DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

CALIFORNIA KIDS, LLC

002553204

(573) 796-2058

800 LAKE DR
CALIFORNIA
MO  65018-2022

CALIFORNIA KIDS, LLC



 

WOLFORD, ANNY NICOLE

californiakidsllc@gmail.com


ALISON MICHELE EVANS

6 WEEKS - 12 YEARS

38

GROUP HOME AND CENTER

12 CHILDREN IN THE INFANT/TODDLER UNIT; 9 CHILDREN UNDER 12 MONTHS
 
Inspection Information

11/08/2021

1:50 PM

2:14 PM

UNANNOUNCED

REINSPECTION

2412009911


DocumentDocument-Date
ANNUAL DECLARATION 11/02/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 11/02/2021
LLC OPERATING AGREEMENT 09/01/2015
LLC ARTICLES OF ORGANIZATION 09/01/2015
LINES OF ADMINISTRATIVE AUTHORITY 09/01/2015
DIRECTOR'S QUALIFICATIONS 09/11/2015
DIAGRAM/INDOOR 09/18/2015
DIAGRAM/OUTDOOR 09/18/2015
SAMPLE WEEKLY MENU 10/08/2015
DISCIPLINE POLICIES 10/26/2015
CHILD CARE PRACTICES 10/26/2015
POLICIES 10/26/2015
SAMPLE FORMS 10/28/2015
JOB RESPONSIBILITIES 11/02/2015
DAILY SCHEDULE 11/04/2015
OWNER/PROVIDER REFERENCES 11/04/2015
LOCAL FIRE DEPARTMENT NOTIFICATION 11/04/2015
APPLICATION 09/04/2019
STAFF SHEET 09/04/2019
EQUIPMENT LIST 11/02/2021
SANITATION INSPECTION 07/07/2021
FIRE/SAFETY INSPECTION 07/13/2020

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:00PM   5:00PM   11/4/2015



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 6
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 7
Total Children 34
StaffChildClass AgeNote
1 4 INFANTS AND TODDLERS Taylor Vines all children under 12 months.
2 8 INFANTS AND TODDLERS Riley Bisges and Jeralyn Miller (all children over 12 months).
3 12 MIXED Brittany Loethen, Anny Rolls, and Brianna Kauffman with 6 (3-5) and 6 (2 year old) in a group.
1 10 PRESCHOOL Madisyn Schulp (3-5 year old)

 
5 CSR 25-500.032 Organization and Administration
Not Observed
5 CSR 25-500.042 Licensing Process
Not Observed
5 CSR 25-500.052 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Jeralyn Miller, Madison Schlup, Anny Roll, Brianna Kauffman, Brittany Loethen, Brooklyn Salmons, Hailey Tarrants, Taylor Vines, Courtney Pettigrew, Riley Bisges and Brooke Stone within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Submit Documentation

Compliance Date

Violation
The annual fire safety inspection was not approved.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.
Correction Required
The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Not Observed
5 CSR 25-500.087 Fire Safety
Not Observed
5 CSR 25-500.090 Disaster and Emergency Preparedness
Not Observed
5 CSR 25-500.092 Furniture, Equipment and Materials
Not Observed
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Courtney Pettigrew, Riley Bisges and Brooke Stone.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (K) . 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 facility 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

Violation
Safe sleep training was not completed within the past 3 years for the following staff Courtney Pettigrew, Riley Bisges and Brooke Stone.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) . states: Safe Sleep Training. Every three (3) years the center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios in a group child care home or child care center 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 director, group home provider, other caregivers, and those volunteers counted in staff/child ratio, shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.112 Staff/Child Ratios
Violation
 Provider Comments
Violation
Staff/child ratio requirements were not met as evidenced by 8 children, ages birth to two, were cared for by 1 caregiver(s).
Licensing Rule Reference
5 CSR 25-500.112 Staff/Child Ratios (1) (A) states: Birth Through Two (2) Years. Groups composed of mixed ages through two (2)- years shall have no less than one (1) adult to four (4) children, with no more than eight (8) children in a group;
Correction Required
Correct staff/child ratios and group size shall be maintained.

Correction Verification
Return Inspection

Compliance Date
11/8/2021
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Brooklyn Salmons.
Licensing Rule Reference
5 CSR 25-500.122 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

5 CSR 25-500.132 Admission Policies and Procedures
Not Observed
5 CSR 25-500.142 Nighttime Care
Not Observed
5 CSR 25-500.152 Hourly Care Facilities
Not Observed
5 CSR 25-500.162 Overlap Care of Children
Not Observed
5 CSR 25-500.172 Emergency School Closings
Not Observed
5 CSR 25-500.182 Child Care Program
Not Observed
5 CSR 25-500.192 Health Care
Not Observed
5 CSR 25-500.202 Nutrition and Food Service
Not Observed
5 CSR 25-500.212 Transportation and Field Trips
Not Observed
5 CSR 25-500.222 Records and Reports
Not Observed
5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Jeralyn Miller, Brittany Loethen, Brooklyn Salmons, Courtney Pettigrew, Riley Bisges, and Brooke Stone.
Licensing Rule Reference
5 CSR 25-600.020 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

5 CSR 25-600.040 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