DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

TINY HEARTS LEARNING CENTER

002571051

(816) 548-0448

300 NE 58TH TER
GLADSTONE
MO  64118-4221

TINY HEARTS LEARNING CENTER, LLC

7026 N JARBOE ST
KANSAS CITY
MO  64118-1884

HALER, STEPHANIE EMERSON

Stephanie.tinyhearts@gmail.com


BIONICA D SMITHJACKSON

BIRTH - 12 YEARS

67

GROUP HOME AND CENTER

16 CHILDREN IN THE INFANT/TODDLER UNIT; 8 CHILDREN UNDER 12 MONTHS; 51 FULL DAY PRESCHOOL CHILDREN
 
Inspection Information

02/02/2023

11:56 AM

1:23 PM

UNANNOUNCED

REINSPECTION

2440637624


DocumentDocument-Date
LINES OF ADMINISTRATIVE AUTHORITY 03/31/2016
LLC ARTICLES OF ORGANIZATION 03/31/2016
LLC OPERATING AGREEMENT 03/31/2016
DIRECTOR'S QUALIFICATIONS 03/31/2016
DIAGRAM/OUTDOOR 03/31/2016
DIAGRAM/INDOOR 03/31/2016
DISCIPLINE POLICIES 03/31/2016
SAMPLE WEEKLY MENU 03/31/2016
CHILD CARE PRACTICES 03/31/2016
JOB RESPONSIBILITIES 03/31/2016
DAILY SCHEDULE 03/31/2016
POLICIES 03/31/2016
OWNER/PROVIDER REFERENCES 03/31/2016
SAMPLE FORMS 03/31/2016
LOCAL BUILDING APPROVAL 03/31/2016
LOCAL ZONING APPROVAL 03/31/2016
SAFE SLEEP POLICY 02/01/2016
APPLICATION 03/19/2021
EQUIPMENT LIST 04/11/2022
FIRE/SAFETY INSPECTION 04/01/2022
SANITATION INSPECTION 12/13/2021
ANNUAL DECLARATION 04/11/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/11/2022




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 11
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 9
Total Children 41
StaffChildClass AgeNote
1 4 INFANTS AND TODDLERS caregiver Hannah Cayton with four infants, all under 12 months
2 7 INFANTS AND TODDLERS caregivers Audrey Karabin and Ruby Burton with seven children, all under 24 months
1 11 MIXED caregiver Aaron Burton with eleven children, one 2-years old and ten 3-to-4-years old
2 8 MIXED caregivers Breanne Echols and Kaitlyn Thomas with eight children, five 2-years old and three-3-years old
2 0 NO CHILDREN IN ATTENDANCE caregivers Jessica Sinclair and Jessica Cude with no children
1 11 PRESCHOOL caregiver Myklynn Theno with eleven children, all 3-to-4-years old

Compliance List
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
Children were not restricted to approved space as evidenced by kitchen door and office door not locked.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.
Correction Required
Caregivers shall restrict children to approved space.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
The walls located 2's and 3's classrooms was/were not in good condition as evidenced by vents cover falling off walls.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
The floors located in upstairs hallway and 3's room was/were not clean as evidenced by dirty.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
The floors located several rooms was/were not clean as evidenced by dirty area rugs and mats.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

Violation
The walls located infant classroom by doorway; 1-year old classroom on south window sill, north wall on left and right of doorway and north door; 2-year old classroom bathroom door and window sill; pre-k classroom wall under chalkboard and east wall; 3-year old classroom wall by fishtank; 4/5-year old classroom by storage closet was/were not in good condition as evidenced by chipping and peeling paint.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
The floors located in 1-year old, 2-year old, and pre-k classrooms was/were not in good condition as evidenced by broken floor tiles.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
The walls located in 3 year old room was/were not in good condition as evidenced by chipping paint.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

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
Documentation of caregiver completion of the facility orientation was not on file for the following staff: all staff.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (L) states: The child care provider shall ensure that documentation of caregiver completion of the facility orientation is maintained and on file for review by the department.
Correction Required
Documentation of caregiver completion of the facility orientation shall be maintained and on file for review by the department as required.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
Background screening information was not available for review for all staff .
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
2/2/2023
Violation
A caregiver did not obtain one clock hour of training for each month of employment. The staff listed need the following information: Madison Cox- 5 hours, Angie Warren- 5 hours, Sarah Dobson- 5 hours.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (C) states: Caregivers who were employed after the first of the year shall obtain one (1) clock of hour training for each one (1) month of employment, regardless of the date employment began.
Correction Required
Required training hours shall be documented for each employee.

Correction Verification
Corrected on Site

Compliance Date
2/2/2023
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2021, the staff listed need the following information: AB-missing 1.5 hours, SH-missing 7.75 hours.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2021, the staff listed need the following information: Anna Sinclair- 4 hours.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

Violation
The director is not routinely on duty, as evidenced by director is not living in the state.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.
Correction Required
The director/group home provider shall be routinely on duty, as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Safe sleep training was not completed within the past 3 years for the following staff Ruby Burton, Madison Cox, Sarah Dobson, and Angie Warren.
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
2/2/2023
Violation
Hannah Cayton, Audrey Karabin, Jessica Cude, and Kaitlyn Tomlin did not complete safe sleep training within 30 days of employment or volunteering at the facility.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) (C) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall complete safe sleep training described in section (4) of this rule within thirty (30) days of employment or volunteering at the facility.
Correction Required
The department approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification
Submit Documentation

Compliance Date

Violation
Background screening information was not available for review for Kaitlyn Tomlin and Audrey Karabin, Breanne Echoles.
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

Violation
Documentation of caregiver completion of the facility orientation was not on file for the following staff: Kaitlyn Tomlin.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (L) states: The child care provider shall ensure that documentation of caregiver completion of the facility orientation is maintained and on file for review by the department.
Correction Required
Documentation of caregiver completion of the facility orientation shall be maintained and on file for review by the department as required.

