DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

MICKENS, CYNTHIA LORRAYNE

000402755

(816) 921-0526

3943 PASEO BLVD
KANSAS CITY
MO  64110-1311

MICKENS, CYNTHIA LORRAYNE



 

MICKENS, CYNTHIA LORRAYNE

cmickenspoj@gmail.com


PENNY SNODGRASS

BIRTH - 12 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

02/07/2024

10:30 AM

11:59 AM

UNANNOUNCED

COMPLIANCE MONITORING

2463890102


DocumentDocument-Date
ANNUAL DECLARATION 01/29/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/29/2024
ASSISTANT APPROVAL REQUEST 01/22/2016
CHILD CARE/DISCIPLINE POLICIES 01/31/2008
DAILY SCHEDULE 01/30/2008
SAMPLE WEEKLY MENU 08/24/1990
DIAGRAM/INDOOR 10/30/2007
DIAGRAM/OUTDOOR 10/30/2007
POLICIES 01/31/2008
APPLICATION 12/09/2019
EQUIPMENT LIST 01/29/2024
SANITATION INSPECTION 11/02/2022
FIRE/SAFETY INSPECTION 02/07/2023




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 8
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 5
StaffChildClass AgeNote
2 5 MIXED 2 children are 2 years old, 2 children are 3 years old and 1 child is 4 years old. Staff: Cynthia Mickens and Britney Jackson

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 annual sanitation inspection was not conducted.
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

Violation
The annual fire safety inspection was not approved.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.
Correction Required
The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
The premises were not safe and suitable as evidenced by observed a chest freezer on the outside deck that was not locked.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (A) states: The premises shall be safe and suitable for the care of children.
Correction Required
The premises shall be safe and suitable for the care of children.

Correction Verification
Corrected on Site

Compliance Date
2/7/2024
5 CSR 25-400.086 Fire Safety
Compliance
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 requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2023, the staff listed need the following information: Lamar Mickens (5) and Brittany Jackson (12).
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (4) (A) states: The provider shall obtain at least twelve (12) clock hours of child care-related training during each calendar year. Any assistant who works or volunteers more than five (5) hours per week shall meet the same training requirements. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

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
Violation
 Provider Comments
Violation
Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 2/13/23.
Licensing Rule Reference
5 CSR 25-400.125 Medical Examination Reports (2) (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School), 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
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by two (2) immunization record(s) was/were not on file .
Licensing Rule Reference
5 CSR 25-400.185 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been adequately immunized against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
One (1) child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-400.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
One (1) child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
5 CSR 25-400.210 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
One (1) child(ren) records did not include name and phone number of the family physician or hospital.
Licensing Rule Reference
5 CSR 25-400.210 Records and Reports (2) (D) states: Name and phone number of the family physician, or hospital, or both, to be used in an emergency.
Correction Required
Child enrollment information shall be completed and on file as required.

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