DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

WILD BLOOMS CHILDCARE CENTER LLC

002728561

(573) 491-3799

328 STATE ROAD AE
NEW BLOOMFIELD
MO  65063-5402

WILD BLOOMS CHILDCARE CENTER LLC

8575 STATE ROAD BB
NEW BLOOMFIELD
MO  65063-1335

SCHAFFER, ALAXANDRA NICOLE

wildbloomschildcare@gmail.com


JIM PARSLEY

6 WEEKS - 12 YEARS

60

GROUP HOME AND CENTER

8 CHILDREN UNDER 12 MONTHS; 15 CHILDREN UNDER 24 MONTHS
 
Inspection Information

09/30/2021

2:30 PM

3:38 PM

UNANNOUNCED

REINSPECTION

2409594521


DocumentDocument-Date
SAFE SLEEP POLICY 08/01/2018
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 11/18/2020
ANNUAL DECLARATION 11/18/2020
APPLICATION 09/05/2018
CHILD CARE PRACTICES 08/01/2018
DIAGRAM/INDOOR 09/05/2019
DAILY SCHEDULE 09/05/2019
DIAGRAM/OUTDOOR 09/11/2018
DIRECTOR'S QUALIFICATIONS 08/30/2018
DISCIPLINE POLICIES 08/01/2018
EQUIPMENT LIST 11/18/2020
LLC OPERATING AGREEMENT 08/01/2018
LLC ARTICLES OF ORGANIZATION 08/01/2018
LINES OF ADMINISTRATIVE AUTHORITY 07/26/2018
POLICIES 08/01/2018
SAMPLE FORMS 08/01/2018
STAFF SHEET 07/26/2018
SAMPLE WEEKLY MENU 08/01/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 09/05/2019
FIRE/SAFETY INSPECTION 08/03/2020
SANITATION INSPECTION 07/22/2020
LOCAL ZONING APPROVAL 09/19/2018
JOB RESPONSIBILITIES 09/26/2018
LOCAL FIRE DEPARTMENT NOTIFICATION 08/18/2018
LOCAL BUILDING APPROVAL 09/19/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
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 6
Total Children 25
StaffChildClass AgeNote
1 4 INFANTS AND TODDLERS Paige Cassels with 4 children 6 weeks through 1 year of age.
1 4 INFANTS AND TODDLERS Tanny Vaughn with 4 one-year-olds.
1 0 NO CHILDREN IN ATTENDANCE Alexandra Schaffer, the director, also on the premises.
1 6 PRESCHOOL Seara Barnard with 6 three-year-olds.
1 4 PRESCHOOL Erica Schaffer with 4 four-year-olds.
1 7 TWO YEAR OLDS Jaydia Brandt with 7 two-year-olds.

 
19 CSR 30-62.032 Organization and Administration
Not Observed
19 CSR 30-62.042 Licensing Process
Not Observed
19 CSR 30-62.052 Annual Requirements
Not Observed
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Not Observed
19 CSR 30-62.087 Fire Safety
Not Observed
19 CSR 30-62.090 Disaster and Emergency Preparedness
Not Observed
19 CSR 30-62.092 Furniture, Equipment and Materials
Not Observed
19 CSR 30-62.102 Personnel
Not Observed
19 CSR 30-62.112 Staff/Child Ratios
Not Observed
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
A school-age child's health report was not on file at the time of enrollment as evidenced by a school age child needed a parent health statement .
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (2) (D) states: The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child's health history, any current health problems, and any restrictions necessary for the child's care.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
7/20/2021
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 5/24/20, 8/1/20, 8/1/20.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report 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 admission.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/30/2021
Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Kaci Jordan .
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

Violation
Medical examination report(s) was/were not on file for Holly Ellsworth, Laura Avalos, Kaci Jordan 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
7/20/2021
19 CSR 30-62.132 Admission Policies and Procedures
Not Observed
19 CSR 30-62.142 Nighttime Care
Not Observed
19 CSR 30-62.152 Hourly Care Facilities
Not Observed
19 CSR 30-62.162 Overlap Care of Children
Not Observed
19 CSR 30-62.172 Emergency School Closings
Not Observed
19 CSR 30-62.182 Child Care Program
Not Observed
19 CSR 30-62.192 Health Care
Not Observed
19 CSR 30-62.202 Nutrition and Food Service
Not Observed
19 CSR 30-62.212 Transportation and Field Trips
Not Observed
19 CSR 30-62.222 Records and Reports
Not Observed
19 CSR 30-63.020 General Requirements
Not Observed
19 CSR 30-63.040 Background Screening Findings
Not Observed
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. —
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed