DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

MISSOURI STATE UNIVERSITY

000222093

(417) 836-7650

609 E CHERRY ST
SPRINGFIELD
MO  65806-3401

MISSOURI STATE UNIVERSITY

901 S NATIONAL AVE
SPRINGFIELD
MO  65804-0028

ROAM, KIMBERLY JOY

kimroam@missouristate.edu


ELAINE S COX

6 WEEKS - 6 YEARS

88

GROUP HOME AND CENTER

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

09/14/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2430305026


DocumentDocument-Date
STAFF SHEET 01/22/2021
APPLICATION 10/29/2019
LINES OF ADMINISTRATIVE AUTHORITY 12/05/2002
JOB RESPONSIBILITIES 12/10/1999
DIRECTOR'S QUALIFICATIONS 11/03/2011
CHILD CARE PRACTICES 11/29/1999
SAMPLE WEEKLY MENU 11/29/1999
DAILY SCHEDULE 12/05/2002
POLICIES 02/17/1999
DIAGRAM/OUTDOOR 11/16/1999
DIAGRAM/INDOOR 02/17/1999
SAFE SLEEP POLICY 02/24/2016
DISCIPLINE POLICIES 11/29/1999
ANNUAL DECLARATION 12/20/2021
EQUIPMENT LIST 01/19/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/19/2022
FIRE/SAFETY INSPECTION 08/30/2021
SANITATION INSPECTION 09/01/2021




Inspection determined facility to be in compliance with licensing rules.
Open Violations: NA
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
Violation
 Provider Comments
Violation
Posting requirements were not met as evidenced by the posted license was outdated.
Licensing Rule Reference
5 CSR 25-500.042 Licensing Process (12) states: Once granted, the license shall be posted near the entrance of the facility where it may be seen easily by parents or others who visit.
Correction Required
The official license shall be posted.

Correction Verification
Submit Documentation

Compliance Date
9/2/2022
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
Diapering requirements were not met as evidenced by the diapering table was not located where caregiver could maintain supervision of his/her group of children. The diapering table was located The diapering table was located in a separate room in which case the caregiver has their back to the class.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (4) (A) states: A safe diapering table with a waterproof washable surface shall be used for changing diapers. The diapering table shall be located within or adjacent to the group space so the caregiver using the diapering table can maintain supervision of his/her group of children at all times.
Correction Required
The facility shall provide a safe and clean diapering table as required.

Correction Verification
Submit Documentation

Compliance Date
9/14/2022
Violation
The facility's outdoor space was not safe for children's activities as evidenced by embedded rock is exposed to the walkway into the first play yard.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
9/2/2022
Violation
The bathroom was not clean and odor free as evidenced by the toilet 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
9/2/2022
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 the evacuation time was not recorded.
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
9/2/2022
5 CSR 25-500.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
The facility's disaster and emergency plan was not available in each room used for childcare as evidenced by the plan could not be located in 2 classrooms..
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster and emergency plan is readily available in the office area and in each room used for care of children;
Correction Required
The facilities disaster and emergency plan must be available in required locations.

Correction Verification
Submit Documentation

Compliance Date
9/2/2022
Violation
The facility’s name, address and telephone number was not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. A. states: The name, address, and telephone number of the facility;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date
9/2/2022
Violation
The facility's list of emergency numbers that are posted do not include the numbers for local radio station.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;
Correction Required
The facility must post all emergency numbers as required.

Correction Verification
Submit Documentation

Compliance Date
9/2/2022
5 CSR 25-500.092 Furniture, Equipment and Materials
Compliance
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: Kim Roam, Ashley Wheeler, Nicole Hall, Erin Jacobs and Haylee Harris
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
9/2/2022
Violation
Safe sleep training was not completed within the past 3 years for the following staff Ashley Wheeler.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) . states: Safe Sleep Training. Every three (3) years the center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 138, No. 5, November 1, 2016 and available at http://pediatrics.aappublications.org/content/pediatrics/early/2016/10/20/peds.2016-2938.full.pdf. This rule does not incorporate any subsequent amendments or additions.
Correction Required
The director, group home provider, other caregivers, and those volunteers counted in staff/child ratio, shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date
9/14/2022
Violation
Kim Roam, Nicole Hall, Erin Jacobs, Haylee Harris, and Genevie Chin 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
9/14/2022
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 Kim Roam, Nicole Hall and Erin Jacobs 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
9/2/2022
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
9/14/2022
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: Kim Roam, Ashely Wheeler, Nicole Hall, Erin Jacobs and Haylee Harris .
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
9/14/2022
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 12/6/21 and 8/2/21.
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
9/2/2022
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