DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

HUMMEL, REBECCA PATTUGALAN

001911131

(417) 823-7868

3870 S HOMEWOOD ST
SPRINGFIELD
MO  65807-3963

HUMMEL, REBECCA PATTUGALAN



 

HUMMEL, REBECCA PATTUGALAN

RPATHUMMEL@GMAIL.COM


MELISSA HOLMAN

BIRTH - 13 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 6 CHILDREN IN CARE NO MORE THAN 3 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
 
Inspection Information

03/01/2022

12:01 PM

1:22 PM

UNANNOUNCED

COMPLIANCE MONITORING

2419591037


DocumentDocument-Date
ANNUAL DECLARATION 03/01/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/01/2022
EQUIPMENT LIST 03/01/2022
FIRE/SAFETY INSPECTION 11/18/2021
SANITATION INSPECTION 12/03/2021
DIAGRAM/INDOOR 01/24/2005
DIAGRAM/OUTDOOR 01/24/2005
DAILY SCHEDULE 01/24/2005
SAMPLE WEEKLY MENU 01/24/2005
SAMPLE FORMS 01/24/2005
POLICIES 01/24/2005
OWNER/PROVIDER REFERENCES 03/14/2005
ASSISTANT REFERENCES 01/15/2013
CHILD CARE/DISCIPLINE POLICIES 01/24/2005
LOCAL FIRE DEPARTMENT NOTIFICATION 01/31/2018
ASSISTANT APPROVAL REQUEST 01/23/2018
SAFE SLEEP POLICY 08/03/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/03/2018
SAFETY PLAN 03/10/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:15PM   5:15PM   1/9/2015



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 5
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 1
Total Children 7
StaffChildClass AgeNote
1 7 MIXED Rebecca Hummel with 7 children ages 11 months to 4-years-old.

 
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 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
Submit Documentation

Compliance Date
3/1/2022
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
Submit Documentation

Compliance Date
3/1/2022
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
Submit Documentation

Compliance Date
3/1/2022
Violation
The Family Care Safety Registry check was not conducted for Rebecca Hummel and Aloysius Hummel within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Compliance
5 CSR 25-400.086 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by the evacuation time was not recorded.
Licensing Rule Reference
5 CSR 25-400.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for protective outlet covers were not met as evidenced by electrical outlet uncovered next to the table in the play room.
Licensing Rule Reference
5 CSR 25-400.086 Fire Safety 11 (B) states: Protective covers or inserts for electrical receptacles shall be installed in all areas occupied by children.
Correction Required
The facility shall use protective outlet covers as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.090 Disaster and Emergency Preparedness
Compliance
5 CSR 25-400.095 Furniture, Equipment and Materials
Compliance
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: Rebecca Hummel needs 12 clock 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
Violation
 Provider Comments
Violation
1 child(ren) records did not include work schedule of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-400.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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