DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

JACKSON, JACQUELINE MARIE

001425934

(314) 531-4959

3814 PENROSE ST
ST LOUIS
MO  63107-1636

JACKSON, JACQUELINE MARIE



 

JACKSON, JACQUELINE MARIE

JTRJJ@AOL.COM


SHALINDA WALLACE

6 WEEKS - 13 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

04/13/2021

8:23 AM

10:20 AM

UNANNOUNCED

COMPLIANCE MONITORING

2397373309


DocumentDocument-Date
FIRE/SAFETY INSPECTION 01/28/2021
SANITATION INSPECTION 02/04/2021
EQUIPMENT LIST 01/26/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/26/2021
ANNUAL DECLARATION 02/09/2021
ASSISTANT REFERENCES 01/05/2011
ASSISTANT APPROVAL REQUEST 01/05/2011
SAMPLE WEEKLY MENU 10/31/2002
SAMPLE FORMS 10/31/2002
POLICIES 10/31/2002
DIAGRAM/OUTDOOR 10/31/2002
DIAGRAM/INDOOR 10/31/2002
CHILD CARE/DISCIPLINE POLICIES 10/31/2002
DAILY SCHEDULE 10/31/2002
LLC OPERATING AGREEMENT 12/28/2015
DISASTER AND EMERGENCY PREPAREDNESS PLAN 03/27/2018
SAFE SLEEP POLICY 09/26/2018
APPLICATION 02/05/2019

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:30PM   4:30PM   2/6/2015
  7:30AM   8:30AM   2/6/2015



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 2
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 1
StaffChildClass AgeNote
2 1 TWO YEAR OLDS Ms. Jacqueline Jackson and Ms. Teina Evans is present with one 2 year old child.

 
19 CSR 30-61.025 Organization and Administration
Compliance
19 CSR 30-61.045 Licensing Process
Compliance
19 CSR 30-61.055 Annual Requirements
Compliance
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Compliance
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
Compliance
19 CSR 30-61.105 The Child Care Provider and Other Child Care Personnel
Compliance
19 CSR 30-61.115 Day Care Family and Household
Compliance
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 unknown.
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
Compliance
19 CSR 30-61.145 Nighttime Care
Not Observed
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
Violation
 Provider Comments
Violation
Records were not available for inspection by the department upon request as evidenced by child care enrollment form for one child.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (11) states: All records shall be available in the home for inspection by the department upon request.
Correction Required
All required records shall be kept on file at the facility and accessible at all time.

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
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance