DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

SHAMODD & ME

002630380

(314) 227-5314

1615 PARKER RD
ST LOUIS
MO  63138-1908

GEORGE, KIMBERLY MARIE



 

GEORGE, KIMBERLY MARIE

shamoddandme@yahoo.com


DENISE ELAYNE KOCH

6 WEEKS - 5 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; UP TO 8 CHILDREN IN CARE, ALL CHILDREN MAY BE UNDER AGE 2 WITH 2 ADULT CAREGIVERS
 
Inspection Information

06/14/2021

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2402214234


DocumentDocument-Date
APPLICATION 05/28/2019
EQUIPMENT LIST 08/02/2019
SAFE SLEEP POLICY 08/02/2019
SANITATION INSPECTION 09/11/2020
FIRE/SAFETY INSPECTION 07/09/2020
ASSISTANT APPROVAL REQUEST 09/08/2017
CHILD CARE/DISCIPLINE POLICIES 09/27/2017
DAILY SCHEDULE 09/27/2017
POLICIES 09/27/2017
REGISTERING FICTITIOUS NAMES 09/08/2017
SAMPLE WEEKLY MENU 09/27/2017
DIAGRAM/INDOOR 09/01/2017
DIAGRAM/OUTDOOR 09/01/2017




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 30-61.025 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
Violation
 Provider Comments
Violation
A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Tyria Baker.
Licensing Rule Reference
19 CSR 30-61.105 The Child Care Provider and Other Child Care Personnel (1) (J) . 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 provider 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
5/5/2021
Violation
The the provider, Tyria Baker, did not complete safe sleep training within 30 days of employment or volunteering.
Licensing Rule Reference
19 CSR 30-61.105 The Child Care Provider and Other Child Care Personnel (5) (C) states: The provider and any assistant hired or volunteering at the facility after initial licensure shall complete the safe sleep training described in section (5) 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
5/5/2021
Violation
The following information for the assistant(s) was not posted as required: the name, address and telephone number of the assistant(s) was not posted with emergency numbers.
Licensing Rule Reference
19 CSR 30-61.105 The Child Care Provider and Other Child Care Personnel (3) (B) states: The names, addresses, and telephone numbers of all assistants shall be posted with other emergency numbers in the home.
Correction Required
Assistant information shall be posted.

Correction Verification
Submit Documentation

Compliance Date
5/5/2021
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: Tyria Baker- 1, Kourtney Burchfield-8.5.
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
6/7/2021
19 CSR 30-61.115 Day Care Family and Household
Compliance
19 CSR 30-61.125 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for staff and volunteers as evidenced by the medical examination was not signed by the required medical source.
Licensing Rule Reference
19 CSR 30-61.125 Medical Examination Reports (1) (F) states: Medical examination reports shall be 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 beginning work in the home. These reports may be transferable to another day care facility for subsequent employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
5/5/2021
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 6/30/20.
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
5/5/2021
19 CSR 30-61.135 Admission Policies and Procedures
Compliance
19 CSR 30-61.145 Nighttime Care
Compliance
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
One child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (2) (F) states: Field trip and transportation authorization.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
5/5/2021
Violation
One child(ren) records did not include name and phone number of the family physician or hospital.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (2) (D) states: Name and phone number of the family physician, or hospital, or both, to be used in an emergency.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
5/5/2021
Violation
One child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
5/5/2021
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