DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

BLUE GOOSE CHILD CARE, LLC

002320349

(314) 704-0683

598 VIRGINIA AVE
WEBSTER GROVES
MO  63119-4211

BLUE GOOSE CHILD CARE, LLC



 

GOBER, KAREN A

karengober@sbcglobal.net


MICHELLE (SHELLEY) TRUESDALE

6 WEEKS - 12 YEARS

8

FAMILY HOME

IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE 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; UP TO 8 CHILDREN IN CARE, ALL CHILDREN MAY BE UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 8 CHILDREN NO MORE THAN 2 CHILDREN UNDER 2 WITH 1 ADULT
 
Inspection Information

03/02/2021

1:00 PM

1:24 PM

UNANNOUNCED

REINSPECTION

2394361087


DocumentDocument-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 10/01/2020
ANNUAL DECLARATION 10/01/2020
LLC ARTICLES OF ORGANIZATION 11/07/2011
OWNER/PROVIDER REFERENCES 04/24/2012
ASSISTANT REFERENCES 02/01/2013
SAMPLE FORMS 10/21/2011
SAMPLE WEEKLY MENU 10/21/2011
POLICIES 10/21/2011
DAILY SCHEDULE 10/21/2011
CHILD CARE/DISCIPLINE POLICIES 10/21/2011
DIAGRAM/OUTDOOR 10/21/2011
ASSISTANT APPROVAL REQUEST 10/21/2011
DIAGRAM/INDOOR 10/21/2011
FIRE/SAFETY INSPECTION 07/28/2020
SANITATION INSPECTION 08/11/2020
EQUIPMENT LIST 09/13/2018
APPLICATION 08/31/2018
SAFE SLEEP POLICY 10/01/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/25/2018
LLC OPERATING AGREEMENT 10/25/2018
CERTIFICATE OF GOOD STANDING 10/25/2018
ARTICLES OF INCORPORATION 02/19/2010
CERTIFICATE OF INCORPORATION 02/19/2010




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
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 8
StaffChildClass AgeNote
2 8 MIXED Karen and Heather Gober present with 4 under two, 2 two year-olds, and 2 four year-olds

 
19 CSR 30-61.025 Organization and Administration
Not Observed
19 CSR 30-61.045 Licensing Process
Not Observed
19 CSR 30-61.055 Annual Requirements
Not Observed
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Not Observed
19 CSR 30-61.086 Fire Safety
Not Observed
19 CSR 30-61.090 Disaster and Emergency Preparedness
Not Observed
19 CSR 30-61.095 Furniture, Equipment and Materials
Not Observed
19 CSR 30-61.105 The Child Care Provider and Other Child Care Personnel
Not Observed
19 CSR 30-61.115 Day Care Family and Household
Not Observed
19 CSR 30-61.125 Medical Examination Reports
Not Observed
19 CSR 30-61.135 Admission Policies and Procedures
Not Observed
19 CSR 30-61.145 Nighttime Care
Not Observed
19 CSR 30-61.155 Overlap Care of Children
Not Observed
19 CSR 30-61.165 Emergency School Closings
Not Observed
19 CSR 30-61.175 Child Care Program
Not Observed
19 CSR 30-61.185 Health Care
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for one child(ren).
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
12/12/2020
19 CSR 30-61.190 Nutrition and Food Service
Not Observed
19 CSR 30-61.200 Transportation and Field Trips
Not Observed
19 CSR 30-61.210 Records and Reports
Not Observed
19 CSR 30-63.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Arlene Segur.
Licensing Rule Reference
19 CSR 30-63.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a family child care home, group child care home, child care center, or license-exempt facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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.
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance