MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
FAMILY SELF-HELP CENTER, INC.

Facility DVN
000199119

Phone
(417) 782-1772

Physical Address
1809 S CONNOR AVE
JOPLIN
MO 64804-1837

Owner
FAMILY SELF-HELP CENTER, INC.

Mailing Address

Provider/Director
STIVERS, ALICIA DAWN

E-mail Address
suzannesimek@lafayettehouse.org

Incorporated
Incorporated

Child Care Specialist
JENNIFER GOMEZ

Age Range
6 WEEKS - 12 YEARS

Capacity
67

Facility Type
GROUP HOME AND CENTER

Limitations
16 CHILDREN IN THE INFANT/TODDLER UNIT; 9 CHILDREN UNDER 12 MONTHS

Inspection Information

Date
12/19/2023

Arrival Time
11:30 AM

Departure Time
12:39 PM

Notice
UNANNOUNCED

Inspection Type
CLOSE SUPERVISION

Inspection ID
2461332561

Document	Document-Date
LOCAL ZONING APPROVAL	04/29/2009
LOCAL BUILDING APPROVAL	04/25/2005
JOB RESPONSIBILITIES	06/07/1993
CHILD CARE PRACTICES	05/19/1993
SAMPLE WEEKLY MENU	05/19/1993
DAILY SCHEDULE	04/30/1986
POLICIES	05/19/1993
DIAGRAM/OUTDOOR	07/06/1988
DIAGRAM/INDOOR	04/30/2003
DIRECTOR'S QUALIFICATIONS	05/01/2001
LINES OF ADMINISTRATIVE AUTHORITY	02/18/1986
ARTICLES OF INCORPORATION	10/15/1985
STAFF SHEET	03/14/2019
APPLICATION	03/14/2019
DISCIPLINE POLICIES	02/18/1986
SAFE SLEEP POLICY	01/29/2016
SAMPLE FORMS	10/21/2016
LOCAL FIRE DEPARTMENT NOTIFICATION	06/09/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN	06/09/2020
CERTIFICATE OF GOOD STANDING	04/23/2021
ANNUAL DECLARATION	05/23/2023
EQUIPMENT LIST	05/23/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	05/23/2023
SANITATION INSPECTION	04/12/2023
FIRE/SAFETY INSPECTION	05/10/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:00PM	5:00PM	5/24/2017

Inspection determined facility to be in compliance with 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.

Attendance at Time of Inspection

Total Staff 8

Total Children 26

Staff	Child	Class Age	Note
2	5	INFANTS AND TODDLERS	Caregivers Sara Mason and Avery Gage were present with five children, ages 3 -12 months old.
1	4	INFANTS AND TODDLERS	Caregiver Taylor McDown present with four children, ages 1-2 years old.
1	0	NO CHILDREN IN ATTENDANCE	Caregiver Kira Newhouse was present with no children in her care.
2	9	PRESCHOOL	Caregivers Sherri Brinkoetter and Alyssa Clines were present with nine children, ages 3-5 years old.
2	8	TWO YEAR OLDS	Caregivers Lily Williams and Tannio Willis were present with eight children, all 2 years of age.


5 CSR 25-500.032 Organization and Administration Compliance
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 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 Compliance
5 CSR 25-500.112 Staff/Child Ratios Compliance
5 CSR 25-500.122 Medical Examination Reports Not Observed
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 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 Not Observed
5 CSR 25-500.222 Records and Reports Not Observed
5 CSR 25-600.020 General Requirements Compliance
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