Correction Verification
Corrected on Site

Compliance Date
2/2/2023
5 CSR 25-500.112 Staff/Child Ratios
Violation
 Provider Comments
Violation
Staff/child ratio requirements were not met as evidenced by 11 children, ages 3-to-4 years old, were cared for by 1 caregiver(s).
Licensing Rule Reference
5 CSR 25-500.112 Staff/Child Ratios (1) (C) states: Ages Three Through Four (3 - 4) Years. Groups composed solely of three (3)- and four (4)-year olds shall have no less than one (1) adult to ten (10) children;
Correction Required
Correct staff/child ratios shall be maintained.

Correction Verification
Return Inspection

Compliance Date

Violation
Staff/child ratio requirements were not met as evidenced by 11 children, ages 2-to-4-years old, were cared for by 1 caregiver(s).
Licensing Rule Reference
5 CSR 25-500.112 Staff/Child Ratios (1) (E) states: Mixed Age Groups Two Years (2) and Up. Groups composed of mixed ages of children two (2) years of age and older shall have no less than one (1) adult to ten (10) children with a maximum of four (4) two (2)-year olds. When there are more than four (4) two (2)-year olds in a mixed group, the staff/child ratio shall be no less than one (1) adult to eight (8) children.
Correction Required
Correct staff/child ratios shall be maintained.

Correction Verification
Return Inspection

Compliance Date

5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Myklynn Theno and Breanne Echoles as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Breanne Echoles.
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 tuberculin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Requirements for handwashing were not met as evidenced by caregiver didn't wash hands between diapering children.
Licensing Rule Reference
5 CSR 25-500.192 Health Care (6) (A) states: Caregivers shall wash their hands with soap and running water after toileting or assisting a child with toileting, after diapering a child, before food preparation or serving of food and at other times as needed.
Correction Required
Staff/children shall wash hands as required.

Correction Verification
Corrected on Site

Compliance Date
2/2/2023
Violation
Requirements for handwashing were not met as evidenced by children didn't wash hands after toileting.
Licensing Rule Reference
5 CSR 25-500.192 Health Care (6) (B) states: Caregivers shall teach children to wash their hands before eating and after toileting.
Correction Required
Staff/children shall wash hands as required.

Correction Verification
Corrected on Site

Compliance Date
2/2/2023
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
Violation
 Provider Comments
Violation
The provider failed to maintain accurate records to meet administrative requirements as evidenced by no records available to review.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (1) states: The child care provider shall maintain accurate records to meet administrative requirements and to ensure knowledge of the individual needs of children and their families.
Correction Required
Accurate records shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
7 child(ren) records did not include child's full name, address, date of birth and date care begins and ends.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
7 child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 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
2/2/2023
Violation
7 child(ren) records did not include name, address and telephone number of another individual who might be reached in an emergency.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
7 child(ren) records did not include name of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
7 child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
7 child(ren) records did not include name of individual authorized to take the child from the facility.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (E) states: Name of the individual(s) authorized to take the child from the facility;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
7 child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (F) states: Field trip and transportation authorization.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
An individual file was not kept for 7 child(ren).
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) . states: An individual file shall be kept to identify each child and enable the provider to communicate with the parent(s), guardian or legal custodian of the child in an emergency.
Correction Required
Accurate records shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
Daily attendance records were not maintained on file as evidenced by there was no child attendance record for all child(ren).
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (5) states: Daily child attendance records shall be maintained and kept on file a minimum of one (1) year.
Correction Required
Child attendance records shall be maintained and retained as required.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
Daily attendance records were not maintained on file as evidenced by there was no staff/volunteer attendance record for the following staff: all staff.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (6) states: Daily staff and volunteer attendance records shall be maintained and kept on file a minimum of one (1) year.
Correction Required
Staff/volunteer attendance records shall be maintained and retained as required.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
Enrollment, medical and attendance records were not accessible at all times as evidenced by files locked in cabinet and no key on premises.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (7) states: All enrollment records, medical examination records and attendance records shall be filed in a place known to caregivers and shall be accessible at all times. Records shall not be in a locked area or removed from the facility during the hours the facility is open and operating.
Correction Required
All required records shall be kept on file at the facility and accessible at all times.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
A copy of qualifying background screening results was/were not kept on file for: all staff.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (8) states: A copy of qualifying background screening results shall be kept on file for child care staff members, as required by 5 CSR 25-600.020 General Requirements.
Correction Required
The facility shall keep on file a copy of qualifying background screening results for child care staff member(s).

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
Violation
Records were not available for inspection by the department upon request as evidenced by files locked in cabinet with no key on premises.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (10) states: All records shall be available in the facility for inspection by the department upon request.
Correction Required
Records shall be available at the facility for inspection.

Correction Verification
Submit Documentation

Compliance Date
2/2/2023
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