DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

INSPECTION REPORT
Facility Information






 




 








 
Inspection Information








DocumentDocument-Date
ANNUAL DECLARATION 11/19/2021
APPLICATION 04/20/2020
SANITATION INSPECTION 01/25/2022
LOCAL ZONING APPROVAL 10/05/2020
LOCAL BUILDING APPROVAL 10/05/2020
LLC ARTICLES OF ORGANIZATION 08/11/2020
LLC OPERATING AGREEMENT 08/11/2020
FIRE/SAFETY INSPECTION 08/10/2021
SAMPLE WEEKLY MENU 08/11/2020
DIAGRAM/INDOOR 08/11/2020
DIAGRAM/OUTDOOR 08/11/2020
EQUIPMENT LIST 11/19/2021
DAILY SCHEDULE 08/17/2020
JOB RESPONSIBILITIES 10/05/2020
LINES OF ADMINISTRATIVE AUTHORITY 10/05/2020
DIRECTOR'S QUALIFICATIONS 10/05/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/05/2020
LICENSING ORIENTATION 10/05/2020
SAMPLE FORMS 10/05/2020
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 11/19/2021
CHILD CARE PRACTICES 11/03/2020
POLICIES 11/03/2020
DISCIPLINE POLICIES 11/03/2020
SAFE SLEEP POLICY 11/03/2020
STAFF SHEET 10/05/2020




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.

 
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
Violation
 Provider Comments
Violation
There was evidence of dirt/debris in the two's room on the carpet.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 9. states: The facility shall be clean at all times and free of dirt, insects, spiders, rodents or other pests.
Correction Required
The facility shall be clean and pest free.

Correction Verification
Submit Documentation

Compliance Date
7/6/2022
5 CSR 25-500.087 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-62.087 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.
Licensing Rule Reference
5 CSR 25-500.087 Fire Safety (2) (F) 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
7/6/2022
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
Violation
 Provider Comments
Violation
The medical examination report on file was older than 12 months before the individual's begin date at the facility.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (C) states: Medical examination reports shall be completed not more than twelve (12) months prior to beginning work in the facility and may be transferable to another child care facility for subsequent employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
7/6/2022
Violation
A medical examination report did not include either a completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: Raven Talbott & Paige Kunzler.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberulin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date
7/7/2022
5 CSR 25-500.132 Admission Policies and Procedures
Compliance
5 CSR 25-500.142 Nighttime Care
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