DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

INSPECTION REPORT
Facility Information






 




 








 
Inspection Information








DocumentDocument-Date
ARTICLES OF INCORPORATION 07/27/2017
CHILD CARE PRACTICES 07/27/2017
DIAGRAM/INDOOR 07/27/2017
DIAGRAM/OUTDOOR 07/27/2017
DIRECTOR'S QUALIFICATIONS 01/28/2016
DISCIPLINE POLICIES 07/27/2017
LINES OF ADMINISTRATIVE AUTHORITY 07/27/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 07/27/2017
POLICIES 07/27/2017
SAMPLE FORMS 07/27/2017
LOCAL ZONING APPROVAL 07/27/2017
LOCAL BUILDING APPROVAL 07/27/2017
SAMPLE WEEKLY MENU 07/27/2017
DAILY SCHEDULE 06/16/2017
JOB RESPONSIBILITIES 06/16/2017
LLC ARTICLES OF ORGANIZATION 09/26/2016
LLC OPERATING AGREEMENT 09/26/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN 07/27/2017
SAFE SLEEP POLICY 07/27/2017
APPLICATION 02/22/2019
CERTIFICATE OF GOOD STANDING 06/04/2019
EQUIPMENT LIST 07/30/2024
FIRE/SAFETY INSPECTION 05/15/2021
ANNUAL DECLARATION 07/30/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 08/28/2024
SANITATION INSPECTION 05/14/2024




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 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Compliance
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
The premises were not safe and suitable as evidenced by the top portion of the glass door was shattered. This was located on the door that leads from the I/T play area into the gross motor room.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (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
Submit Documentation

Compliance Date
11/12/2024
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
Violation
 Provider Comments
Violation
A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Brianna Vanvickle.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number from the department.
Correction Required
All caregivers shall obtain a MOPD ID.

Correction Verification
Submit Documentation

Compliance Date
8/30/2024
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Jada Pulley.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberculin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date
8/30/2024
Violation
Medical examination report form did not contain all required information as evidenced by the facility used the correct form; however, the medical provider failed to select whether or not the staff member was in good physical and emotional health and free of contagious disease.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (D) states: The medical examination report form shall be supplied by the department or the facility may use its own form if it contains all the information on the department’s form. The Medical Examination Report for Caregivers and Staff 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
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/10/2024
5 CSR 25-500.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.
Correction Required
An individualized plan from a professional source shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/10/2024
5 CSR 25-500.142 Nighttime Care
Compliance
5 CSR 25-500.162 Overlap Care of Children
Compliance
5 CSR 25-500.172 Emergency School Closings
Compliance
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
Violation
 Provider Comments
Violation
The provider did not serve nourishing foods as specified by his/her parent in the written diet plan.
Licensing Rule Reference
5 CSR 25-500.202 Nutrition and Food Service (2) (A) states: The provider shall serve nourishing foods appropriate for the infant's nutritional requirements and developmental stages as specified by his/her parent(s) in a written diet plan.
Correction Required
A written diet plan shall be on file for each infant/toddler, updated as needed and followed by caregivers.

Correction Verification
Submit Documentation

Compliance Date
8/30/2024
5 CSR 25-500.212 Transportation and Field Trips
Compliance
5 CSR 25-500.222 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