DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

MERCY HOSPITAL SPRINGFIELD

000180709

(417) 820-7955

1831 S FREMONT AVE
SPRINGFIELD
MO  65804

MERCY HOSPITAL SPRINGFIELD

1235 E CHEROKEE ST
SPRINGFIELD
MO  65804-2203

GHAN, KARA GAY

Kara.Ghan@mercy.net

Incorporated

BILLIE RUSSELL

6 WEEKS - 12 YEARS

133

GROUP HOME AND CENTER

16 CHILDREN IN THE INFANT/TODDLER UNIT
 
Inspection Information

12/15/2022

10:30 AM

12:14 PM

UNANNOUNCED

COMPLIANCE MONITORING

2437643305


DocumentDocument-Date
SAMPLE WEEKLY MENU 10/24/1984
POLICIES 10/21/2009
LOCAL ZONING APPROVAL 10/05/2005
LOCAL BUILDING APPROVAL 10/05/2005
LINES OF ADMINISTRATIVE AUTHORITY 01/26/1982
JOB RESPONSIBILITIES 10/31/1997
DISCIPLINE POLICIES 10/21/2009
DIRECTOR'S QUALIFICATIONS 05/19/2006
DAILY SCHEDULE 10/24/1997
ARTICLES OF INCORPORATION 03/24/1982
CHILD CARE PRACTICES 10/21/2009
CERTIFICATE OF GOOD STANDING 08/29/2013
DIAGRAM/INDOOR 08/14/2014
DIAGRAM/OUTDOOR 08/15/2014
APPLICATION 09/26/2019
SAFE SLEEP POLICY 10/09/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/09/2019
STAFF SHEET 12/22/2020
FIRE/SAFETY INSPECTION 09/20/2021
SANITATION INSPECTION 11/03/2022
EQUIPMENT LIST 11/01/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 11/01/2022
ANNUAL DECLARATION 11/01/2022




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.
Attendance at Time of Inspection
Total Staff 14
Total Children 52
StaffChildClass AgeNote
1 4 INFANTS AND TODDLERS KW was with 14 to 18 month old children.
1 3 INFANTS AND TODDLERS EW was with 4 to 10 month old children.
2 0 NO CHILDREN IN ATTENDANCE Additional staff in building: KG and LH.
2 9 PRESCHOOL SM and CH were with 4 year old children.
2 7 PRESCHOOL WT and RB were with 3 year old children.
2 7 PRESCHOOL MC and RM were with 4 and 5 year old children.
1 7 PRESCHOOL DL was with 4 year old children.
2 9 TWO YEAR OLDS MB and KG were with 2 year old children.
1 6 TWO YEAR OLDS KJ was with 2 year old children.

 
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Violation
 Provider Comments
Violation
The annual fire safety inspection was not conducted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.
Correction Required
The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification
Submit Documentation

Compliance Date

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
Compliance
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