DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

JACOBS, ERIN LUCERO

002089118

(573) 897-5700

13 COUNTY ROAD 804
LINN
MO  65051-4076

JACOBS, ERIN LUCERO



 

JACOBS, ERIN LUCERO

lucero_erin@yahoo.com


LAUREN R RAYWARNKE

6 WEEKS - 12 YEARS

10

FAMILY HOME

UP TO 10 CHILDREN IN CARE NO MORE THAN 2 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 8 CHILDREN IN CARE, ALL CHILDREN MAY BE UNDER AGE 2 WITH 2 ADULT CAREGIVERS
 
Inspection Information

01/19/2022

10:45 AM

12:13 PM

UNANNOUNCED

COMPLIANCE MONITORING

2416329267


DocumentDocument-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/19/2022
ANNUAL DECLARATION 01/19/2022
DIAGRAM/OUTDOOR 12/30/2010
DIAGRAM/INDOOR 12/30/2010
SAMPLE WEEKLY MENU 04/24/2008
POLICIES 03/03/2008
DAILY SCHEDULE 04/24/2008
CHILD CARE/DISCIPLINE POLICIES 03/03/2008
ASSISTANT REFERENCES 03/15/2010
ASSISTANT APPROVAL REQUEST 11/07/2012
APPLICATION 11/05/2018
EQUIPMENT LIST 01/19/2022
FIRE/SAFETY INSPECTION 10/18/2021
SANITATION INSPECTION 12/27/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:30PM   5:30PM   2/14/2012



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 2
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 10
StaffChildClass AgeNote
2 10 MIXED Erin Jacobs and Dorian Hill with 10 children, one child 3 months old, one child 8 months old, two children age 2, two children age 3, two children age 4 and two children age 5.

 
5 CSR 25-400.025 Organization and Administration
Compliance
5 CSR 25-400.045 Licensing Process
Compliance
5 CSR 25-400.055 Annual Requirements
Violation
 Provider Comments
Violation
The listing of household members and assistants was not submitted.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (1) (C) states: A listing of household members and assistant(s).
Correction Required
The child care provider shall submit a listing of all household members and assistants.

Correction Verification
Corrected on Site

Compliance Date
1/19/2022
Violation
The equipment list was not submitted.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (1) (B) states: A current list of available equipment.
Correction Required
The child care provider shall submit an equipment list as required.

Correction Verification
Corrected on Site

Compliance Date
1/19/2022
Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-400.055 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 family child care home and agreement to comply with all statutes and department licensing rules.
Correction Required
The child care provider shall submit the Annual Declaration as required.

Correction Verification
Corrected on Site

Compliance Date
1/19/2022
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
Hazardous items as follows were accessible to children: Glass Mason Jars. The item(s) was/were located in a unlocked cabinet underneath the kitchen.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
1/19/2022
Violation
Hazardous items as follows were accessible to children: Plastic Walmart bags. The item(s) was/were located in a unlocked cabinet underneath the kitchen.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
1/19/2022
5 CSR 25-400.086 Fire Safety
Compliance
5 CSR 25-400.090 Disaster and Emergency Preparedness
Compliance
5 CSR 25-400.095 Furniture, Equipment and Materials
Violation
 Provider Comments
Violation
The facility did not meet requirements for cloth or plastic coated books. The facility needed an additional 1 item(s) in this category.
Licensing Rule Reference
5 CSR 25-400.095 Furniture, Equipment and Materials 2 (C) 1 D states: Cloth or plastic-coated books.
Correction Required
The facility shall provide approved equipment as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel
Violation
 Provider Comments
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2021, the staff listed need the following information: Erin Jacobs needs 11 hours.
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (4) (A) states: The provider shall obtain at least twelve (12) clock hours of child care-related training during each calendar year. Any assistant who works or volunteers more than five (5) hours per week shall meet the same training requirements. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.115 Day Care Family and Household
Compliance
5 CSR 25-400.125 Medical Examination Reports
Compliance
5 CSR 25-400.135 Admission Policies and Procedures
Compliance
5 CSR 25-400.145 Nighttime Care
Compliance
5 CSR 25-400.155 Overlap Care of Children
Compliance
5 CSR 25-400.165 Emergency School Closings
Compliance
5 CSR 25-400.175 Child Care Program
Compliance
5 CSR 25-400.185 Health Care
Compliance
5 CSR 25-400.190 Nutrition and Food Service
Compliance
5 CSR 25-400.200 Transportation and Field Trips
Compliance
5 CSR 25-400.210 Records and Reports
Compliance
5 CSR 25-600.020 Background Screening Findings
Compliance
5 CSR 25-600.040 General Requirements
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
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance