DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

APPLESEED DAYCARE, LLC

002734803

(660) 243-4340

706 MAIN ST
WAVERLY
MO  64096-8127

APPLESEED DAYCARE, LLC

29029 HIGHWAY 24
WAVERLY
MO  64096-9115

FORD, AMANDA JENE

APPLESEEDDAYCARELLC@GMAIL.COM


JONATHAN BRADLEY

BIRTH - 11 YEARS

32

GROUP HOME AND CENTER

 
Inspection Information

12/28/2022

10:10 AM

10:10 AM

UNANNOUNCED

SUPPLEMENTAL

2438032248


DocumentDocument-Date
APPLICATION 11/20/2019
SAMPLE WEEKLY MENU 01/29/2020
DAILY SCHEDULE 01/29/2020
DIAGRAM/INDOOR 01/08/2019
CHILD CARE PRACTICES 01/29/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 01/29/2020
SAFE SLEEP POLICY 01/29/2020
JOB RESPONSIBILITIES 01/29/2020
LOCAL FIRE DEPARTMENT NOTIFICATION 01/29/2020
CERTIFICATE OF GOOD STANDING 01/29/2020
LINES OF ADMINISTRATIVE AUTHORITY 01/29/2020
LLC ARTICLES OF ORGANIZATION 01/29/2020
LLC OPERATING AGREEMENT 01/29/2020
SAMPLE FORMS 01/29/2020
DIAGRAM/OUTDOOR 01/29/2020
DISCIPLINE POLICIES 01/31/2020
POLICIES 01/31/2020
LOCAL BUILDING APPROVAL 03/08/2021
LOCAL ZONING APPROVAL 03/08/2021
EQUIPMENT LIST 03/29/2022
STAFF SHEET 03/29/2022
SANITATION INSPECTION 12/17/2021
FIRE/SAFETY INSPECTION 12/22/2021
ANNUAL DECLARATION 03/29/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/29/2022




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.

 
5 CSR 25-500.032 Organization and Administration
Not Observed
5 CSR 25-500.042 Licensing Process
Not Observed
5 CSR 25-500.052 Annual Requirements
Not Observed
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
The facility's outdoor space was not safe for children's activities as evidenced by the lack of parking barrier between the parking area and the playground and all along the front of the building.
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
10/4/2022
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 in the I/T room.
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
8/22/2022
Violation
Diapering requirements were not met as evidenced by the diapering table was not safe in that the diapering mats easily slide on the counter used for diaper changing and there is no barrier to keep them from falling off in the 2's, pre-k, and I/T room.
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

5 CSR 25-500.087 Fire Safety
Not Observed
5 CSR 25-500.090 Disaster and Emergency Preparedness
Not Observed
5 CSR 25-500.092 Furniture, Equipment and Materials
Not Observed
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
Safe sleep training was not completed within the past 3 years for the following staff LLC Members: John Harris, Erin Harris, John Christopherson, Amanda Christopherson, Steven Cramer, Ashley Cramer.
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
11/1/2022
5 CSR 25-500.112 Staff/Child Ratios
Not Observed
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
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: Tyra Brown.
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
8/22/2022
5 CSR 25-500.132 Admission Policies and Procedures
Not Observed
5 CSR 25-500.142 Nighttime Care
Not Observed
5 CSR 25-500.162 Overlap Care of Children
Not Observed
5 CSR 25-500.172 Emergency School Closings
Not Observed
5 CSR 25-500.182 Child Care Program
Not Observed
5 CSR 25-500.192 Health Care
Not Observed
5 CSR 25-500.202 Nutrition and Food Service
Not Observed
5 CSR 25-500.212 Transportation and Field Trips
Not Observed
5 CSR 25-500.222 Records and Reports
Not Observed
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