DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

SHAPES & COLORS

001660877

(314) 429-0221

4417 BILOXI AVE
BERKELEY
MO  63134-3413

HICKS, YOLANDA SHERILL



 

HICKS, YOLANDA SHERILL

yolandahicks33@yahoo.com


KATHERINE D SIMS

6 WEEKS - 12 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

07/13/2021

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2403957965


DocumentDocument-Date
SAMPLE WEEKLY MENU 10/07/2002
SAMPLE FORMS 10/07/2002
DAILY SCHEDULE 10/07/2002
CHILD CARE/DISCIPLINE POLICIES 10/07/2002
ASSISTANT APPROVAL REQUEST 09/01/2010
DIAGRAM/OUTDOOR 07/13/2010
DIAGRAM/INDOOR 07/13/2010
REGISTERING FICTITIOUS NAMES 08/02/2016
POLICIES 10/07/2002
EQUIPMENT LIST 08/16/2018
APPLICATION 08/16/2018
SAFE SLEEP POLICY 08/16/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 09/19/2018
SANITATION INSPECTION 09/08/2020
FIRE/SAFETY INSPECTION 07/09/2019

Overlap Start TimeOverlap End TimeOverlap Submit Date
  6:30AM   8:30AM   12/11/2019



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
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by the fire drill record was not available on the premises.
Licensing Rule Reference
19 CSR 30-61.086 Fire Safety 2 (C) 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
6/2/2021
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
Safe sleep training was not completed within the past 3 years for the provider, Yolanda Hicks.
Licensing Rule Reference
19 CSR 30-61.105 The Child Care Provider and Other Child Care Personnel (5) . states: Safe Sleep Training. Every three (3) years the provider and assistant(s) in a family child care home 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 child care provider and assistant(s) shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date
6/28/2021
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: Yolanda Hicks needs 1hr.
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
7/8/2021
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 1.4.21.
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
6/2/2021
19 CSR 30-61.135 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information as evidenced by Child A and Child B need authorization for emergency medical care.
Licensing Rule Reference
19 CSR 30-61.135 Admission Policies and Procedures (6) (E) 3 states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
6/2/2021
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file .
Licensing Rule Reference
19 CSR 30-61.185 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 adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of 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 completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
6/2/2021
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
1 child(ren) records did not include date care begins and ends.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (2) (A) states: The child’s full name, address, birth date and the date care begins and ends.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
6/2/2021
Violation
1 child(ren) records did not include employers' address of 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
7/13/2021
Violation
1 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
6/2/2021
19 CSR 30-63.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Yolanda Hicks, David Hicks Sr, and David Hicks Jr.
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
6/28/2021
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
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance