DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

SEYMOUR R-II SCHOOL DISTRICT

001378950

(417) 935-2287

425 E CENTER AVE
SEYMOUR
MO  65746-8955

SEYMOUR R-II SCHOOL DISTRICT

416 E CLINTON AVE
SEYMOUR
MO  65746-8938

ERVIN, JULIE DAWN

jervin@seymourschool.net


ELAINE S COX

36 MONTHS - 5 YEARS

30

GROUP HOME AND CENTER

 
Inspection Information

05/21/2021

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2399186618


DocumentDocument-Date
STAFF SHEET 05/26/2020
APPLICATION 03/19/2020
LOCAL FIRE DEPARTMENT NOTIFICATION 04/08/2019
LOCAL ZONING APPROVAL 10/08/1999
LINES OF ADMINISTRATIVE AUTHORITY 11/19/1999
SAMPLE WEEKLY MENU 11/19/1999
CHILD CARE PRACTICES 03/30/2011
DAILY SCHEDULE 03/30/2011
DISCIPLINE POLICIES 03/30/2011
DIAGRAM/INDOOR 08/01/2016
DIAGRAM/OUTDOOR 08/01/2016
DIRECTOR'S QUALIFICATIONS 02/06/2002
JOB RESPONSIBILITIES 11/19/1999
DISASTER AND EMERGENCY PREPAREDNESS PLAN 04/06/2018
SANITATION INSPECTION 01/20/2021
FIRE/SAFETY INSPECTION 12/22/2020
EQUIPMENT LIST 03/22/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/22/2021
ANNUAL DECLARATION 03/22/2021




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
Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
The provider did not provide resilient material necessary for the protection of children as evidenced by large pieces of sharp wood pieces in the wood mulch.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 6. states: The provider shall be responsible for the type, depth and fall-zone area of resilient material necessary for the protection of children.
Correction Required
Appropriate type, depth and fall zone area of resilient material shall be provided for the protection of children.

Correction Verification
Submit Documentation

Compliance Date
5/14/2021
19 CSR 30-62.087 Fire Safety
Compliance
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 caregiver did not obtain one clock hour of training for each month of employment. The staff listed need the following information: Julie Ervin needs clock 5 hours for 2020, and Brandi Farris needs 5 clock hours for 2020.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (C) states: Caregivers who were employed after the first of the year shall obtain one (1) clock of hour training for each one (1) month of employment, regardless of the date employment began.
Correction Required
Required training hours shall be documented for each employee.

Correction Verification
Submit Documentation

Compliance Date
5/21/2021
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Brandi Ferris.
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
5/4/2021
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
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