DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

IMAGINATION STATION PRESCHOOL

002271447

(660) 829-2727

1109 E 13TH ST
SEDALIA
MO  65301

5 S HOLDINGS, LLC



 

MARTIN, ANGELA PEARL

is-preschool@att.net


SUSAN MARIE DOUGLAS

BIRTH - 6 YEARS

37

GROUP HOME AND CENTER

4 CHILDREN IN THE INFANT/TODDLER UNIT
 
Inspection Information

04/26/2021

2:35 PM

3:22 PM

UNANNOUNCED

REINSPECTION

2398506760


DocumentDocument-Date
JOB RESPONSIBILITIES 04/26/2011
SAMPLE FORMS 04/26/2011
SAMPLE WEEKLY MENU 04/26/2011
DIAGRAM/OUTDOOR 02/04/2011
DIAGRAM/INDOOR 02/04/2011
ARTICLES OF INCORPORATION 04/26/2011
LOCAL BUILDING APPROVAL 04/26/2011
DAILY SCHEDULE 03/09/2011
REGISTERING FICTITIOUS NAMES 01/25/2011
LLC ARTICLES OF ORGANIZATION 01/25/2011
LLC OPERATING AGREEMENT 03/08/2017
SAFE SLEEP POLICY 09/10/2018
FIRE/SAFETY INSPECTION 02/23/2021
LINES OF ADMINISTRATIVE AUTHORITY 03/01/2019
POLICIES 03/01/2019
DISCIPLINE POLICIES 03/01/2019
CHILD CARE PRACTICES 03/01/2019
SANITATION INSPECTION 03/10/2020
APPLICATION 03/01/2019
EQUIPMENT LIST 03/01/2019
STAFF SHEET 03/01/2019
CERTIFICATE OF GOOD STANDING 03/01/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 03/01/2019
DIRECTOR'S QUALIFICATIONS 03/21/2019
LOCAL ZONING APPROVAL 04/17/2019




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 3
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 4
Total Children 21
StaffChildClass AgeNote
1 3 INFANTS AND TODDLERS Laura Franklin was present with 3 children ages 20 months to 24 months
3 18 PRESCHOOL Samantha Walters, Alicia Williams, Jessica Franklin were present with 18 children ages 2 to 5 . 1 child age 2, 17 children ages 3 to 5

 
19 CSR 30-62.032 Organization and Administration
Not Observed
19 CSR 30-62.042 Licensing Process
Not Observed
19 CSR 30-62.052 Annual Requirements
Not Observed
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Not Observed
19 CSR 30-62.087 Fire Safety
Not Observed
19 CSR 30-62.090 Disaster and Emergency Preparedness
Not Observed
19 CSR 30-62.092 Furniture, Equipment and Materials
Not Observed
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
Laura Franklin did not complete safe sleep training within 30 days of employment or volunteering at the facility.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (4) (C) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall complete safe sleep training described in section (4) of this rule within thirty (30) days of employment or volunteering at the facility.
Correction Required
The department approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification
Submit Documentation

Compliance Date
1/11/2021
Violation
Safe sleep training was not completed within the past 3 years for the following staff Jessica Franklin.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (4) . states: Safe Sleep Training. Every three (3) years the center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 138, No. 5, November 1, 2016 and available at http://pediatrics.aappublications.org/content/pediatrics/early/2016/10/20/peds.2016-2938.full.pdf. This rule does not incorporate any subsequent amendments or additions.
Correction Required
The director, group home provider, other caregivers, and those volunteers counted in staff/child ratio, shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date
1/11/2021
Violation
A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Laura Frankilin.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (K) . 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
1/11/2021
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2019, the staff listed need the following information: Samantha Walters 6.5 .
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. 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
2/1/2021
19 CSR 30-62.112 Staff/Child Ratios
Not Observed
19 CSR 30-62.122 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 10-3-2016.
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

Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Laura Franklin.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include a “Risk Assessment for Tuberculosis” form, included herein, completed and signed by a health care professional, as provided by the Missouri Department of Health and Senior Services (MDHSS). If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
TB reports shall be on file as required

Correction Verification
Submit Documentation

Compliance Date

Violation
Medical examination report(s) was/were not on file for Laura Franklin 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
1/11/2021
19 CSR 30-62.132 Admission Policies and Procedures
Not Observed
19 CSR 30-62.142 Nighttime Care
Not Observed
19 CSR 30-62.152 Hourly Care Facilities
Not Observed
19 CSR 30-62.162 Overlap Care of Children
Not Observed
19 CSR 30-62.172 Emergency School Closings
Not Observed
19 CSR 30-62.182 Child Care Program
Not Observed
19 CSR 30-62.192 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 1 child(ren).
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
Not Observed
19 CSR 30-62.212 Transportation and Field Trips
Not Observed
19 CSR 30-62.222 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 Laura Franklin.
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
4/1/2021
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