DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

MISSOURI OZARKS COMMUNITY ACTION, INC.

002607325

(573) 668-0137

357 JOST ST
BOURBON
MO  65441-6182

MISSOURI OZARKS COMMUNITY ACTION, INC.

100 HOOD PARK
CUBA
MO  65453-6270

EICKELMANN, TANNA MARIE

teickelmann@mocacaa.org

Incorporated

SHELBY N KOETTING

36 MONTHS - 5 YEARS

20

GROUP HOME AND CENTER

 
Inspection Information

05/10/2021

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2399175450


DocumentDocument-Date
DIAGRAM/INDOOR 07/26/2016
DAILY SCHEDULE 07/26/2016
SAMPLE WEEKLY MENU 07/26/2016
ARTICLES OF INCORPORATION 04/26/2007
DISCIPLINE POLICIES 07/26/2016
CHILD CARE PRACTICES 07/26/2016
JOB RESPONSIBILITIES 07/26/2016
LINES OF ADMINISTRATIVE AUTHORITY 07/26/2016
POLICIES 07/27/2016
REGISTERING FICTITIOUS NAMES 06/26/2008
DIAGRAM/OUTDOOR 10/03/2016
CERTIFICATE OF GOOD STANDING 06/26/2008
LLC ARTICLES OF ORGANIZATION 11/10/1986
DIRECTOR'S QUALIFICATIONS 10/28/2016
APPLICATION 05/13/2020
STAFF SHEET 05/13/2020
EQUIPMENT LIST 05/13/2020
SANITATION INSPECTION 12/16/2020
FIRE/SAFETY INSPECTION 03/03/2021




Inspection determined facility to be in compliance with licensing rules.
Open Violations: NA
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Licensing Process
Compliance
19 CSR 30-62.052 Annual Requirements
Violation
 Provider Comments
Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 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 group child care home or child care center and agreement to comply with all statutes and department licensing rules.
Correction Required
The facility shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date
4/26/2021
Violation
The equipment list was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (C) states: A current list of available equipment.
Correction Required
The facility shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date
4/26/2021
Violation
The staff sheet was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (D) states: A current staff sheet.
Correction Required
The facility shall submit a current staff sheet as required.

Correction Verification
Submit Documentation

Compliance Date
4/26/2021
Violation
The Family Care Safety Registry check was not conducted for Tanna Eickelmann, Rebecca Elliott, and Wendy Renner within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
19 CSR 30-62.052 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
4/21/2021
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
19 CSR 30-62.087 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.
Licensing Rule Reference
19 CSR 30-62.087 Fire Safety (2) (F) 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
5/5/2021
Violation
Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by the disaster and tornado drill was not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-62.087 Fire Safety (2) (F) 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
5/5/2021
19 CSR 30-62.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Jessica Elrod.
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
4/21/2021
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Compliance
19 CSR 30-62.132 Admission Policies and Procedures
Compliance
19 CSR 30-62.142 Nighttime Care
Compliance
19 CSR 30-62.152 Hourly Care Facilities
Compliance
19 CSR 30-62.162 Overlap Care of Children
Compliance
19 CSR 30-62.172 Emergency School Closings
Compliance
19 CSR 30-62.182 Child Care Program
Compliance
19 CSR 30-62.192 Health Care
Compliance
19 CSR 30-62.202 Nutrition and Food Service
Compliance
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Compliance
19 CSR 30-63.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Jessica Elrod.
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
4/21/2021
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. —
Compliance
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance