DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

ELLIOTT, KAREN ANN

000614562

(417) 588-1499

15186 GLENDALE RD
LEBANON
MO  65536-6637

ELLIOTT, KAREN ANN



 

ELLIOTT, KAREN ANN

karenelliott1957@icloud.com


ALLA GERASIMOVA

BIRTH - 13 YEARS

10

FAMILY HOME

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; IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER
 
Inspection Information

01/23/2024

12:00 PM

2:48 PM

UNANNOUNCED

COMPLIANCE MONITORING

2461470374


DocumentDocument-Date
SAMPLE WEEKLY MENU 12/01/1999
DAILY SCHEDULE 12/01/1999
CHILD CARE/DISCIPLINE POLICIES 12/01/1999
DIAGRAM/OUTDOOR 12/01/1999
DIAGRAM/INDOOR 12/01/1999
ASSISTANT APPROVAL REQUEST 09/26/2013
APPLICATION 10/28/2019
SANITATION INSPECTION 09/19/2023
FIRE/SAFETY INSPECTION 08/29/2023
EQUIPMENT LIST 12/04/2023
ANNUAL DECLARATION 12/04/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 12/04/2023

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:30PM   5:30PM   9/9/2019



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 5
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 2
Total Children 4
StaffChildClass AgeNote
2 4 MIXED Caregiver/provider Karen, Elliott and caregiver Karen Barker present with four children , including two 3 years old, one 8 years old and one 12 years old children.

 
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 Family Care Safety Registry check was not conducted for Karen Elliott, Karen Baker and Emily Elliott within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-400.055 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
Corrected on Site

Compliance Date
1/23/2024
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
Hazardous items as follows were accessible to children: a kitchen knife. The item(s) was/were located on the kitchen counter top. .
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
1/23/2024
Violation
Emergency numbers for the police, fire department, and ambulance were not posted.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (A) 11. states: Telephone numbers for the police, fire department, ambulance and other emergency telephone numbers shall be posted near the telephone.
Correction Required
Emergency numbers shall be posted near the telephone.

Correction Verification
Submit Documentation

Compliance Date

Violation
Hazardous items as follows were accessible to children: an air spray . The item(s) was/were located in a second bathroom , on the sink counter top.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
1/23/2024
5 CSR 25-400.086 Fire Safety
Compliance
5 CSR 25-400.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
The facility's disaster and emergency plan was not available in each room used for child care as evidenced by two bedrooms that are used for care of children were missing the Emergency Preparedness Plan.
Licensing Rule Reference
5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster emergency plan is readily available in the office area and in each room used for care of children.
Correction Required
The facilities disaster and emergency plan must be available in required locations.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility's name, address and telephone number was not posted in each room used for child care.
Licensing Rule Reference
5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (B) 1. A. states: The name, address, and telephone number of the facility.
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility's list of emergency numbers are not posted in each room used for child care, specifically in two bedrooms where the children sleep and play.
Licensing Rule Reference
5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station.
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date

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

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