DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

BELBEN, ALLISON

002212126

(417) 315-1621

3934 W YOUNG ST
SPRINGFIELD
MO  65803-5404

BELBEN, ALLISON



 


mrsbelben@gmail.com


ANGEL DONSON

6 WEEKS - 5 YEARS

10

FAMILY HOME

2 CHILDREN UNDER 12 MONTHS; IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER; 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

01/11/2021

11:55 AM

12:51 PM

UNANNOUNCED

COMPLIANCE MONITORING

2391217944


DocumentDocument-Date
SANITATION INSPECTION 06/10/2020
ASSISTANT APPROVAL REQUEST 03/09/2020
FIRE/SAFETY INSPECTION 03/04/2020
ASSISTANT REFERENCES 06/27/2012
OWNER/PROVIDER REFERENCES 04/05/2012
SAMPLE FORMS 11/18/2011
SAMPLE WEEKLY MENU 11/18/2011
DAILY SCHEDULE 11/18/2011
CHILD CARE/DISCIPLINE POLICIES 11/18/2011
DIAGRAM/OUTDOOR 11/18/2011
DIAGRAM/INDOOR 11/18/2011
APPLICATION 04/25/2018
EQUIPMENT LIST 07/25/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 4
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 1
Total Children 5
StaffChildClass AgeNote
1 5 MIXED Two children are under the age of 2 and three children are preschool age.

 
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
Compliance
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
Hazardous items as follows were accessible to children: gasoline container, bug spray, cigarette butts and cigarette lighter. The item(s) was/were located play yard.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home (1) (J) 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
Submit Documentation

Compliance Date

Violation
Animal excrement was observed in an outdoor area used by children; the location of the excrement was play yard.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home (4) (D) states: Areas used by children shall be free of animal excrement.
Correction Required
No animal excrement shall be in areas used by children.

Correction Verification
Submit Documentation

Compliance Date

Violation
Hazardous items as follows were accessible to children: Axe body spray, Lysol spray and cleaning product. The item(s) was/were located bathroom.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home (1) (J) 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
1/11/2021
19 CSR 30-61.086 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by the disaster and tornado drill record was not available on the premises.
Licensing Rule Reference
19 CSR 30-61.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by the fire drill record was not available on the premises.
Licensing Rule Reference
19 CSR 30-61.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

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
Compliance
19 CSR 30-61.115 Day Care Family and Household
Compliance
19 CSR 30-61.125 Medical Examination Reports
Compliance
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
Medication was not stored out of children's reach.
Licensing Rule Reference
19 CSR 30-61.185 Health Care (3) (E) states: All medication shall be stored out of reach of children or in a locked container.
Correction Required
Medication shall be inaccessible to children and handled as required.

Correction Verification
Corrected on Site

Compliance Date
1/11/2021
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