DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

SHIPLEY, KELLY J

002069827

(660) 227-3402

619 W HARRISON ST
BUTLER
MO  64730-1303

SHIPLEY, KELLY J



 

SHIPLEY, KELLY J

KJSHIPLEY@HOTMAIL.COM


BILLIE RUSSELL

BIRTH - 13 YEARS

10

FAMILY HOME

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

02/25/2021

9:45 AM

11:02 AM

UNANNOUNCED

COMPLIANCE MONITORING

2394108904


DocumentDocument-Date
SAMPLE WEEKLY MENU 01/02/2008
POLICIES 01/27/2010
DIAGRAM/OUTDOOR 12/06/2007
DIAGRAM/INDOOR 12/06/2007
CHILD CARE/DISCIPLINE POLICIES 01/27/2010
DAILY SCHEDULE 12/06/2007
ASSISTANT APPROVAL REQUEST 12/14/2017
SAFE SLEEP POLICY 06/26/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/01/2018
APPLICATION 10/30/2019
FIRE/SAFETY INSPECTION 12/02/2019
EQUIPMENT LIST 10/30/2019
SANITATION INSPECTION 10/16/2019
ANNUAL DECLARATION 02/25/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  11:00AM   12:00PM   12/12/2019
  3:30PM   4:30PM   12/12/2019



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 1
Total Children 11
StaffChildClass AgeNote
1 11 MIXED Kelly Shipley was with eleven (11) children ages nine (9) months, 23 months and two (2) to five (5) years old.

 
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 Annual Declaration was not submitted.
Licensing Rule Reference
19 CSR 30-61.055 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, promulgated as of 2020 and incorporated by reference in this rule. As published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102-0570 and available by the department at https://health.mo.gov/safety/childcare/forms.php indicating the licensee’s intent to continue operating a licensed family child care home and agreement to comply with all statutes and department licensing rules.
Correction Required
The child care provider shall submit the Annual Declaration as required.

Correction Verification
Corrected on Site

Compliance Date
2/25/2021
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

Violation
The listing of household members and assistants was not submitted.
Licensing Rule Reference
19 CSR 30-61.055 Annual Requirements (1) (C) states: A listing of household members and assistant(s).
Correction Required
The child care provider shall submit a listing of all household members and assistants.

Correction Verification
Submit Documentation

Compliance Date

Violation
The Family Care Safety Registry check was not conducted for Kelly Shipley and Teola Shipley 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

19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by wooden lattice broken with sharp pieces of wood accessible to children .
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home (3) (A) 5. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Requirements for the crib mattress/playpen pad/bedding were not met as evidenced by a fitted sheet was not used.
Licensing Rule Reference
19 CSR 30-61.095 Furniture, Equipment and Materials 1 (B) 2 C states: The crib mattress or playpen pad shall be sized correctly to the crib or playpen, in good condition, waterproof and kept clean and dry, be firm and maintain its shape even when the fitted sheet designated for that model is used, such that there are no gaps between the mattress and the side of the crib or playpen. Only fitted sheets shall be used and shall be changed immediately when soiled or wet.
Correction Required
Sleeping equipment shall meet safety and sanitation requirements.

Correction Verification
Submit Documentation

Compliance Date

Violation
Outdoor equipment, playhouse, in the play yard was not in good condition as evidenced by broken plastic with sharp pieces accessible to children.
Licensing Rule Reference
19 CSR 30-61.095 Furniture, Equipment and Materials 3 (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.
Correction Required
Outdoor equipment shall have no exposed hazards.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel
Violation
 Provider Comments
Violation
Requirements for maintaining the facility's license capacity were not met as evidenced by there was one (1) provider, Kelly Shipley with eleven (11) children; two (2) were under 24 months.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel (2) (A) states: If there is one (1) adult provider, the home may be licensed for up to six (6) children including a maximum of three (3) children under age two (2), or for up to ten (10) children including a maximum of two (2) children under age two (2), or both. If only four (4) children are present, all the children may be under the age of two (2).
Correction Required
The facility's license capacity shall not be exceeded.

Correction Verification
Return Inspection

Compliance Date

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
Compliance
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