DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

HERNANDEZ, INES TRINIDAD

001928310

(573) 442-4416

3100 FOX TROT DR
COLUMBIA
MO  65202-1482

HERNANDEZ, INES TRINIDAD



 


ABIGSCRUB@YAHOO.COM


CYNTHIA D MADDOX

BIRTH - 12 YEARS

10

FAMILY HOME

UP TO 10 CHILDREN IN CARE NO MORE THAN 2 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER
 
Inspection Information

12/01/2020

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2390571618


DocumentDocument-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 11/09/2020
ANNUAL DECLARATION 11/09/2020
CHILD CARE/DISCIPLINE POLICIES 08/17/2005
POLICIES 08/17/2008
OWNER/PROVIDER REFERENCES 09/06/2005
SAMPLE FORMS 07/05/2001
SAMPLE WEEKLY MENU 08/17/2005
DAILY SCHEDULE 09/28/2008
DIAGRAM/OUTDOOR 08/17/2005
DIAGRAM/INDOOR 08/17/2005
ARTICLES OF INCORPORATION 08/17/2005
ASSISTANT APPROVAL REQUEST 09/30/2015
ASSISTANT REFERENCES 09/30/2015
APPLICATION 08/05/2019
EQUIPMENT LIST 11/30/2020
FIRE/SAFETY INSPECTION 09/14/2020
SANITATION INSPECTION 08/13/2020

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:50PM   4:50PM   8/4/2010
  7:00AM   8:00AM   3/8/2010



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 30-61.025 Organization and Administration
Compliance
19 CSR 30-61.045 Initial Licensing Information
Compliance
19 CSR 30-61.055 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Ines Hernandez, Charles Robinson, Christian Robinson and Justin Robinson within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
19 CSR 30-61.055 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Submit Documentation

Compliance Date
11/30/2020
Violation
The equipment list was not submitted.
Licensing Rule Reference
19 CSR 30-61.055 Annual Requirements (1) (B) states: A current list of available equipment.
Correction Required
The child care provider shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date
11/30/2020
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
Compliance
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 safe sleep training were not met as evidence by the assistant(s), Christian Robinson and Charles Robinson, 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
11/30/2020
Violation
Requirements for safe sleep training were not met as evidence by the child care provider, Ines Hernandez, 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
11/30/2020
19 CSR 30-61.115 Day Care Family and Household
Compliance
19 CSR 30-61.125 Medical Examination Reports
Violation
 Provider Comments
Violation
Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 9/21/20 and September 20, 2020.
Licensing Rule Reference
19 CSR 30-61.125 Medical Examination Reports (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of licensed physician and completed not more than twelve (12) months prior to admission.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
11/30/2020
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file .
Licensing Rule Reference
19 CSR 30-61.185 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 adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of 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 completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
11/30/2020
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 30-63.020 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
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance