DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

INSPECTION REPORT
Facility Information






 




 








 
Inspection Information








DocumentDocument-Date
SAMPLE WEEKLY MENU 08/04/2014
LINES OF ADMINISTRATIVE AUTHORITY 08/04/2014
SAMPLE FORMS 08/04/2014
POLICIES 08/04/2014
DISCIPLINE POLICIES 08/04/2014
DAILY SCHEDULE 08/04/2014
CHILD CARE PRACTICES 08/04/2014
REGISTERING FICTITIOUS NAMES 04/09/2014
LLC ARTICLES OF ORGANIZATION 04/09/2014
DIRECTOR'S QUALIFICATIONS 08/05/2014
DIRECTOR'S JOB RESPONSIBILITIES 08/05/2014
JOB RESPONSIBILITIES 08/05/2014
APPLICATION 06/02/2018
STAFF SHEET 06/07/2018
FIRE/SAFETY INSPECTION 01/12/2021
EQUIPMENT LIST 03/29/2021
SANITATION INSPECTION 02/03/2021
ANNUAL DECLARATION 03/29/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/29/2021
LOCAL ZONING APPROVAL 08/04/2014
DIAGRAM/INDOOR 08/04/2014
DIAGRAM/OUTDOOR 08/04/2014
DISASTER AND EMERGENCY PREPAREDNESS PLAN 06/07/2018
LICENSING ORIENTATION 08/04/2014
OWNER/PROVIDER REFERENCES 08/04/2014
LLC OPERATING AGREEMENT 06/07/2018
LOCAL BUILDING APPROVAL 08/04/2014
LOCAL FIRE DEPARTMENT NOTIFICATION 08/04/2014

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:05PM   5:05PM   6/19/2017



Compliance Licensing Rules
Open Violations:
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

Compliance List
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
Not Observed
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
Not Observed
5 CSR 25-500.112 Staff/Child Ratios
Not Observed
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Mikayla Cuddy as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a day care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Mikayla Cuiddy.
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
Not Observed
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