DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

SHEPHERD'S TREE HOUSE LLC

002423201

(417) 778-6003

406 HALL ST
ALTON
MO  65606-8352

SHEPHERD'S TREE HOUSE LLC

PO BOX 429
ALTON
MO  65606-0429


shepherdstreehouse@outlook.com


SARAH L THACKER

6 WEEKS - 12 YEARS

50

GROUP HOME AND CENTER

16 CHILDREN IN THE INFANT/TODDLER UNIT; 8 CHILDREN UNDER 12 MONTHS; 8 CHILDREN UNDER 24 MONTHS
 
Inspection Information

07/19/2022

10:20 AM

12:32 PM

UNANNOUNCED

COMPLIANCE MONITORING

2427322389


DocumentDocument-Date
LOCAL ZONING APPROVAL 11/13/2020
DAILY SCHEDULE 12/09/2020
SAMPLE WEEKLY MENU 11/13/2020
DIRECTOR'S QUALIFICATIONS 11/30/2020
JOB RESPONSIBILITIES 12/09/2020
DISCIPLINE POLICIES 12/09/2020
POLICIES 12/09/2020
SAFE SLEEP POLICY 12/09/2020
CHILD CARE PRACTICES 12/09/2020
APPLICATION 11/13/2020
LOCAL FIRE DEPARTMENT NOTIFICATION 12/01/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 11/13/2020
CERTIFICATE OF GOOD STANDING 09/05/2013
LLC ARTICLES OF ORGANIZATION 09/13/2013
LLC OPERATING AGREEMENT 08/17/2020
FIRE/SAFETY INSPECTION 10/20/2021
EQUIPMENT LIST 04/22/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/22/2022




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 22
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 9
Total Children 27
StaffChildClass AgeNote
2 7 INFANTS AND TODDLERS Caregivers Harly Howell and Kaylie Nelson with children ages 18 months to 24 months.
2 4 INFANTS AND TODDLERS Caregivers Sally Simmons and Kylie Dell with children ages 7 months to 8 months.
2 10 MIXED Caregivers Autum Hunter and Lauren Bell with one child 2-years-of-age and nine children 3-years-of-age to 5-years-of-age.
2 0 NO CHILDREN IN ATTENDANCE Two staff on the premises that did not count in ratio were the Director, Ashley Schmidt and Cook Tamaria Killpack.
1 6 SCHOOL AGE Caregiver Laiken Heck with children ages 5 through 12.

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 conducted.
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
3/9/2022
Violation
The Family Care Safety Registry check was not conducted for Virginia Gazaway, Sheila Campbell, Managing Member, Beckie Combs, Managing Member, Sarah Chewning, Melissa Pearson, Kayla Pearson, Ashley Schmidt, Tamaria Killpack, and Kacey Hollis. As of 4/25/22, The only people needing the FCSR are Tamaria Killpack within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 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 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
The premises were not safe and suitable as evidenced by there were 3 window panes sitting in the floor of the school age room propped against the wall.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.
Correction Required
The premises shall be safe and suitable for the care of children.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that the school age room had 1 outlet on the back of the wall between the two windows that was not covered.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.
Correction Required
The facility shall use outlet covers or twist-lock outlets as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The walls located in the preschool bathroom was/were not clean as evidenced by the baseboards had a yellow substance on each side of the toilet in both stalls.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

Violation
There was evidence of rodents/droppings in under the kitchen cabinet to the left of the sink.
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

Violation
The bathroom was not clean and odor free as evidenced by the floor was soiled.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 7. states: Bathrooms shall be clean and odor free.
Correction Required
Bathrooms shall be clean and odor free.

Correction Verification
Submit Documentation

Compliance Date

Violation
The walls located the school age bathroom was/were not clean as evidenced by the baseboards had a yellow substance on each side of the toilets..
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Stationary equipment, the airplane teeter totter , was unsafe as evidenced by the equipment was placed in close proximity to other equipment which could cause a collision hazard - the equipment location and measured distance from other equipment was less than 2 feet. It was 1 foot 3 inches.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (3) (D) states: Stationary equipment such as swings, slides and climbers shall be securely anchored, have no exposed footings and be placed to avoid accidents or collisions.
Correction Required
Stationary equipment shall be safely installed, stable and securely anchored.

Correction Verification
Submit Documentation

Compliance Date
7/19/2022
Violation
Outdoor equipment, airplane teeter totter, in playground was not in good condition as evidenced by the side of the teeter totter has become unattached.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.
Correction Required
Outdoor play equipment shall be safe and in good repair.

Correction Verification
Submit Documentation

Compliance Date
7/19/2022
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Kaylea Barnhart, Autum Hunter, Kaylee Nelson and Harly Howell
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering and before being left alone with children that caregivers receive a facility orientation. The facility orientation shall include:
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

Correction Verification
Submit Documentation

Compliance Date

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: Sarah Chewning needs 1.5, Virginia (Ginger) Gazaway needs 6 hours, Ashley Schmidt needs 12 hours, Melissa Pearson needs 11 hours, Kacey Hollis needs 1 hour, Tamaria Killpack needs 4 hours, Kayla Person needs 10 hours. As of 4/25/2022, Sarah Chewning, Ginger Gazaway, Melissa Pearson, Kacey Hollis and Kayla Pearson are no longer employed. Ashley Schmidt still needs 12 hours and Tamaria Killpack needs 4 hours.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. 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

Violation
Ashley Schmidt, Kayla Pearson, Melissa Pearson, Tamaria Killpack-Jameson and Kacey Hollis did not complete safe sleep training within 30 days of employment or volunteering at the facility. As of 4/25/2022, Ashley Schmidt and Tamaria Killpack. As of 7/19/2022, Tamaria Killpack 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

Violation
Kaylea Barnhart, Autum Hunter, Laiken Heck, Sally Simmons, Kaylee Nelson, and Harley Howell 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

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 Tamaria Killpack-Jameson, Allena Roe, Jennifer Simpson. During inspection on 1/24/22, Ginger (Director) stated that Allena Roe and Jennifer Simpson are no longer here. The only one still needing a medical exam is Tamaria Killpack 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 child 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 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: Laiken Heck and Kaylee Nelson.
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

Violation
Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 8/30/21, 6/31/20, 8/1/21 and two were unknown.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is incorporated by reference in this rule, as published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Medical examination report(s) was/were not on file for Autum Hunter, Sally Simmons, and Harly Howell 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 child 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

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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 4 immunization record(s) was/were not on file.
Licensing Rule Reference
5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
3 child(ren) records did not include child's full name, address, date of birth and date care begins and ends.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
3 child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 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

Violation
3 child(ren) records did not include name, address and telephone number of another individual who might be reached in an emergency.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
3 child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
3 child(ren) records did not include name of individual authorized to take the child from the facility.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (E) states: Name of the individual(s) authorized to take the child from the facility;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
4 child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (F) states: Field trip and transportation authorization.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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