DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

INSPECTION REPORT
Facility Information






 




 








 
Inspection Information








DocumentDocument-Date
SAMPLE WEEKLY MENU 06/18/2002
DAILY SCHEDULE 06/18/2002
CHILD CARE/DISCIPLINE POLICIES 06/18/2002
DIAGRAM/OUTDOOR 06/18/2002
DIAGRAM/INDOOR 06/18/2002
APPLICATION 06/08/2018
FIRE/SAFETY INSPECTION 07/10/2023
SANITATION INSPECTION 01/26/2022
ANNUAL DECLARATION 08/22/2022
EQUIPMENT LIST 08/22/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 08/22/2022




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 25-400.025 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

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

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

Violation
The annual sanitation inspection was not approved.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.
Correction Required
The facility shall submit evidence of compliance with annual sanitation requirements.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
When children were outdoors, there was inadequate adult supervision as evidenced by 2 children under three years of age were observed without a caregiver.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 3. states: An adult shall be outside at all times to provide supervision for children under three (3) years of age.
Correction Required
Adult supervision shall be provided at all times.

Correction Verification
Return Inspection

Compliance Date

Violation
The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by bare ground in the fall zones of the slide and swinging piece of play equipment.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 9. states: Concrete, asphalt, carpet or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.
Correction Required
The facility shall maintain approved resilient material in all fall-zone areas.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.086 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.
Licensing Rule Reference
5 CSR 25-400.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by the disaster and tornado drill was not held at least one time every three months.
Licensing Rule Reference
5 CSR 25-400.086 Fire Safety 2 (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
The following information for the assistant(s) was not posted as required: the name, address and telephone number of the assistant(s) was not posted with emergency numbers.
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (3) (B) states: The names, addresses, and telephone numbers of all assistants shall be posted with other emergency numbers in the home.
Correction Required
Assistant information shall be posted.

Correction Verification
Submit Documentation

Compliance Date

Violation
Safe sleep training was not completed within the past 3 years for the assistant(s), Suzanne Putman.
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) (A) . states: Every three (3) years the provider, assistant(s), and volunteers in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs dese-administrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.
Correction Required
The child care provider and assistant(s) shall complete department-approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information as evidenced by provider did not have permission for emergency medical care.
Licensing Rule Reference
5 CSR 25-400.135 Admission Policies and Procedures (6) (E) 3 states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
The diapering table or other approved area did not have a waterproof surface.
Licensing Rule Reference
5 CSR 25-400.175 Child Care Program 1 (E) 1 states: A safe diapering table or other approved area with a waterproof, washable surface shall be used for changing diapers. The table or area shall be cleaned thoroughly with a disinfectant after each use.
Correction Required
The facility shall provide a safe and clean diapering table as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
A copy of qualifying background screening results was/were not kept on file for: Julie Graves, Ray Graves and Suzanne Putman.
Licensing Rule Reference
5 CSR 25-400.210 Records and Reports (8) states: A copy of qualifying background screening results shall be kept on file for child care staff members, as required by 5 CSR 25-600.020 General Requirements.
Correction Required
The child care provider shall keep on file a copy of qualifying background screening results for child care staff member(s).

Correction Verification
Submit Documentation

Compliance Date

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