DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

DOLLINS, BELINDA

000939613

(573) 888-1660

2132 EASTWOOD AVE
KENNETT
MO  63857-2322

DOLLINS, BELINDA



 

DOLLINS, BELINDA

belindadollins@clgw.net


MELISSA JILL SMITH

6 WEEKS - 12 YEARS

10

FAMILY HOME

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 2 CHILDREN 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
 
Inspection Information

01/10/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2416421276


DocumentDocument-Date
CERTIFICATE OF INCORPORATION 06/08/2020
SANITATION INSPECTION 04/05/2021
APPLICATION 03/25/2019
ASSISTANT APPROVAL REQUEST 03/27/2017
EQUIPMENT LIST 07/16/2021
OWNER/PROVIDER REFERENCES 05/09/1997
SAMPLE WEEKLY MENU 05/20/1997
CHILD CARE/DISCIPLINE POLICIES 05/20/1997
POLICIES 05/20/1997
DAILY SCHEDULE 05/20/1997
ASSISTANT REFERENCES 05/13/2015
DIAGRAM/INDOOR 05/20/1997
DIAGRAM/OUTDOOR 05/20/1997
SAFE SLEEP POLICY 11/29/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN 05/25/2018
ANNUAL DECLARATION 07/16/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 07/16/2021
FIRE/SAFETY INSPECTION 07/16/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  11:15AM   12:15PM   11/28/2017
  3:15PM   4:15PM   11/28/2017



Inspection determined facility to be in compliance with licensing rules.
Compliance 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 2
Total Children 7
StaffChildClass AgeNote
2 7 MIXED Marlenia Cook and Kay Cook with seven mixed aged children. Two children are under the age of two years old. Three children are three years old. Two children are two years old.

Compliance List
5 CSR 25-400.025 Organization and Administration
Compliance
5 CSR 25-400.045 Licensing Process
Compliance
5 CSR 25-400.055 Annual Requirements
Compliance
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Compliance
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
Furniture/equipment, the white toy cabinet, in the play room, beside the couch was not free of pointed parts as evidenced by the paint is chipping along the edges resulting in rough patches.
Licensing Rule Reference
5 CSR 25-400.095 Furniture, Equipment and Materials 1 (A) 1 states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead free paint shall be used.
Correction Required
The facility shall provide safe and clean furniture/equipment as required.

Correction Verification
Submit Documentation

Compliance Date
1/10/2022
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel
Compliance
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
Violation
 Provider Comments
Violation
The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider’s safe sleep policy when enrolling children less than 1 year of age.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 E states: They have received a copy of the provider’s safe sleep policy when enrolling children less than one (1) year of age.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
1/10/2022
Violation
The provider did not have parental acknowledgement on file indicating the parent understands and agrees that the child may not be accepted for care when ill.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 7 D states: They understand and agree that the child may not be accepted for care when ill.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
1/10/2022
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