DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

EXCLUSIVE KIDZ ZONE

002835918

(314) 641-9882

3740 MARINE AVE
ST LOUIS
MO  63118-4175

EXCLUSIVE KIDZ ZONE

2813 LAFAYETTE AVE
ST LOUIS
MO  63104-2015

BLOUNT, TAMIKO

teneshabady@gmail.com

Incorporated

CHARMEL WILLIAMS

4 YEARS - 12 YEARS

50

GROUP HOME AND CENTER

 
Inspection Information

11/18/2021

7:35 AM

8:40 AM

UNANNOUNCED

COMPLIANCE MONITORING

2412721362


DocumentDocument-Date
ARTICLES OF INCORPORATION 10/14/2019
CHILD CARE PRACTICES 10/21/2020
DIAGRAM/INDOOR 07/31/2020
DIAGRAM/OUTDOOR 10/21/2020
DISCIPLINE POLICIES 10/21/2020
EQUIPMENT LIST 06/29/2020
LINES OF ADMINISTRATIVE AUTHORITY 10/15/2020
JOB RESPONSIBILITIES 10/15/2020
STAFF SHEET 10/22/2020
SAMPLE WEEKLY MENU 10/21/2020
SAMPLE FORMS 07/22/2020
POLICIES 10/21/2020
LOCAL ZONING APPROVAL 10/05/2020
LOCAL BUILDING APPROVAL 10/05/2020
SANITATION INSPECTION 08/16/2021
FIRE/SAFETY INSPECTION 11/02/2020
LOCAL FIRE DEPARTMENT NOTIFICATION 11/06/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/22/2020
DIRECTOR'S QUALIFICATIONS 10/28/2020
DAILY SCHEDULE 11/10/2020
CERTIFICATE OF GOOD STANDING 07/24/2020
APPLICATION 11/06/2020
CERTIFICATE OF GOOD STANDING 11/04/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/22/2020
DIRECTOR'S QUALIFICATIONS 10/28/2020
FIRE/SAFETY INSPECTION 11/02/2020
LOCAL FIRE DEPARTMENT NOTIFICATION 11/06/2020




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 5
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 2
Total Children 14
StaffChildClass AgeNote
2 14 MIXED Takia Gayden Site Supervisor and Diane Sutherlin Assistant Teacher, were present with fourteen children ages four to eight years old

 
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 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

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

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

Violation
The Family Care Safety Registry check was not conducted for Diane Sutherlin, Trinese Lawhorn, Takia Gayden, and Stephania Smith 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

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
5 CSR 25-500.087 Fire Safety
Compliance
5 CSR 25-500.090 Disaster and Emergency Preparedness
Compliance
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
Compliance
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
A written record of fire and disaster drills was not maintained.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (8) states: The provider shall maintain a written record at the facility for fire and disaster drills.
Correction Required
Fire and disaster drills shall be recorded and kept on file.

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