DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

BLAIR, DONNA K

001563660

(417) 546-3990

614 ROCKHILL DR
FORSYTH
MO  65653-5383

BLAIR, DONNA K

PO BOX 941
FORSYTH
MO  65653-0941

BLAIR, DONNA K

larryblair65614@yahoo.com


PENNY KREITZER

6 WEEKS - 12 YEARS

20

GROUP HOME AND CENTER

4 CHILDREN UNDER 24 MONTHS
 
Inspection Information

04/24/2023

1:52 PM

3:33 PM

UNANNOUNCED

CLOSE SUPERVISION

2445927158


DocumentDocument-Date
SANITATION INSPECTION 06/06/2022
FIRE/SAFETY INSPECTION 07/18/2022
SAFE SLEEP POLICY 12/09/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 12/09/2019
OWNER/PROVIDER REFERENCES 02/20/2001
SAMPLE WEEKLY MENU 12/01/2011
POLICIES 07/23/2009
LOCAL BUILDING APPROVAL 12/20/2001
LOCAL ZONING APPROVAL 12/20/2001
LINES OF ADMINISTRATIVE AUTHORITY 12/20/2001
JOB RESPONSIBILITIES 12/20/2001
DISCIPLINE POLICIES 07/23/2009
DIRECTOR'S QUALIFICATIONS 01/02/2001
DIAGRAM/OUTDOOR 10/28/2004
DIAGRAM/INDOOR 08/05/2004
DAILY SCHEDULE 12/01/2001
CHILD CARE PRACTICES 07/23/2009
APPLICATION 06/26/2019
STAFF SHEET 06/26/2019
EQUIPMENT LIST 12/08/2021
LOCAL FIRE DEPARTMENT NOTIFICATION 07/10/2017
ANNUAL DECLARATION 12/08/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 12/08/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:15PM   5:15PM   6/11/2013



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 12
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 3
Total Children 14
StaffChildClass AgeNote
3 14 MIXED Tammy Pollard, Donna Blair and Yanira Contras, Caregivers, with 2 infants, ages 8 and 9 months, 1 one year old child, 2 two year old children, 8 preschool age children and 1 school age child.

 
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 Family Care Safety Registry check was not conducted for Carol Gilmore within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Submit Documentation

Compliance Date
4/24/2023
Violation
The staff sheet was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (D) states: A current staff sheet.
Correction Required
The facility shall submit a current staff sheet as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The equipment list was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (C) states: A current list of available equipment.
Correction Required
The facility shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Evidence of local zoning approval was not received.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (B) states: Evidence of compliance with local building and zoning requirements, if applicable.
Correction Required
The facility shall submit evidence of local building/zoning approval as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Evidence of local building approval was not received.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (B) states: Evidence of compliance with local building and zoning requirements, if applicable.
Correction Required
The facility shall submit evidence of local building/zoning approval as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.
Correction Required
The facility shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date

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 the gate to restrict children's access to the back yard and the steps leading to the back yard was not in place.
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
Corrected on Site

Compliance Date
4/24/2023
Violation
Hazardous items as follows were accessible to children: diaper cream. The item(s) was/were located in a basket on the sink in the children's bathroom.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) 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
Submit Documentation

Compliance Date
3/29/2023
Violation
The provider did not provide resilient material necessary for the protection of children as evidenced by the roller coaster slide was not placed in the area with sufficient resilient surfacing to protect children in case of a fall.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 6. states: The provider shall be responsible for the type, depth and fall-zone area of resilient material necessary for the protection of children.
Correction Required
Appropriate type, depth and fall zone area of resilient material shall be provided for the protection of children.

Correction Verification
Submit Documentation

Compliance Date
3/29/2023
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
Violation
 Provider Comments
Violation
Furniture/equipment, the closet door, in the orange play room was not free of sharp parts as evidenced by a missing handle left the pointed part of a screw exposed. This was observed again on 3/23/2023.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.
Correction Required
The facility shall provide safe and clean furniture/equipment as required.

Correction Verification
Submit Documentation

Compliance Date
3/29/2023
Violation
An infant was observed sleeping in a/an swing.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. I states: Sitting devices such as car safety seats, strollers, swings, infant carriers, infant slings, and other sitting devices shall not be used for sleep/nap time. Infants who fall asleep anywhere other than a crib, portable crib, or playpen shall be placed in the crib or playpen for the remainder of their sleep or nap time.
Correction Required
Infants shall only sleep in a crib, portable crib, or playpen.

Correction Verification
Return Inspection

Compliance Date
4/24/2023
Violation
Requirements for feeding equipment for infants and toddlers who are unable to sit at a table were not met as evidenced by the restraints were not available.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (1) (C) 2. states: Infants and toddlers. Infants and toddlers who are unable to sit at a table shall have one (1) piece of mealtime feeding equipment for every four (4) infant/toddlers which may include feeding tables, high chairs, infant seats or other safely designed infant seating equipment. Equipment shall be provided which will allow the child to sit comfortably and securely while being fed. Appropriate restraints shall be used.
Correction Required
Safe and secure feeding equipment shall be provided as required.

Correction Verification
Submit Documentation

Compliance Date
4/24/2023
Violation
The seats of swings in the outdoor play area did not have lightweight seats of rubber, plastic, canvas or nylon as evidenced by a saucer swing was present on the swing set which has a metal frame per the Provider.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (3) (G) states: Swings shall have lightweight seats of rubber, plastic, canvas or nylon.
Correction Required
Swing seats shall be constructed of an approved material.

Correction Verification
Submit Documentation

Compliance Date
4/24/2023
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
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: Donna Blair needs 6 clock hours, Tammy Pollard needs 12 clock hours, and Kate Turner needs 7 clock hours. As of the 5/19/2022 inspection, the director stated Kate Turner is no longer employed and Donna Blair's 6 hours were observed to be in OPEN . Tammy Pollard still needs 12 clock hours for 2021. As of the inspection dated 8/26/22, Tammy Pollard still needs 12 clock hours for 2021. On 3/23/23, OPEN was observed to show Tammy Pollard had completed 12 clock hours in 2021, but Donna Blair still needs 6 additional clock hours for 2021.
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 first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate first aid was not on site.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid/CPR were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification for the requested/licensed capacity.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid/CPR were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification for the requested/licensed capacity.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate CPR was not on site.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be approved by the department.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 10/10/2022.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is incorporated by reference in this rule, as published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
1 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
4/24/2023
Violation
1 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
4/24/2023
5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Donna Blair, Tammy Pollard, Carol Gilmore, Meghan Holvick and Kaily Burton. On 3/23/2023, criminal background checks were not on file for Donna Blair, Tammy Pollard, Carol Gilmore and Yanira Contras. On 4/24/2023, only the results for Yanira Contras were still needed.
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

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