DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

INSPECTION REPORT
Facility Information






 




 








 
Inspection Information








DocumentDocument-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/30/2023
ARTICLES OF INCORPORATION 02/15/2017
DAILY SCHEDULE 02/15/2017
DIAGRAM/INDOOR 02/15/2017
DIAGRAM/OUTDOOR 02/15/2017
DIRECTOR'S QUALIFICATIONS 10/17/2014
DISCIPLINE POLICIES 02/15/2017
JOB RESPONSIBILITIES 02/15/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 02/15/2017
SAMPLE WEEKLY MENU 02/15/2017
CHILD CARE PRACTICES 02/15/2017
LINES OF ADMINISTRATIVE AUTHORITY 03/14/2017
POLICIES 02/21/2017
APPLICATION 01/30/2019
CERTIFICATE OF GOOD STANDING 01/11/2019
EQUIPMENT LIST 01/30/2023
LOCAL BUILDING APPROVAL 12/28/2018
LOCAL ZONING APPROVAL 12/28/2018
REGISTERING FICTITIOUS NAMES 12/28/2018
SAFE SLEEP POLICY 03/27/2017
SAMPLE FORMS 03/14/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN 02/15/2017
FIRE/SAFETY INSPECTION 12/21/2022
STAFF SHEET 02/23/2022
SANITATION INSPECTION 10/18/2022
ANNUAL DECLARATION 01/30/2023




Compliance Licensing Rules
Open Violations:
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

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
Not Observed
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
Not Observed
5 CSR 25-500.112 Staff/Child Ratios
Not Observed
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Tamera Rainey, Craig Crosby, Michelle Butler, Debora Whiteside, LaShauna Hunter and Pamela Williams, 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
6/2/2023
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: Tamera Rainey, Craig Crosby, Michelle Butler, Debora Whiteside, LaShauna Hunter and Pamela Williams,.
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
6/2/2023
Violation
The medical examination report and/or the school-age health report form(s) used was not supplied by the department or did not contain all the required information as evidenced by the forms for two children did not state they could participate in a child care program.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (2) (E) states: The medical examination report form and the health history report for school-age children shall be supplied by the department or the facility may use its own form if it contains all the information on the department’s form. The School-Age Child Health Report 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 athttps://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
5/15/2023
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
The requirements for administering medication were not met as follows: medication was given to a child without the length of time the medication may be given specified.
Licensing Rule Reference
5 CSR 25-500.192 Health Care (3) (B) states: All medication shall be given to a child only with the dated, written permission of the parent(s) stating the length of time medication may be given.
Correction Required
All medication shall be administered and recorded as required.

Correction Verification
Submit Documentation

Compliance Date
5/15/2023
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
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