MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
MERCY HOSPITAL SPRINGFIELD

Facility DVN
000180709

Phone
(417) 820-7955

Physical Address
1831 S FREMONT AVE
SPRINGFIELD
MO 65804

Owner
MERCY HOSPITAL SPRINGFIELD

Mailing Address
1235 E CHEROKEE ST
SPRINGFIELD
MO 65804-2203

Provider/Director
GHAN, KARA GAY

E-mail Address
Kara.Ghan@mercy.net

Incorporated
Incorporated

Child Care Specialist
BILLIE RUSSELL

Age Range
6 WEEKS - 12 YEARS

Capacity
133

Facility Type
GROUP HOME AND CENTER

Limitations
16 CHILDREN IN THE INFANT/TODDLER UNIT

Inspection Information

Date
12/07/2021

Arrival Time
12:00 PM

Departure Time
1:42 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2414472744

Document	Document-Date
ANNUAL DECLARATION	12/07/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	12/07/2021
SAMPLE WEEKLY MENU	10/24/1984
POLICIES	10/21/2009
LOCAL ZONING APPROVAL	10/05/2005
LOCAL BUILDING APPROVAL	10/05/2005
LINES OF ADMINISTRATIVE AUTHORITY	01/26/1982
JOB RESPONSIBILITIES	10/31/1997
DISCIPLINE POLICIES	10/21/2009
DIRECTOR'S QUALIFICATIONS	05/19/2006
DAILY SCHEDULE	10/24/1997
ARTICLES OF INCORPORATION	03/24/1982
CHILD CARE PRACTICES	10/21/2009
CERTIFICATE OF GOOD STANDING	08/29/2013
DIAGRAM/INDOOR	08/14/2014
DIAGRAM/OUTDOOR	08/15/2014
APPLICATION	09/26/2019
FIRE/SAFETY INSPECTION	09/20/2021
SANITATION INSPECTION	09/16/2021
STAFF SHEET	12/22/2020
EQUIPMENT LIST	12/07/2021
SAFE SLEEP POLICY	10/09/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	10/09/2019

Inspection determined facility to be in compliance with licensing rules.

Open Violations: NA

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 14

Total Children 50

Staff	Child	Class Age	Note
2	7	INFANTS AND TODDLERS	Caregivers, Jenn Smith and Kaitlyn Wilson, were with twelve (12) to 23 month old children.
1	3	INFANTS AND TODDLERS	Caregiver, Jennifer Payne, was with one (1) three (3) month and two (2) eight (8) month old children.
2	8	MIXED	Caregivers, Kimberly Jones and Jessica Browning, were with two (2) two year old and six (6) three (3) year old children.
2	0	NO CHILDREN IN ATTENDANCE	Additional staff in the building during the inspection were, Kara Ghan and Leslie Harvey.
1	6	PRESCHOOL	Caregiver, Deana Lumley, was with four (4) year old children.
2	6	PRESCHOOL	Caregivers, Shella Jones and Whitney Temple, were with three (3) year old children.
1	6	PRESCHOOL	Caregiver, Becky Wessel, was with five (5) year old children.
1	7	PRESCHOOL	Caregiver, Linda Manning, was with four (4) year old children.
2	7	TWO YEAR OLDS	Caregivers, Ramona McCann and Lacey Patton, were with two (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 Compliance
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 Compliance
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