DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

JEFFERSON FRANKLIN COMMUNITY ACTION CORPORATION

001481963

(636) 583-0657

5008 HWY N
ROBERTSVILLE
MO  63072

JEFFERSON FRANKLIN COMMUNITY ACTION CORPORATION

PO BOX 920
HILLSBORO
MO  63050-0920

ROCHE, TIFFANY DAWN

kkorman@jfcac.org

Incorporated

CYNTHIA D MADDOX

36 MONTHS - 5 YEARS

20

GROUP HOME AND CENTER

 
Inspection Information

04/25/2022

10:20 AM

11:00 AM

UNANNOUNCED

COMPLIANCE MONITORING

2422407551


DocumentDocument-Date
ANNUAL DECLARATION 03/14/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/03/2022
SANITATION INSPECTION 04/08/2021
FIRE/SAFETY INSPECTION 12/28/2021
ARTICLES OF INCORPORATION 10/10/2017
CERTIFICATE OF GOOD STANDING 03/02/2021
DIAGRAM/OUTDOOR 10/10/2017
DIAGRAM/INDOOR 10/10/2017
DAILY SCHEDULE 10/10/2017
STAFF SHEET 01/15/2019
SAMPLE WEEKLY MENU 10/10/2017
JOB RESPONSIBILITIES 10/10/2017
DIRECTOR'S QUALIFICATIONS 01/22/2020
DISCIPLINE POLICIES 02/21/2018
EQUIPMENT LIST 03/03/2022
APPLICATION 10/10/2018
CHILD CARE PRACTICES 02/21/2018
LOCAL ZONING APPROVAL 01/15/2019
LOCAL FIRE DEPARTMENT NOTIFICATION 03/19/2018
POLICIES 02/21/2018
LINES OF ADMINISTRATIVE AUTHORITY 10/10/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN 04/22/2021
LOCAL BUILDING APPROVAL 01/15/2019




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 1
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 4
StaffChildClass AgeNote
4 0 NO CHILDREN IN ATTENDANCE Facility closed for professional development day. Kimberly Korman, Tiffany Roche, Melinda Myers and Stephanie Herron were all present at the facility during the inspection.

Compliance List
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Violation
 Provider Comments
Violation
The annual sanitation inspection was not approved.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.
Correction Required
The facility shall submit evidence of compliance with annual sanitation requirements.

Correction Verification
Submit Documentation

Compliance Date

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
Compliance
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Compliance
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