DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

SUNDERLAND, GAYLA DAWN

002021038

(660) 373-0291

1001 S 12TH ST
BETHANY
MO  64424-1819

SUNDERLAND, GAYLA DAWN



 

SUNDERLAND, GAYLA DAWN

gayladsunderland@gmail.com


ELLEN DONOHO

6 WEEKS - 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 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; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS
 
Inspection Information

05/09/2024

10:10 AM

10:53 AM

UNANNOUNCED

COMPLIANCE MONITORING

2470103225


DocumentDocument-Date
POLICIES 12/05/2006
DIAGRAM/OUTDOOR 12/05/2006
DIAGRAM/INDOOR 12/05/2006
CHILD CARE/DISCIPLINE POLICIES 12/05/2006
SAMPLE WEEKLY MENU 12/05/2006
DAILY SCHEDULE 11/05/2006
ASSISTANT REFERENCES 01/25/2017
OWNER/PROVIDER REFERENCES 12/05/2006
ASSISTANT APPROVAL REQUEST 04/03/2017
APPLICATION 03/09/2019
SANITATION INSPECTION 01/17/2024
EQUIPMENT LIST 03/18/2024
FIRE/SAFETY INSPECTION 02/16/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/18/2024
ANNUAL DECLARATION 03/18/2024
SAFETY PLAN 03/18/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:10PM   5:10PM   10/7/2017



Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 3
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 1
Total Children 8
StaffChildClass AgeNote
1 8 MIXED 2-4 years 2- two year old children Catherine Klindt, staff

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
Compliance
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Compliance
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
Compliance
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 not present on form.
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

Violation
Child's medical examination report did not contain evidence that child’s current health is satisfactory for participation in a child care program.
Licensing Rule Reference
5 CSR 25-400.125 Medical Examination Reports (2) (B) states: Examination reports shall determine if a child’s medical history and current state of health is satisfactory for participation in a child care program.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The medical examination report and/or the school-age health report form(s) used were not supplied by the department or did not contain all the required information as evidenced by No admission date was on file and the child was school aged and no school aged medical form was present..
Licensing Rule Reference
5 CSR 25-400.125 Medical Examination Reports (2) (E) states: The medical examination report form and the health history report for school-age children shall be supplied by the department or the provider may use his/her own form if it contains all the information on the department's form. The School-Age Child Health Report 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
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
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