DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

HUMPTY DUMPTY DAYCARE

000679725

(573) 406-5107

301 S LANE
PALMYRA
MO  63461

HOBART, DAYNA RENA



 

HOBART, DAYNA RENA

DAYNA.HOBART@GMAIL.COM


BETHANY CARREL DUCKWORTH

6 WEEKS - 10 YEARS

20

GROUP HOME AND CENTER

4 CHILDREN UNDER 24 MONTHS
 
Inspection Information

08/21/2023

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2452936277


DocumentDocument-Date
DISASTER AND EMERGENCY PREPAREDNESS PLAN 05/02/2012
LINES OF ADMINISTRATIVE AUTHORITY 06/15/2009
DISCIPLINE POLICIES 05/28/2003
POLICIES 05/28/2003
SAMPLE WEEKLY MENU 03/18/2009
DAILY SCHEDULE 03/18/2009
OWNER/PROVIDER REFERENCES 12/16/1994
DIRECTOR'S QUALIFICATIONS 07/28/1999
DIAGRAM/INDOOR 01/26/2006
DIAGRAM/OUTDOOR 01/26/2006
CHILD CARE PRACTICES 05/28/2003
JOB RESPONSIBILITIES 06/18/2009
APPLICATION 03/26/2019
STAFF SHEET 03/26/2019
SAFE SLEEP POLICY 02/07/2019
REGISTERING FICTITIOUS NAMES 09/28/2016
FIRE/SAFETY INSPECTION 05/16/2023
SANITATION INSPECTION 04/17/2023
EQUIPMENT LIST 06/28/2023
ANNUAL DECLARATION 06/28/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 06/28/2023

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:00PM   5:00PM   7/20/2005



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 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Compliance
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
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
Compliance
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Breanna Garner and Camrie Stewart
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include:
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

Correction Verification
Submit Documentation

Compliance Date
8/18/2023
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
A medical examination report included either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) which was completed more than 12 months before beginning work in the facility for the following staff: Breanna Garner and Camrie Stewart.
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
8/18/2023
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
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