DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

CREATIVE WORLD SCHOOL - COUNTRYSIDE

002443538

(816) 373-6700

19701 SW EAST US HIGHWAY 40
BLUE SPRINGS
MO  64015-2235

EARLY LEARNING CENTER COUNTRYSIDE, LLC

6314 OVERTON AVE
RAYTOWN
MO  64133-5013

FIZER, BONNIE JO

COUNTRYSIDE@CREATIVEWORLDSCHOOL.COM


ROBYN EMBREE

6 WEEKS - 10 YEARS

244

GROUP HOME AND CENTER

40 CHILDREN IN THE INFANT/TODDLER UNIT; 8 CHILDREN UNDER 12 MONTHS
 
Inspection Information

03/07/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2419264793


DocumentDocument-Date
LOCAL BUILDING APPROVAL 11/08/2013
LOCAL ZONING APPROVAL 11/08/2013
LLC OPERATING AGREEMENT 10/25/2013
LLC ARTICLES OF ORGANIZATION 10/25/2013
SAMPLE FORMS 11/08/2013
POLICIES 11/08/2013
LINES OF ADMINISTRATIVE AUTHORITY 11/08/2013
JOB RESPONSIBILITIES 11/08/2013
DISCIPLINE POLICIES 11/08/2013
DIAGRAM/OUTDOOR 12/04/2008
DIAGRAM/INDOOR 12/04/2008
DAILY SCHEDULE 11/08/2013
CHILD CARE PRACTICES 11/08/2013
SAMPLE WEEKLY MENU 06/09/2016
CERTIFICATE OF GOOD STANDING 11/13/2017
SAFE SLEEP POLICY 05/24/2018
APPLICATION 11/06/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 11/19/2019
DIRECTOR'S QUALIFICATIONS 12/23/2019
ANNUAL DECLARATION 01/10/2022
SANITATION INSPECTION 01/10/2022
FIRE/SAFETY INSPECTION 12/22/2021
EQUIPMENT LIST 01/10/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/10/2022




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.

 
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
Violation
 Provider Comments
Violation
Savannah Stussy and Abbey English did not complete safe sleep training within 30 days of employment or volunteering at the facility.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) (C) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall complete safe sleep training described in section (4) of this rule within thirty (30) days of employment or volunteering at the facility.
Correction Required
The department approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification
Submit Documentation

Compliance Date
3/5/2022
Violation
The facility does not have an approved director on staff.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 3. states: The licensee is required to maintain an approved certificated group child care home provider or center director on staff.
Correction Required
The facility shall have an approved director/group home provider.

Correction Verification
Submit Documentation

Compliance Date
3/7/2022
Violation
The director is not routinely on duty, as evidenced by there is no approved director on staff.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.
Correction Required
The director/group home provider shall be routinely on duty, as required.

Correction Verification
Submit Documentation

Compliance Date
3/7/2022
Violation
The facility has not submitted the approval request for proposed director: Lesley Garretson.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 1. B. states: Once the center director or group child care home provider is certificated by the Department, the Center Director or Group Child Care Home Provider Approval Request form shall be submitted to the department and maintained on file at the facility. See Center Director or Group Child Care Home Provider Approval Request 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. This rule does not incorporate any subsequent amendment or additions.
Correction Required
An approval request form shall be submitted to the department.

Correction Verification
Submit Documentation

Compliance Date
3/7/2022
Violation
The director was not responsible for the daily planning, monitoring and managing of the facilities program as evidenced by an approved director is not on staff at the facility.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 1. . states: An approved certificated group child care home provider or center director shall be responsible for planning, monitoring, and managing the facility’s daily program.
Correction Required
The director or group home provider shall be responsible for the daily program.

Correction Verification
Submit Documentation

Compliance Date
3/7/2022
Violation
A caregiver did not obtain one clock hour of training for each month of employment. The staff listed need the following information: Abbey English (needs 3 clock hours for 2021) and Tanner Kremeier (needs 1 clock hour for 2021).
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (C) states: Caregivers who were employed after the first of the year shall obtain one (1) clock of hour training for each one (1) month of employment, regardless of the date employment began.
Correction Required
Required training hours shall be documented for each employee.

Correction Verification
Submit Documentation

Compliance Date
3/5/2022
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Tiffany Caraveo and Dorris Marshall 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
3/5/2022
Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Tiffany Caraveo and Dorris Marshall.
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
3/5/2022
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