DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

EXCLUSIVE KIDZ ZONE

002835918

(314) 641-9882

3740 MARINE AVE
ST LOUIS
MO  63118-4175

EXCLUSIVE KIDZ ZONE

2813 LAFAYETTE AVE
ST LOUIS
MO  63104-2015

BLOUNT, TAMIKO

teneshabady@gmail.com

Incorporated

MICHELLE A WILLIAMS

4 YEARS - 12 YEARS

50

GROUP HOME AND CENTER

 
Inspection Information

01/20/2021

3:00 PM

3:58 PM

UNANNOUNCED

POST LICENSING

2391739730


DocumentDocument-Date
APPLICATION 11/06/2020
ARTICLES OF INCORPORATION 10/14/2019
CHILD CARE PRACTICES 10/21/2020
DIAGRAM/INDOOR 07/31/2020
DIAGRAM/OUTDOOR 10/21/2020
DISCIPLINE POLICIES 10/21/2020
EQUIPMENT LIST 06/29/2020
LINES OF ADMINISTRATIVE AUTHORITY 10/15/2020
JOB RESPONSIBILITIES 10/15/2020
STAFF SHEET 10/22/2020
SAMPLE WEEKLY MENU 10/21/2020
SAMPLE FORMS 07/22/2020
POLICIES 10/21/2020
LOCAL ZONING APPROVAL 10/05/2020
LOCAL BUILDING APPROVAL 10/05/2020
SANITATION INSPECTION 11/13/2020
FIRE/SAFETY INSPECTION 11/02/2020
LOCAL FIRE DEPARTMENT NOTIFICATION 11/06/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/22/2020
DIRECTOR'S QUALIFICATIONS 10/28/2020
DAILY SCHEDULE 11/10/2020
CERTIFICATE OF GOOD STANDING 07/24/2020
CERTIFICATE OF GOOD STANDING 11/04/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/22/2020
DIRECTOR'S QUALIFICATIONS 10/28/2020
FIRE/SAFETY INSPECTION 11/02/2020
LOCAL FIRE DEPARTMENT NOTIFICATION 11/06/2020




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 7
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 2
Total Children 7
StaffChildClass AgeNote
2 7 SCHOOL AGE Lorna Johnson, Isabella Principe (School agers)

 
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
Violation
 Provider Comments
Violation
A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Lorna Johnson.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (J) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering and before being left alone with children that caregivers receive a facility orientation. The child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not meet requirements for a criminal background check. Results were not on file for the following staff member(s): Lorna Johnson and Isabella Principe .
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (M) states: Child care staff members shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
Prospective child care staff member(s), Lorna Johnson and Isabella Principe , was/were not supervised at all times by another child care staff member who received a qualifying result on the criminal background check within the past five years.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (O) states: A prospective child care staff member may begin work for a child care provider after the criminal background check has been requested from the department; however, pending completion of the criminal background check, the prospective child care staff member shall be supervised at all times by another child care staff member who received a qualifying result on the criminal background check within the past five (5) years.
Correction Required
All prospective child care staff member(s) who have requested a criminal background check shall be supervised at all times by another child care staff member who has received a qualifying result on the criminal background check within the past five years.

Correction Verification
Submit Documentation

Compliance Date

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 Isabella Principe 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

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 Ukn.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a 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

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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 4 immunization record(s) was/were not on file.
Licensing Rule Reference
19 CSR 30-62.192 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 immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the 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 on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Records were not available for inspection by the department upon request as evidenced by Lorna Johnson and Isabella Principe records were not on site.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (11) states: All records shall be available in the facility for inspection by the department upon request.
Correction Required
Records shall be available at the facility for inspection.

Correction Verification
Corrected on Site

Compliance Date
1/20/2021
Violation
Records were not available for inspection by the department upon request as evidenced by Terrell Thomas and Jayce McCurry records were not on site.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (11) states: All records shall be available in the facility for inspection by the department upon request.
Correction Required
Records shall be available at the facility for inspection.

Correction Verification
Submit Documentation

Compliance Date

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