DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

CALIFORNIA KIDS, LLC

002553204

(573) 796-2058

800 LAKE DR
CALIFORNIA
MO  65018-2022

CALIFORNIA KIDS, LLC



 

ROLL, ANNY NICOLE

californiakidsllc@gmail.com


LACEY BERENDZEN

6 WEEKS - 12 YEARS

38

GROUP HOME AND CENTER

12 CHILDREN IN THE INFANT/TODDLER UNIT; 9 CHILDREN UNDER 12 MONTHS
 
Inspection Information

09/20/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2431383435


DocumentDocument-Date
LLC OPERATING AGREEMENT 09/01/2015
LLC ARTICLES OF ORGANIZATION 09/01/2015
LINES OF ADMINISTRATIVE AUTHORITY 09/01/2015
DIRECTOR'S QUALIFICATIONS 09/11/2015
DIAGRAM/INDOOR 09/18/2015
DIAGRAM/OUTDOOR 09/18/2015
SAMPLE WEEKLY MENU 10/08/2015
DISCIPLINE POLICIES 10/26/2015
CHILD CARE PRACTICES 10/26/2015
POLICIES 10/26/2015
SAMPLE FORMS 10/28/2015
JOB RESPONSIBILITIES 11/02/2015
DAILY SCHEDULE 11/04/2015
OWNER/PROVIDER REFERENCES 11/04/2015
LOCAL FIRE DEPARTMENT NOTIFICATION 11/04/2015
APPLICATION 09/04/2019
STAFF SHEET 09/04/2019
SANITATION INSPECTION 07/07/2021
EQUIPMENT LIST 11/02/2021
ANNUAL DECLARATION 11/02/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 11/02/2021
FIRE/SAFETY INSPECTION 11/08/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:00PM   5:00PM   11/4/2015



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
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
Background screening information was not available for review for Darla Roll, Jazmine Salmons, Breanna Walker, and Tyanna Busch.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (Q) states: Background screening information received by the provider shall be retained in the individual’s file in a confidential manner and available for review.
Correction Required
Background screening information shall be available and kept confidential.

Correction Verification
Submit Documentation

Compliance Date
9/14/2022
Violation
Safe sleep training was not completed within the past 3 years for the following staff Darla Roll, Breanna Walker, Tyanna Busch, and Jazmine Salmons.
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
9/20/2022
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Compliance
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