DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

FAMILYFORWARD

002651170

(314) 534-9350

3309 S KINGSHIGHWAY BLVD
ST LOUIS
MO  63139-1101

THE CHILDREN'S HOME SOCIETY OF MISSOURI



 

BLEVENS, JENNIFER MARIE

jennifer.blevens@familyforwardmo.org

Incorporated

JOYCE E GREEN

35 MONTHS - 5 YEARS

19

GROUP HOME AND CENTER

 
Inspection Information

07/28/2022

11:15 AM

12:45 PM

UNANNOUNCED

COMPLIANCE MONITORING

2427922076


DocumentDocument-Date
LINES OF ADMINISTRATIVE AUTHORITY 03/28/2017
CERTIFICATE OF GOOD STANDING 03/28/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 07/07/2017
REGISTERING FICTITIOUS NAMES 03/31/2017
ARTICLES OF INCORPORATION 03/20/2017
CHILD CARE PRACTICES 06/30/2017
DISCIPLINE POLICIES 06/29/2017
POLICIES 06/30/2017
SAMPLE WEEKLY MENU 06/29/2017
DAILY SCHEDULE 06/30/2017
JOB RESPONSIBILITIES 06/30/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN 06/30/2017
SAMPLE FORMS 06/30/2017
DIAGRAM/INDOOR 07/21/2017
DIAGRAM/OUTDOOR 07/21/2017
DIRECTOR'S QUALIFICATIONS 06/16/2017
APPLICATION 05/07/2019
STAFF SHEET 03/15/2019
LOCAL ZONING APPROVAL 03/11/2019
FIRE/SAFETY INSPECTION 04/19/2022
EQUIPMENT LIST 05/25/2022
SANITATION INSPECTION 04/21/2022
LOCAL BUILDING APPROVAL 07/15/2020
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 05/24/2022
ANNUAL DECLARATION 05/24/2022




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 8
Total Children 6
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Jennifer Blevins, director, was present with no children.
3 3 PRESCHOOL Sarah Walsh, teacher, Tahirah Allar, teacher, and Jeremy Boal, teacher, were present with three children, all aged five years.
4 3 PRESCHOOL Katie Bry, practicum student, Chelsea De Mease,, teacher, Katherine Burgess. teacher, and Breanne Douglas, educational therapist.

 
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Violation
 Provider Comments
Violation
The name, address and telephone number of the board chairperson was not prominently posted near the license.
Licensing Rule Reference
5 CSR 25-500.042 Licensing Process (13) (C) states: Board president or chairperson;
Correction Required
The name, address, and board president or chairperson shall be posted near the license.

Correction Verification
Submit Documentation

Compliance Date

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
The premises were not safe and suitable as evidenced by tall grass was observed around the perimeter of the outside play area.
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 facility did not have a fenced outdoor play area that was on or adjoining the day care property and was accessible without hazard as evidenced by the fence was not in good condition in that a large opening was observed in the fence. This inspector was advised that a car drove from the side walk, became airbourne and damaged the fence. A protective material was used to encase the opening and prevent any children from exiting the play area.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 1. states: A fenced outdoor play area shall be available on or adjoining the day care property. The play area shall be located so it is convenient and the children can gain access to it without hazard. For facilities initially licensed after the effective date of these rules or for the installation of new fences in existing facilities, the fence shall be at least forty-two inches (42") high. An outdoor play area used exclusively for school-age children shall not be required to have a fence. Fences shall be constructed to prevent children from crawling or falling through or becoming entrapped.
Correction Required
The outdoor play area shall be accessible without hazard.

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
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
Medical examination report form did not contain all required information as evidenced by the medical documents did not note that the person examined could work with children or in a child care facility.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (D) states: The medical examination report form shall be supplied by the department or the facility may use its own form if it contains all the information on the department’s form. The Medical Examination Report for Caregivers and Staff 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
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
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