DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

A LITTLE PIOLIN

002860462

(913) 710-0339

1115 S COTTAGE ST
INDEPENDENCE
MO  64050-4349

RAY, CITLALI



 

RAY, CITLALI

alittlepiolin.fcch@gmail.com


ROBYN EMBREE

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

06/26/2023

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2449645681


DocumentDocument-Date
APPLICATION 10/22/2020
DIAGRAM/INDOOR 05/21/2021
DAILY SCHEDULE 05/21/2021
LOCAL FIRE DEPARTMENT NOTIFICATION 05/21/2021
CHILD CARE/DISCIPLINE POLICIES 07/14/2021
DIAGRAM/OUTDOOR 05/24/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN 07/02/2021
REGISTERING FICTITIOUS NAMES 11/07/2020
SAFETY PLAN 07/14/2021
POLICIES 07/14/2021
SAFE SLEEP POLICY 07/14/2021
SAMPLE WEEKLY MENU 05/24/2021
LICENSING ORIENTATION 09/20/2020
FIRE/SAFETY INSPECTION 03/22/2023
SANITATION INSPECTION 03/02/2023
EQUIPMENT LIST 06/22/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 06/22/2022
ANNUAL DECLARATION 06/22/2022




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: NA
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 25-400.025 Organization and Administration
Compliance
5 CSR 25-400.045 Licensing Process
Compliance
5 CSR 25-400.055 Annual Requirements
Violation
 Provider Comments
Violation
The equipment list was not submitted.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (1) (B) states: A current list of available equipment.
Correction Required
The child care provider shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date
6/26/2023
Violation
The listing of household members and assistants was not submitted.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (1) (C) states: A listing of household members and assistant(s).
Correction Required
The child care provider shall submit a listing of all household members and assistants.

Correction Verification
Submit Documentation

Compliance Date
6/26/2023
Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-400.055 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 family child care home and agreement to comply with all statutes and department licensing rules;
Correction Required
The child care provider shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date
6/26/2023
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by a broken table was present that contained broken ceramic and broken wood.
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
6/26/2023
5 CSR 25-400.086 Fire Safety
Compliance
5 CSR 25-400.090 Disaster and Emergency Preparedness
Compliance
5 CSR 25-400.095 Furniture, Equipment and Materials
Compliance
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
Compliance
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