DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

BOTTLES TO BANDITS

002484600

(573) 433-9710

206 W 4TH ST
DIXON
MO  65459-7906

DOBA, TARA MARIE



 

DOBA, TARA MARIE

tmdoba83@icloud.com


LACEY BERENDZEN

BIRTH - 10 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 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER
 
Inspection Information

03/20/2023

10:28 AM

11:47 AM

UNANNOUNCED

COMPLIANCE MONITORING

2443472093


DocumentDocument-Date
SANITATION INSPECTION 07/20/2022
APPLICATION 03/24/2021
CHILD CARE/DISCIPLINE POLICIES 04/19/2021
EQUIPMENT LIST 08/30/2022
LOCAL FIRE DEPARTMENT NOTIFICATION 04/01/2021
SAFE SLEEP POLICY 05/17/2021
SAMPLE WEEKLY MENU 05/18/2021
POLICIES 05/28/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN 06/07/2021
DIAGRAM/INDOOR 06/07/2021
DIAGRAM/OUTDOOR 06/07/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 08/30/2022
DAILY SCHEDULE 06/22/2021
REGISTERING FICTITIOUS NAMES 09/04/2015
ANNUAL DECLARATION 08/30/2022




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 7
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 1
Total Children 9
StaffChildClass AgeNote
1 9 MIXED Tara Doba with 9 children. One child age 1 year old, two children age 2 years old, and six children age 3-5 years old.

 
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
Violation
 Provider Comments
Violation
The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by no resilient material was present.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 6. states: The fall-zone area under and around outdoor equipment where children might fall and be injured shall be covered with impact absorbing materials which effectively cushions the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material. Grass may be an approved resilient material, but if grass becomes worn or sparse, the area must be covered with another approved resilient material.
Correction Required
The facility shall maintain approved resilient material in all fall-zone areas.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by a deteriorating cardboard box underneath the water table and a broken plastic inflatable ball in the right fence corner need to be removed from playground space.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 5. 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

Violation
Bathroom supplies were not available and accessible to children as evidenced by there were no paper towels.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (C) 1. C. states: An individual cloth towel for each child or paper towels, soap and toilet paper shall be provided and easily accessible so the children can reach them without assistance. If individual towels are used, they shall be laundered daily.
Correction Required
The facility shall provide required supplies accessible for children's use.

Correction Verification
Submit Documentation

Compliance Date

Violation
Hazardous items as follows were accessible to children: cans of paint. The item(s) was/were located in the unlocked kitchen closet to the left of the fridge.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
3/20/2023
5 CSR 25-400.086 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.
Licensing Rule Reference
5 CSR 25-400.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
Requirements of facility's participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.
Licensing Rule Reference
5 CSR 25-400.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.
Correction Required
Fire, tornado, or other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.095 Furniture, Equipment and Materials
Violation
 Provider Comments
Violation
Stationary equipment, green dome climber, was unsafe as evidenced by the equipment was not securely anchored.
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

Violation
The requirements for sleeping materials were not met as evidenced by 3 children 12 months or older, who nap or sleep, did not have a sheet.
Licensing Rule Reference
5 CSR 25-400.095 Furniture, Equipment and Materials 1 (B) 1 A states: A cot, bed, sofa, padded playpen or crib shall be provided for each child who naps or sleeps. An individually assigned sheet and blanket shall be provided for each child twelve (12) months and older who naps or sleeps. Upper levels of bunk beds shall not be used.
Correction Required
The facility shall provide sleeping equipment and bedding as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
One serving of fluid milk was not served with each meal.
Licensing Rule Reference
5 CSR 25-400.190 Nutrition and Food Service 1 (E) states: One (1) serving of fluid milk shall be served with each meal.
Correction Required
Milk shall be served as required.

Correction Verification
Corrected on Site

Compliance Date
3/20/2023
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
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
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance