MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
MERCY HOSPITAL SPRINGFIELD

Facility DVN
000180709

Phone
(417) 820-7955

Physical Address
1831 S FREMONT AVE
SPRINGFIELD
MO 65804

Owner
MERCY HOSPITAL SPRINGFIELD

Mailing Address
1235 E CHEROKEE ST
SPRINGFIELD
MO 65804-2203

Provider/Director
GHAN, KARA GAY

E-mail Address
Kara.Ghan@mercy.net

Incorporated
Incorporated

Child Care Specialist
BILLIE RUSSELL

Age Range
6 WEEKS - 12 YEARS

Capacity
133

Facility Type
GROUP HOME AND CENTER

Limitations
16 CHILDREN IN THE INFANT/TODDLER UNIT

Inspection Information

Date
12/22/2020

Arrival Time
12:15 PM

Departure Time
1:23 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2390245456

Document	Document-Date
ANNUAL DECLARATION	11/10/2020
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	12/22/2020
SAMPLE WEEKLY MENU	10/24/1984
POLICIES	10/21/2009
LOCAL ZONING APPROVAL	10/05/2005
LOCAL BUILDING APPROVAL	10/05/2005
LINES OF ADMINISTRATIVE AUTHORITY	01/26/1982
JOB RESPONSIBILITIES	10/31/1997
DISCIPLINE POLICIES	10/21/2009
DIRECTOR'S QUALIFICATIONS	05/19/2006
DAILY SCHEDULE	10/24/1997
ARTICLES OF INCORPORATION	03/24/1982
CHILD CARE PRACTICES	10/21/2009
CERTIFICATE OF GOOD STANDING	08/29/2013
DIAGRAM/INDOOR	08/14/2014
DIAGRAM/OUTDOOR	08/15/2014
APPLICATION	09/26/2019
FIRE/SAFETY INSPECTION	07/29/2019
SANITATION INSPECTION	07/21/2020
STAFF SHEET	12/22/2020
EQUIPMENT LIST	12/22/2020
SAFE SLEEP POLICY	10/09/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	10/09/2019

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.

Attendance at Time of Inspection

Total Staff 12

Total Children 46

Staff	Child	Class Age	Note
2	5	INFANTS AND TODDLERS	Caregivers, Christine Quinn and Jessica Dawning, were with five (5) one (1) year old children.
1	3	INFANTS AND TODDLERS	Caregiver, Ebbony McCrimmons, was with three (3) children under twelve (12) months old.
1	7	MIXED	Caregiver, Misty Schirmer, was with seven (7) children, three (3) two (2) years old and four (4) three (3) years old.
3	0	NO CHILDREN IN ATTENDANCE	Additional staff present during inspection; Teresa Chiusolo, Leslie Harvey and Kara Ghan.
1	8	PRESCHOOL	Caregiver Leah Freeze, was with eight (8) five (5) year old children.
1	6	PRESCHOOL	Caregiver, Sheila Jones, was with six (6) four (4) year old children.
2	7	PRESCHOOL	Caregivers, Elizabeth Fortney and Whitney Temple, were with seven (7) children, two (2) three (3) years old and five (5) four (4) years old.
1	10	PRESCHOOL	Caregiver, Julie Hagen, was with ten (10) three year old children.


19 CSR 30-62.032 Organization and Administration Compliance
19 CSR 30-62.042 Initial Licensing Information Compliance
19 CSR 30-62.052 Annual Requirements 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 Compliance
19 CSR 30-62.112 Staff/Child Ratios Compliance
19 CSR 30-62.122 Medical Examination Reports Compliance
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 Not Observed
19 CSR 30-62.212 Transportation and Field Trips Compliance
19 CSR 30-62.222 Records and Reports Compliance
19 CSR 30-63.020 General Requirements 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