DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

CIRCUS-CIRCUS DAY CARE CENTER, INC.

000276222

(417) 257-7603

1016 ST. LOUIS ST
WEST PLAINS
MO  65775

CIRCUS-CIRCUS DAY CARE CENTER, INC.



 

KIRKLAND, LISA MARIE

circusdaycare@gmail.com

Incorporated

ELAINE S COX

BIRTH - 12 YEARS

20

GROUP HOME AND CENTER

4 CHILDREN UNDER 24 MONTHS
 
Inspection Information

11/08/2021

10:40 AM

1:04 PM

UNANNOUNCED

COMPLIANCE MONITORING

2411559278


DocumentDocument-Date
EQUIPMENT LIST 01/05/2021
LOCAL ZONING APPROVAL 08/29/2013
POLICIES 04/27/1993
SAMPLE WEEKLY MENU 04/27/1993
DIRECTOR'S QUALIFICATIONS 04/27/1993
DISCIPLINE POLICIES 04/27/1993
DIAGRAM/OUTDOOR 04/27/1993
DIAGRAM/INDOOR 04/27/1993
CHILD CARE PRACTICES 04/27/1993
ARTICLES OF INCORPORATION 04/27/1993
OWNER/PROVIDER REFERENCES 02/01/1993
DAILY SCHEDULE 03/17/2015
LINES OF ADMINISTRATIVE AUTHORITY 11/02/2005
JOB RESPONSIBILITIES 10/19/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 09/15/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN 03/20/2018
SAFE SLEEP POLICY 07/12/2016
CERTIFICATE OF GOOD STANDING 10/14/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 10/14/2021
ANNUAL DECLARATION 10/14/2021
FIRE/SAFETY INSPECTION 08/04/2021
SANITATION INSPECTION 06/22/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:00PM   5:00PM   8/19/2016



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 13
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 3
Total Children 13
StaffChildClass AgeNote
1 1 INFANTS AND TODDLERS Kaitlin Lee with 1- 3month old child.
2 12 MIXED Kaitlin Marsh and Rose Yutzy with 12 children on the play yard, age 18 months to 4 years. There were 2 children under 24 months, and 4- 2 year old children.

 
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Violation
 Provider Comments
Violation
The staff sheet was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (D) states: A current staff sheet.
Correction Required
The facility shall submit a current staff sheet as required.

Correction Verification
Submit Documentation

Compliance Date
10/14/2021
Violation
The equipment list was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (C) states: A current list of available equipment.
Correction Required
The facility shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date
10/14/2021
Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, promulgated as of 2020 and incorporated by reference in this rule. As published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102-0570 and available by the department at https://health.mo.gov/safety/childcare/forms.php indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.
Correction Required
The facility shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date
10/14/2021
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
The walls located in the back entrance and in the bathroom was/were not finished with material which can be cleaned easily as evidenced by unsealed wood.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

Violation
Diapering requirements were not met as evidenced by the diapering table did not have a waterproof washable surface.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (4) (A) states: A safe diapering table with a waterproof washable surface shall be used for changing diapers. The diapering table shall be located within or adjacent to the group space so the caregiver using the diapering table can maintain supervision of his/her group of children at all times.
Correction Required
The facility shall provide a safe and clean diapering table as required.

Correction Verification
Corrected on Site

Compliance Date
11/8/2021
Violation
The walls located in the back area was/were not in good condition as evidenced by unfinished door casings, section of wall not complete, this area is under construction and it not yet finished, no electrical wires, or sharp edges or construction equipment or debris are accessible to the children.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

Violation
The walls located in the facility (base boards and door casings also) was/were not in good condition as evidenced by chipping paint.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.087 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by the disaster and tornado drill record was not available on the premises.
Licensing Rule Reference
5 CSR 25-500.087 Fire Safety (2) (F) 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

5 CSR 25-500.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
The facility’s name, address and telephone number was not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. A. states: The name, address, and telephone number of the facility;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility's list of emergency numbers are not posted in each room used for child care, specifically in dining room and preschool room at the front of the building.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;
Correction Required
The facility must post all emergency numbers as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility's evacuation route diagram was not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 2. states: A diagram of evacuation routes from the room;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.092 Furniture, Equipment and Materials
Compliance
5 CSR 25-500.102 Personnel
Compliance
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Compliance
5 CSR 25-500.132 Admission Policies and Procedures
Compliance
5 CSR 25-500.142 Nighttime Care
Compliance
5 CSR 25-500.152 Hourly Care Facilities
Compliance
5 CSR 25-500.162 Overlap Care of Children
Compliance
5 CSR 25-500.172 Emergency School Closings
Compliance
5 CSR 25-500.182 Child Care Program
Compliance
5 CSR 25-500.192 Health Care
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for 1 child(ren).
Licensing Rule Reference
5 CSR 25-500.192 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

5 CSR 25-500.202 Nutrition and Food Service
Compliance
5 CSR 25-500.212 Transportation and Field Trips
Compliance
5 CSR 25-500.222 Records and Reports
Violation
 Provider Comments
Violation
3 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 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

Violation
1 child(ren) records did not include work schedule of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 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

Violation
2 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 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

Violation
1 child(ren) records did not include date care begins and ends.
Licensing Rule Reference
5 CSR 25-500.222 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

Violation
1 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
5 CSR 25-500.222 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 CSR 25-600.020 General Requirements
Compliance
5 CSR 25-600.040 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