DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

HINES, KRISTI

001482284

(573) 259-4832

1151 LILAC DR
SULLIVAN
MO  63080

HINES, KRISTI



 


MKHINES@FIDNET.COM


SHELBY N KOETTING

BIRTH - 12 YEARS

10

FAMILY HOME

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

03/30/2021

1:00 PM

1:09 PM

UNANNOUNCED

REINSPECTION

2396313126


DocumentDocument-Date
OWNER/PROVIDER REFERENCES 06/08/2000
ASSISTANT APPROVAL REQUEST 04/20/2012
SAMPLE FORMS 07/26/2000
SAMPLE WEEKLY MENU 07/26/2000
DAILY SCHEDULE 07/26/2000
POLICIES 08/07/2000
CHILD CARE/DISCIPLINE POLICIES 08/07/2000
DIAGRAM/OUTDOOR 07/26/2000
DIAGRAM/INDOOR 07/26/2000
APPLICATION 07/08/2020
EQUIPMENT LIST 07/03/2018
FIRE/SAFETY INSPECTION 06/03/2020
SANITATION INSPECTION 06/16/2020

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:00PM   4:30PM   4/20/2012
  6:30AM   7:00AM   4/20/2012



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 6
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 Kristi Hines and Robert Hines with 8 children (1 under age 2 years).

 
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
Violation
 Provider Comments
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

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

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
Violation
 Provider Comments
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2020, the staff listed need the following information: Kristi Hines needs 12 clock hour training credits.
Licensing Rule Reference
19 CSR 30-61.105 The Child Care Provider and Other Child Care Personnel (4) (A) states: The provider shall obtain at least twelve (12) clock hours of child care-related training during each calendar year. Any assistant who works or volunteers more than five (5) hours per week shall meet the same training requirements. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification.
Licensing Rule Reference
19 CSR 30-61.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-61.115 Day Care Family and Household
Not Observed
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 07/11/2020.
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

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
Violation
 Provider Comments
Violation
Emergency school closing overlap was used for a scheduled day of school closing as evidenced by a school age child was present during the inspection due to the school being closed for spring break, which is a scheduled school closing, and is not permitted.
Licensing Rule Reference
19 CSR 30-61.165 Emergency School Closings 3 states: Emergency school closing overlap shall not be permitted for scheduled days of school closing.
Correction Required
The provider shall not use overlap for scheduled days of school closing.

Correction Verification
Return Inspection

Compliance Date
3/30/2021
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

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
Not Observed
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