DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

HUMMEL, REBECCA PATTUGALAN

001911131

(417) 823-7868

3870 S HOMEWOOD ST
SPRINGFIELD
MO  65807-3963

HUMMEL, REBECCA PATTUGALAN



 

HUMMEL, REBECCA PATTUGALAN

RPATHUMMEL@GMAIL.COM


ELAINE S COX

BIRTH - 13 YEARS

10

FAMILY HOME

IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 2 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS
 
Inspection Information

12/23/2022

12:10 PM

12:10 PM

UNANNOUNCED

SUPPLEMENTAL

2432067947


DocumentDocument-Date
DIAGRAM/INDOOR 01/24/2005
DIAGRAM/OUTDOOR 01/24/2005
DAILY SCHEDULE 01/24/2005
SAMPLE WEEKLY MENU 01/24/2005
SAMPLE FORMS 01/24/2005
POLICIES 01/24/2005
OWNER/PROVIDER REFERENCES 03/14/2005
ASSISTANT REFERENCES 01/15/2013
CHILD CARE/DISCIPLINE POLICIES 01/24/2005
LOCAL FIRE DEPARTMENT NOTIFICATION 01/31/2018
ASSISTANT APPROVAL REQUEST 01/23/2018
SAFE SLEEP POLICY 08/03/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/03/2018
SAFETY PLAN 03/10/2021
SANITATION INSPECTION 12/03/2021
FIRE/SAFETY INSPECTION 11/18/2021
EQUIPMENT LIST 03/01/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/01/2022
ANNUAL DECLARATION 03/01/2022

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:15PM   5:15PM   1/9/2015



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
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 25-400.025 Organization and Administration
Not Observed
5 CSR 25-400.045 Licensing Process
Not Observed
5 CSR 25-400.055 Annual Requirements
Not Observed
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Not Observed
5 CSR 25-400.086 Fire Safety
Not Observed
5 CSR 25-400.090 Disaster and Emergency Preparedness
Not Observed
5 CSR 25-400.095 Furniture, Equipment and Materials
Violation
 Provider Comments
Violation
Stationary equipment, swings and slides, 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 then 24 inches.
Licensing Rule Reference
5 CSR 25-400.095 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
10/3/2022
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel
Violation
 Provider Comments
Violation
The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification.
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date
10/3/2022
Violation
The requirements for first aid and CPR certification were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification.
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (S) states: The provider shall have documentation on file at the home of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. First aid/CPR training may count toward the annual clock hour training requirement.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date
10/3/2022
Violation
The provider does not have an assistant available.
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (3) (A) states: The provider shall have at least one assistant available.
Correction Required
The provider shall name at least one assistant.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.115 Child Care Family and Household
Not Observed
5 CSR 25-400.125 Medical Examination Reports
Not Observed
5 CSR 25-400.135 Admission Policies and Procedures
Not Observed
5 CSR 25-400.145 Nighttime Care
Not Observed
5 CSR 25-400.155 Overlap Care of Children
Not Observed
5 CSR 25-400.165 Emergency School Closings
Not Observed
5 CSR 25-400.175 Child Care Program
Not Observed
5 CSR 25-400.185 Health Care
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file .
Licensing Rule Reference
5 CSR 25-400.185 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 adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of 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 completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
10/3/2022
5 CSR 25-400.190 Nutrition and Food Service
Not Observed
5 CSR 25-400.200 Transportation and Field Trips
Not Observed
5 CSR 25-400.210 Records and Reports
Violation
 Provider Comments
Violation
1 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-400.210 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
10/7/2022
Violation
1 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-400.210 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
10/7/2022
5 CSR 25-600.020 General Requirements
Not Observed
5 CSR 25-600.040 Background Screening Findings
Not Observed
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.
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance