UNDER 24 MONTHS
 
Inspection Information

08/09/2020

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2384017806


DocumentDocument-Date
LINES OF ADMINISTRATIVE AUTHORITY 09/06/2012
JOB RESPONSIBILITIES 09/20/2012
DIRECTOR'S QUALIFICATIONS 09/20/2012
SAMPLE FORMS 09/06/2012
CHILD CARE PRACTICES 09/06/2012
SAMPLE WEEKLY MENU 09/06/2012
DAILY SCHEDULE 09/06/2012
POLICIES 09/06/2012
DIAGRAM/OUTDOOR 09/06/2012
DIAGRAM/INDOOR 09/06/2012
STAFF SHEET 06/21/2018
EQUIPMENT LIST 06/21/2018
APPLICATION 06/21/2018
SANITATION INSPECTION 07/17/2019
FIRE/SAFETY INSPECTION 06/18/2019




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
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
Violation
 Provider Comments
Violation
Requirements for safe sleep training were not met in that the following staff did not complete department-approved safe sleep training within the past three years: Terri Radar.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (4) . states: Safe Sleep Training. Every three (3) years the center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios in a group child care home or child care center 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: expansion of recommendations for a safe infant sleeping environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 128, No. 5, November 1, 2011, and available from the University of Vermont College of Medicine, Given Building S261, 89 Beaumont Avenue, Burlington, Vermont 05405-0068, telephone number 802-656-2505, fax number 802-656-4844, or at www.pediatrics.aapublications.org/content/128/5/1030.full. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Center director, group child care home provider, and other caregivers, and those volunteers counted in staff/child ratios shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date
3/10/2020
Violation
The provider did not meet requirements for a criminal background check. The provider did not request the results of a criminal background check prior to employment or presence in the facility for the following staff: Olive Trusty.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (L) states: The provider shall request the results of a criminal background check for child care staff members as required by 19 CSR 30-63.020 General Requirements.
Correction Required
Required requests of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
8/7/2020
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 Terri Radar 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
7/24/2020
Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Terri Radar.
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
7/24/2020
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
7/17/2020
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 210.115. 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