DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

ARCHIE R-V SCHOOL DISTRICT

001681096

(816) 293-5312

302 W STATE ROUTE A
ARCHIE
MO  64725-8217

ARCHIE R-V SCHOOL DISTRICT



 

HARMON, KELLEY JO

kharmon@archie.k12.mo.us


BIONICA D SMITHJACKSON

36 MONTHS - 6 YEARS

20

GROUP HOME AND CENTER

 
Inspection Information

05/10/2022

9:00 AM

10:26 AM

UNANNOUNCED

COMPLIANCE MONITORING

2423217917


DocumentDocument-Date
LOCAL ZONING APPROVAL 09/27/2002
LOCAL BUILDING APPROVAL 09/27/2002
LINES OF ADMINISTRATIVE AUTHORITY 09/20/2002
SAMPLE FORMS 09/20/2002
DIAGRAM/INDOOR 09/20/2002
DIAGRAM/OUTDOOR 09/20/2002
SAMPLE WEEKLY MENU 09/09/2014
POLICIES 09/09/2014
DISCIPLINE POLICIES 09/09/2014
JOB RESPONSIBILITIES 09/09/2014
DAILY SCHEDULE 09/09/2014
CHILD CARE PRACTICES 09/09/2014
DIRECTOR'S QUALIFICATIONS 03/21/2014
APPLICATION 09/14/2018
STAFF SHEET 09/14/2018
SANITATION INSPECTION 08/27/2020
EQUIPMENT LIST 10/20/2020
FIRE/SAFETY INSPECTION 10/12/2021
ANNUAL DECLARATION 11/30/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 11/30/2021




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 4
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 3
Total Children 14
StaffChildClass AgeNote
3 14 PRESCHOOL dierctor Kelley Harmon and staff Nikki Tenholder and Kara Essenpries with fourteen children, all 3-years-to 5 years- old

 
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
A caregiver did not obtain one clock hour of training for each month of employment. The staff listed need the following information: Nicole Tenholder-three hours; Kelley Harmon-five hours.
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

Violation
The facility did not conduct a Family Care Safety Registry screening for Nicole Tenholder, who was hired on 10/22/2022.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.
Correction Required
Required results of the Family Care Safety Registry screening shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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 Nicole Tenholder as evidenced by a medical examination was not on file at the facility at the time of initial licensure.
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 Nicole Tenholder.
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
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