MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
BLUE GOOSE CHILD CARE, LLC

Facility DVN
002320349

Phone
(314) 704-0683

Physical Address
598 VIRGINIA AVE
WEBSTER GROVES
MO 63119-4211

Owner
BLUE GOOSE CHILD CARE, LLC

Mailing Address

Provider/Director
GOBER, KAREN A

E-mail Address
karengober@sbcglobal.net

Incorporated

Child Care Specialist
TANISHA BELL

Age Range
6 WEEKS - 12 YEARS

Capacity
8

Facility Type
FAMILY HOME

Limitations
IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE 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 8 CHILDREN IN CARE, ALL CHILDREN MAY BE UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 8 CHILDREN NO MORE THAN 2 CHILDREN UNDER 2 WITH 1 ADULT

Inspection Information

Date
11/09/2022

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2435456603

Document	Document-Date
LLC ARTICLES OF ORGANIZATION	11/07/2011
OWNER/PROVIDER REFERENCES	04/24/2012
ASSISTANT REFERENCES	02/01/2013
SAMPLE FORMS	10/21/2011
SAMPLE WEEKLY MENU	10/21/2011
POLICIES	10/21/2011
DAILY SCHEDULE	10/21/2011
CHILD CARE/DISCIPLINE POLICIES	10/21/2011
DIAGRAM/OUTDOOR	10/21/2011
ASSISTANT APPROVAL REQUEST	10/21/2011
DIAGRAM/INDOOR	10/21/2011
APPLICATION	08/31/2018
SAFE SLEEP POLICY	10/01/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	10/25/2018
LLC OPERATING AGREEMENT	10/25/2018
CERTIFICATE OF GOOD STANDING	10/25/2018
ARTICLES OF INCORPORATION	02/19/2010
CERTIFICATE OF INCORPORATION	02/19/2010
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	10/01/2022
SANITATION INSPECTION	07/26/2022
FIRE/SAFETY INSPECTION	08/11/2022
EQUIPMENT LIST	10/01/2022
ANNUAL DECLARATION	10/01/2022

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 25-400.025 Organization and Administration

Compliance

5 CSR 25-400.045 Licensing Process

Compliance

5 CSR 25-400.055 Annual Requirements

Compliance

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Compliance

5 CSR 25-400.086 Fire Safety

Compliance

5 CSR 25-400.090 Disaster and Emergency Preparedness

Compliance

5 CSR 25-400.095 Furniture, Equipment and Materials

Compliance

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Compliance

5 CSR 25-400.115 Child Care Family and Household

Compliance

5 CSR 25-400.125 Medical Examination Reports

Compliance

5 CSR 25-400.135 Admission Policies and Procedures

Compliance

5 CSR 25-400.145 Nighttime Care

Compliance

5 CSR 25-400.155 Overlap Care of Children

Compliance

5 CSR 25-400.165 Emergency School Closings

Compliance

5 CSR 25-400.175 Child Care Program

Compliance

5 CSR 25-400.185 Health Care

Compliance

5 CSR 25-400.190 Nutrition and Food Service

Compliance

5 CSR 25-400.200 Transportation and Field Trips

Compliance

5 CSR 25-400.210 Records and Reports

Compliance

5 CSR 25-600.020 General Requirements

Violation

	Provider Comments
Violation Criminal background check results were not on file for H.G (Caregiver), A.S (Household member), B.G ( Caregiver), K.G (Director). Licensing Rule Reference 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department. Correction Required Required results of criminal background checks shall be on file. Correction Verification Submit Documentation Compliance Date 11/9/2022

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

RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.

Compliance