DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

EXCLUSIVE KIDZ ZONE

002835918

(314) 641-9882

3740 MARINE AVE
ST LOUIS
MO  63118-4175

EXCLUSIVE KIDZ ZONE

2813 LAFAYETTE AVE
ST LOUIS
MO  63104-2015

BLOUNT, TAMIKO

teneshabady@gmail.com

Incorporated

JOYCE E GREEN

4 YEARS - 12 YEARS

50

GROUP HOME AND CENTER

 
Inspection Information

08/22/2023

12:00 PM

12:00 PM

UNANNOUNCED

SUPPLEMENTAL

2453078214


DocumentDocument-Date
ARTICLES OF INCORPORATION 10/14/2019
CHILD CARE PRACTICES 10/21/2020
DIAGRAM/INDOOR 07/31/2020
DIAGRAM/OUTDOOR 10/21/2020
DISCIPLINE POLICIES 10/21/2020
EQUIPMENT LIST 06/29/2020
LINES OF ADMINISTRATIVE AUTHORITY 10/15/2020
JOB RESPONSIBILITIES 10/15/2020
STAFF SHEET 10/22/2020
SAMPLE WEEKLY MENU 10/21/2020
SAMPLE FORMS 07/22/2020
POLICIES 10/21/2020
LOCAL ZONING APPROVAL 10/05/2020
LOCAL BUILDING APPROVAL 10/05/2020
FIRE/SAFETY INSPECTION 08/09/2022
LOCAL FIRE DEPARTMENT NOTIFICATION 11/06/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/22/2020
DIRECTOR'S QUALIFICATIONS 10/28/2020
DAILY SCHEDULE 11/10/2020
CERTIFICATE OF GOOD STANDING 07/24/2020
APPLICATION 11/06/2020
CERTIFICATE OF GOOD STANDING 11/04/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/22/2020
DIRECTOR'S QUALIFICATIONS 10/28/2020
LOCAL FIRE DEPARTMENT NOTIFICATION 11/06/2020
SANITATION INSPECTION 08/18/2022




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

 
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
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for RB, RC, TG, LJ, TM, EC, EC2, DB and TB 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
5/24/2023
Violation
The facility is owned by a legal entity and evidence of good standing was not available.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.
Correction Required
The facility shall submit evidence that the legal entity is in good standing with the Missouri Secretary of State and state law.

Correction Verification
Submit Documentation

Compliance Date
5/24/2023
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
Violation
 Provider Comments
Violation
The director is not routinely on duty, as evidenced by Director Tamiko Blount was not present during the inspections conducted on May 4, 2022, November 29, 2022, and May 24, 2023, and the attendance records observed by CI Green during the inspection on May 24, 2023, showed she was on site less than one time a week. At the inspection conducted on May 4, 2022, CI Green was advised by staff that Tamiko Blount appears on site once every month. The facility has an approved variance on file that allows the director to be approved at three different locations. The variance conditions state that the Exclusive Kidz Zone Program Director will visit each program at least twice a week, and the CI will verify their visit through signatures on the Sign In/Out Sheets. A Sign In/Out Sheet was not observed during the inspections. The variance conditions are not being followed.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.
Correction Required
The director/group home provider shall be routinely on duty, as required.

Correction Verification
Submit Documentation

Compliance Date

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 RB, TM, EC2, DB and TB 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
5/24/2023
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: RB, TM, EC2, DB and TB.
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 tuberulin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date
5/24/2023
Violation
Medical examination report form did not contain all required information as evidenced by EC's form did not state that she could work in a child care facility.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (D) states: The medical examination report form 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 Medical Examination Report for Caregivers and Staff 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
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
5/24/2023
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
Not Observed
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