DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

CDI HEAD START

002785455

(660) 717-2027

408 W 4TH ST
APPLETON CITY
MO  64724-1408

CDI HEAD START

702 E OHIO ST STE 15
CLINTON
MO  64735-2362


jsaldana@westmohs.org

Incorporated

HEATHER E RADNEY

36 MONTHS - 5 YEARS

20

GROUP HOME AND CENTER

 
Inspection Information

08/24/2021

10:30 AM

11:47 AM

UNANNOUNCED

COMPLIANCE MONITORING

2407014668


DocumentDocument-Date
FIRE/SAFETY INSPECTION 05/05/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 08/24/2021
EQUIPMENT LIST 08/24/2021
ANNUAL DECLARATION 05/26/2021
DIAGRAM/INDOOR 07/13/2020
DIAGRAM/OUTDOOR 07/13/2020
APPLICATION 05/06/2020
SANITATION INSPECTION 08/21/2020
ARTICLES OF INCORPORATION 07/22/2019
DAILY SCHEDULE 08/13/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/13/2019
CHILD CARE PRACTICES 08/13/2019
DISCIPLINE POLICIES 08/13/2019
JOB RESPONSIBILITIES 08/13/2019
POLICIES 08/13/2019
SAMPLE WEEKLY MENU 08/13/2019
LINES OF ADMINISTRATIVE AUTHORITY 08/13/2019
LOCAL FIRE DEPARTMENT NOTIFICATION 08/15/2019
DIRECTOR'S QUALIFICATIONS 08/13/2019
STAFF SHEET 07/16/2020




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 7
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 7
StaffChildClass AgeNote
4 7 PRESCHOOL Ann Bryant, Shannon Cook, Lori Corbin and Jenny Rohaus

 
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
Evidence of local zoning approval was not received.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (B) states: Evidence of compliance with local building and zoning requirements, if applicable.
Correction Required
The facility shall submit evidence of local building/zoning approval as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The equipment list did not contain a list of equipment as required in 19 CSR 30-62.092.
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
Corrected on Site

Compliance Date
8/24/2021
Violation
The staff sheet was not fully completed as evidenced by the list was submitted on May 26, 2021 and is inaccurate at the time of inspection.
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
Corrected on Site

Compliance Date
8/24/2021
Violation
The annual sanitation inspection was not approved.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.
Correction Required
The facility shall submit evidence of compliance with annual sanitation requirements.

Correction Verification
Submit Documentation

Compliance Date

Violation
Evidence of local building approval was not received.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (B) states: Evidence of compliance with local building and zoning requirements, if applicable.
Correction Required
The facility shall submit evidence of local building/zoning approval as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
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
The facility does not have an approved director on staff.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (2) (A) 3. states: The licensee is required to maintain an approved certificated group child care home provider or center director on staff.
Correction Required
The facility shall have an approved director/group home provider.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Shannon Cook 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

Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Ann Bryant, Shannon Cook, Lori Corbin and Jenny Rohaus.
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

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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by one immunization record(s) was/were not on file.
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
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