DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

LEWIS, HOLLY LYNN

002186781

(785) 577-2190

1221 SW SUMMIT CROSSING DR
LEES SUMMIT
MO  64081-3264

LEWIS, HOLLY LYNN



 

LEWIS, HOLLY LYNN

holly.lewis082884@yahoo.com


RACHEL CATRELL

BIRTH - 10 YEARS

10

FAMILY HOME

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 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; UP TO 8 CHILDREN IN CARE, ALL CHILDREN MAY BE UNDER AGE 2 WITH 2 ADULT CAREGIVERS
 
Inspection Information

05/29/2025

3:03 PM

3:03 PM

UNANNOUNCED

SUPPLEMENTAL

2494198084


DocumentDocument-Date
SANITATION INSPECTION 01/24/2024
ANNUAL DECLARATION 01/08/2025
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/08/2025
EQUIPMENT LIST 01/08/2025
FIRE/SAFETY INSPECTION 10/24/2024




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 4
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 25-400.025 Organization and Administration
Not Observed
5 CSR 25-400.045 Licensing Process
Not Observed
5 CSR 25-400.055 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Patience Lewis, Nevaeh Lewis, Diasha Lewis, and Aireon Lewis 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
Submit Documentation

Compliance Date

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Not Observed
5 CSR 25-400.086 Fire Safety
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-61.086 Fire Safety were not met as evidenced by fire drills were not held at least one time each month.
Licensing Rule Reference
5 CSR 25-400.086 Fire Safety (2) (C) states: Child care staff shall conduct at least one (1) fire drill each month and a disaster drill at least every three (3) months. The disaster drills shall include tornado drills. The provider shall maintain a written record at the facility of the date, type of drill, time required to evacuate the building, and number of children present during the drill.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date
2/11/2025
5 CSR 25-400.090 Disaster and Emergency Preparedness
Not Observed
5 CSR 25-400.095 Furniture, Equipment and Materials
Not Observed
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel
Violation
 Provider Comments
Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Kaleiana Lewis, Patience Lewis, Nevaeh Lewis, and Diasha Lewis.
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (1) (J) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:
Correction Required
The provider shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2024, the staff listed need the following information: 5 hours for Holly Lewis and 4 hours for Sherman Lewis.
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
Not Observed
5 CSR 25-400.125 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: Holly Lewis and children older the age of 16 that want to be caring for children- Daisha Lewis, Patience Lewis, Kaleiana Lewis, Nevaeh Lewis, Keiair Lewis, Aireon Lewis, Jaylin Lewis.
Licensing Rule Reference
5 CSR 25-400.125 Medical Examination Reports (1) (E) . 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 tuberulin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date
3/20/2025
Violation
Medical examination report did not contain all required information as evidenced by No medical form that states they can work in childcare. Needed for Holly Lewis, Sherman Lewis and children older the age of 16 that want to be caring for children- Daisha Lewis, Patience Lewis, Kaleiana Lewis, Nevaeh Lewis, Keiair Lewis, Aireon Lewis, Jaylin Lewis.
Licensing Rule Reference
5 CSR 25-400.125 Medical Examination Reports (1) (G) states: The medical examination report form 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 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
3/20/2025
5 CSR 25-400.135 Admission Policies and Procedures
Not Observed
5 CSR 25-400.145 Nighttime Care
Not Observed
5 CSR 25-400.155 Overlap Care of Children
Not Observed
5 CSR 25-400.165 Emergency School Closings
Not Observed
5 CSR 25-400.175 Child Care Program
Not Observed
5 CSR 25-400.185 Health Care
Not Observed
5 CSR 25-400.190 Nutrition and Food Service
Not Observed
5 CSR 25-400.200 Transportation and Field Trips
Not Observed
5 CSR 25-400.210 Records and Reports
Not Observed
5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Holly Lewis, Sherman Lewis, Kaleiana Lewis, Patience Lewis, Nevaeh Lewis, and Diasha Lewis, and Aireon Lewis.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance