Missouri Department of Health and Senior Services November 14 ...

November 14, 2011
Missouri Department of Health and Senior Services
P.O. Box 570, Jefferson City, MO 65102-0570 Phone: 573-751-6400 FAX: 573-751-6010
RELAy MISSOURI for Hearing and Speech Impaired 1-800-735-2966 VOICE 1-800-735-2466
Margaret T. Donnelly
Director
Alisa Weaver
5526 Jennings Station Road
St. Louis, MO 63136
SUBJECT: DVN 002147126
Dear Alisa Weaver:
Jeremiahf' • (Jay) Nixon
Go emor
As you are aware, the Section for Child Care Regulation (SCCR) received a complaint allegi g rule
violation(s) at your facility on October 25,2011. The allegation(s), the details of the investi ation, the
substantiated licensing rule violations(s), and correction(s) for compliance with licensing rul s are
included on the enclosed Substantiated Complaint BCC-50 form.
Substantiated allegations are placed in the facility's public licensing record retained in the SCCR district
office. You may reply to this report in writing. If you choose to reply, your response will be filed with
the report in the facility's licensing record. We welcome any questions at 314.877.0208.
Sincerely,
Brooke Poskin
Child Care Facility Specialist
Enclosure
-------------------+---------------------------------
www.health.mo.gov
Healthy Missourians for life.
The Missouri Department of Health and Senior Services will be the leader in promoting, protecting and partnering for health.
AN EQUAL OPPORTUNITY I AFFIRMATIVE ACTION EMPLOYER: Services provided on a nondiscriminatory basis.

FACILITY NAME
Alisa Weaver
MISSOURI DEPARTMENT OF HEALTH & SENIOR SERVICES
BUREAU OF CHILD CARE
SUBSTANTIATED COMPLAINT
OF STATUTE OR RULE VIOLATIONS
STREET ADDRESS
5526 Jennings Station Road
CITY ZIP CODE
St. Louis 63136
REPORTER: 181 NAMED
o WITHHELD BY REQUEST
o ANONYMOUS
REPORTER NAME
Pearlynn Harris
REPORTER ADDRESS (STREET, CITY, STATE, ZIP CODE)
Social Services
PHONE
314.802.8141
REPORT MADE: 0 IN PERSON
o PHONE
181 WRITIEN
REPORTER PHONE
DATE OF REPORT
10.25.11
FACILITY TYPE
o HOME
o GROUP HOME/CENTER
o INSPECTED
o UNLICENSED MORE THAN FOUR
FACILITY NUMBER
002147126
RECEIVED BY SUPERVISOR
Jada Spears Brooke Poskin Nancy Scherer
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FACILITY CO~NTY
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DATE

Disposition: (Poskin)
.)
ALLEGATIONS
Alisa Weaver
5526 Jennings Station Road
St. Louis, MO 63136
002147126
Page 1 of 7
On October 25, 2011, the Section for Child Care Regulation (SCCR)received a report of rule violation(s)
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stating that the provider, Ms. Alisa Weaver, claimed she cared for 42 children in the month of
September 2011.
SUMMARY OF INVESTIGATION
Upon CCFSBrooke Poskin's request, Kelly Frye, a Program Development Specialist with the Early
Childhood and Prevention Services Missouri Children's Division Central Office, sent CCFSPoskin copies
of Ms. Alisa Weaver's September 2011 claim for child care payment.
According to the payment claim, Ms. Weaver was paid for child care services for 42 children in the
month of September. Of those 42 children, 26 children were paid for evening/weekend care, 14
children were paid for daytime care, and two children were paid for. both day and evening/weekend
care.
Upon review of Ms. Weaver's licensing record, CCFSPoskin observed that Ms. Weaver is licensed to care
for up to ten (10) children, seven (7) days a week for twenty-four (24) hour care.
On Thursday, October 27,2011, CCFSPoskin made an unannounced inspection to Ms. Weaver's ,amily
day care home. CCFSPoskin arrived at Ms. Weaver's facility at 9:20 AM. Upon arrival, CCFSPoskin
observed, Ms. Weaver's approved assistant, Ms. Candy Costello, present with 3 children (ages 2 months,
1 year and 2 years). CCFSPoskin explained to Ms. Costello that she was there on a report of rule
violation. CCFSPoskin requested to see the enrollment information for all children enrolled in the
facility and the facility's attendance records for the months of September and October 2011.
Ms. Costello was not aware of the location of all the enrollment information. Ms. Costello tried placing
a call to Ms. Weaver and was not able to reach her. Ms. Costello contacted someone else by telephone
and confirmed that attendance records were kept in the file cabinet. Ms. Costello asked the person on
the telephone to text Ms. Weaver to tell her that CCFSPoskin was at the facility. Ms. Costello directed
CCFSPoskin to the top drawer of the filing cabinet in the front room and told her she was unaware of
where the enrollment files for the children were located. CCFSPoskin withdrew the first file in the top
drawer. The folder contained DSSsign-in sheets for four children. CCFSPoskin returned the file 0 the
drawer and told Ms. Costello that she would await Ms. Weaver's arrival.

Page 2 of 7
CCFSPoskin asked about the children's sign-in sheets from that day and Ms. Costello directed CCFS
Poskin to a 3-ring binder that held October OSSsign-in sheets in it. CCFSPoskin did not locate a sign-in.
sheet for the 2 month old child present upon her arrival. CCFSPoskin located a sign-in sheet for the
other two children in care but neither child was signed in for October 2i h • CCFSPoskin did notice that
one child (Child A) was signed in for October 27 th but was not yet present. Child A was signed in at 1:28
PM and signed out at 7:29 PM on October 27 th •
Ms. Weaver arrived at the facility and provided CCFSPoskin with the files for all of her enrolled C~ildren
(41 files). CCFSPoskin started reviewing the files. Ms. Weaver sat down with CCFSPoskin and u dated
the enrollment forms of all the children to reflect their current hours and days of care. CCFSPos in
reviewed all the children's files and noted the children's enrollment dates and current hours and Cl ays of
care as well as what information was missing from each child's file. :
CCFSPoskin inquired about whether Ms. Weaver transported children and Ms. Weaver stated that she
did transport and she has a COLdrivers' license. CCFSPoskin asked whether Ms. Weaver had
transportation permission slips and Ms. Weaver stated that she had the area on the back of the
enrollment forms. CCFSPoskin explained to Ms. Weaver that she should have a more detailed
permission slip in the children's files. CCFSPoskin also noted that the parent of one of the children that
Ms. Weaver claimed to sometimes transport did not give permission to transport on the back of the
enrollment form and another parent had specifically marked the 'does not' give permission box. Ms.
Weaver went on to explain that Ms. Ursula Franklin sometimes helps her transport children but Ms.
Franklin does not have a Class E or COLdrivers' license.
CCFSPoskin explained to Ms. Weaver that because she is a 24-hour facility that the licensing regulations
require her to operate for 6 consecutive hours at only one-third of her licensed capacity. CCFSP1Skin
then asked Ms. Weaver which consecutive 6 hours she only had no more than 3 unrelated childr n in
her care. Ms. Weaver stated that there was only probably one hour where there were only that ew
children. CCFSPoskin asked Ms. Weaver why she didn't have a 6 hour period of time with only one-
third her capacity and she stated that she was unaware that was a rule. CCFSPoskin explained t~at the
rule was in her rule book and Ms. Weaver stated that she just waited for her worker to tell her when she
had violated a rule that she didn't read all the rules.
After reviewing the days and times that children were to be cared for according to the enrollment form,
CCFSPoskin inquired to Ms. Weaver how she could be caring for 41 children when she was only licensed
for 10 children. Ms. Weaver noted that 8 of the children were related to her. CCFSPoskin noted to Ms.
Weaver that her licensing record shows that there is only room in her facility for a total of 12 children.
Ten of those children could be unrelated to her, but the maximum number of children to be cared for in
the facility was 12 whether they were related or not. Ms. Weaver never explained she just noted that
she was looking for a building to be licensed for as a center and for more children.
1

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Page 3 of 7
CCFSPoskin inquired with Ms. Weaver as to what meals Ms. Weaver served the children. Ms. Weaver
replied that she served all three meals and CCFSPoskin clarified that she meant breakfast, lunch and
dinner. CCFSPoskin asked Ms. Weaver what snacks she provided and she replied that she served the
children PM snack and evening snack. CCFSPoskin arrived after breakfast. Children were not served a
morning snack during her inspection. Lunch was served during the inspection. According to Ms.
Weaver, she served chicken nuggets, tator tots, fruit, and milk.
During the inspection, CCFSPoskin observed three (3) children arrive at approximately 10:30 AM and
then Child A arrived at 11:00 AM. Ms. Ursula Franklin also returned to the facility (she had been present
before Ms. Costello arrived that morning at 8 AM.) CCFSPoskin asked Ms. Franklin if she sometimes
helped transport children for the facility. Ms. Franklin stated that she did. CCFSPoskin asked Ms
Franklin if she had a COL with passenger endorsement or a Class E drivers' license and Ms. Franklin
stated that she did not.
While at the facility, CCFSPoskin observed the following violations:
• a torn diaper changing pad on the diaper changing table in the back bedroom
• an area of chipping/peeling paint on the wall in the back bedroom
• no two-foot aisle along the long side of the pack-n-play sleeping equipment in the back
bedroom
• a fan on the floor, accessible to the children, in the front living room
• loose electrical and phone cords, accessible to the children, in the front living room
• Ms. Costello did not sanitize the diapering surface after diapering
• Ms. Ursula Franklin helps to transport children and does not have a Class E drivers' license or a
COLwith passenger endorsement
• All children that Ms. Weaver transports did not have transportation permission or permission to
leave Ms. Weaver's care (to walk).
• Children's enrollment files were missing documentation
Upon return to the office, CCFSPoskin charted the children's attendance for two days in Septem er and
one day in October. According to the charted attendance, Ms. Weaver did not have one consecu ive 6
hour period in either day charted in September when she only cared for one-third of her licensed
capacity. On the October day charted, Ms. Weaver only had relative children between the hours of 11
PM and 5 AM.
Ms. Weaver's approved overlap time is from 3-5 PM. Therefore, on September 14 and 21 and October
6, 2011, according to the sign-in sheets Ms. Weaver provided to CCFSPoskin for review, Ms. Weaver
was caring for more than 10 unrelated children during the hours of 5 - 9 PM. Ms. Weaver was caring for
12-18 unrelated children during these 4 hours. In addition, Ms. Weaver was over the total measured
capacity (12) of her building on the following dates and times:
September 14, 2011: 12-2 AM, 6-7 AM; and 7-9 PM
September 21, 2011: 12-2 AM, 6-7 AM, 7-9 PM and 11 PM -12 AM

October 6,2011: 6 - 7 AM and 5-9 PM
Pa e 4 of7
During the above date and times, Ms. Weaver had between 13 and 19 children in care in the building.
STATUTE/RULE(S) VIOLATED
19 CSR30-61.045(3)(U) The number and ages of children a family day care home is authorized to have in
care at anyone time shall be specified on the license and shall not be exceeded except as permitted
within these rules.
• Ms. Weaver cared for more than ten (10) unrelated children on at least three (3) days for at
least four (4) hours during those three (3) days.
• Ms. Weaver is licensed for no more than ten (10) children, seven (7) days a week for twenty-
four (24) hours.
19 CSR30-61. 105 (2)(C)A family day care home may be licensed at maximum capacity for a periol of
eighteen (18) consecutive hours of the twenty-four (24)-hour day. For the remaining six (6) hours.l~f the
twenty-four (24)-hour day, care may be provided for one-third (1/3) the licensed capacity of the hrme.
• Ms. Weaver noted that there was probably only one hour in a day that she only had one-~hird
her licensed capacity.
• According to the three (3) days that were charted by CCFSPoskin using the submitted sign-in
sheets, Ms. Weaver did not have a consecutive six (6) hour period of time on September 14 and
21,2011 when only one-third of her licensed capacity of unrelated children were present.
19 CSR30-61.105(l)(H) The provider shall have available a copy of the Licensing Rules for Family Day
Care Homes in Missouri. Providers and assistants shall review and be knowledgeable of the rules at the
time they begin work, and shall be able to understand and apply the rules which related to their
respective responsibilities.
• Ms. Weaver informed CCFSPoskin that she was unaware of the rule requiring her to only care
for one-third her capacity during a six (6) hour consecutive time period.
• Ms. Weaver stated to CCFSPoskin that she just waited for her worker to tell her when she was
violating a rule.
19 CSR30-61.085(2)(8)1. At least thirty-five (35) square feet of useable floor space shall be provi ed for
each child coming into the home for day care.
• Ms. Weaver was caring for anywhere from 13-19 children in her building during several ~ours on
September 14 th and 21 st and October 6 th . !
19 CSR30-61.210(8) All enrollment records, medical examination records and attendance records shall
be filed in a place known to caregivers and shall be accessible at all times. Records shall not be in a
locked area or removed from the home during the hours the home is open and operating.

• Ms. Candy Costello was unaware of where the children's enrollment forms/files were ke
CCFSPoskin had to wait for Ms. Weaver's arrival to review the children's enrollment
information.
Page 5 of 7
19 CSR30-61. 095 (l)(B) E.Sleeping equipment shall be arranged to provide at least a two-foot (2') aisle
on one (i) long side of the equipment.
• CCFSPoskin observed pack-n-plays in the back bedroom placed without a 2 foot aisle along the
long side of the piece of napping equipment.
19 CSR30-61. 085 (l)(A) The premises shall be safe and suitable for the care of children.
• CCFSPoskin observed a fan on the floor in the front living room, accessible to the children.
• CCFSPoskin observed several electrical and phone cords loose in the front living room,
accessible to the children.
19 CSR30-61. 085 (2)(A)6. Walls, ceilings and floors shall be finished with material which can be cleaned
easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good can ition.
Lead-free paint shall be used for all painted surfaces.
• CCFSPoskin observed one area of chipping/peeling paint on the wall in the back bed roo .
19 CSR30-61.175(1)(£)1. A safe diapering table or other approved area with a waterproof, washable
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surface shall be used for changing diapers. The table or area shall be cleaned thoroughly with a I
disinfectant after each use.
• CCFSPoskin observed a torn diaper changing pad on the diaper changing table in the back
bedroom.
• Ms. Costello did not sanitize the diaper changing surface after diapering a child.
19 CSR30-61.200(2)(A) The driver of any vehicle used to transport children shall be no less than eighteen
(18) years of age and shall have a valid drivers' license as required by Missouri law.
• Ms. Weaver informed CCFSPoskin that Ms. Ursula Franklin helps her transport children
sometimes and Ms. Franklin does not have a Class E or CDL drivers' license.
• Ms. Ursula Franklin noted to CCFSPoskin that she helps transport children sometimes and she
does not have a Class E or CDL drivers' license.
19 CSR30-61.200(l)(B) Written parental consent shall be on file at the home for field trips and
transportation.
• Upon review of the children's records, CCFSPoskin discovered that Ms. Weaver does not have a
transportation permission for all the children that she transports. Ms. Weaver stated tha she
had transportation permission on the back of the children's enrollment forms. However,ICCFS
Poskin observed that the parent of one child that is transported noted on the enrollment form
that her child could NOT be transported and at least one other parent failed to give or not give
permission on the back of the enrollment form.

Page 6 o~7
19 CSR30-61.190(l)(A} The provider shall supply and serve nourishing food according to the Mea and
Snack Food Chart provided in this rule.
• According to Ms. Weaver, lunch on October 27, 2011 was chicken nuggets, tator tots, fru t and
milk. This meal is missing the required serving from the bread/bread alternate componert.
19 CSR30-61.210(2)(A} & (B) & (C) & (F)An individual file shall be kept to identify each child and to
enable the provider to communicate with the parent(s}, guardian or legal custodian of the child in an
emergency. Records shall include: (A) The child's full nqme, address, birthdate and the date care begins
and ends; (B) Full name of the parent(s}, guardian or legal custodian home address, employers' name
and address, work schedule and home and work telephone numbers; (C) 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; ...(F}Field trip and transportation
authorization.
• Ms. Weaver could not locate the file for one child during CCFSPoskin's inspection
• One of the forty-one children's files reviewed was missing the enrollment date
• Thirteen of the forty-one children's files reviewed were missing some or all of the required
parent information
• Two of the forty-one children's files reviewed were missing an emergency contact persorn's
address
• Four ofthe forty-one children's files reviewed were missing transportation authorization
19 CSR303-61.135(5)(E}3. The provider shall develop and implement a procedure for admitting c1i1dren
which shall include: ...(E) Completeion by the parent(s} of the following written information which shall
be on file before the child is accepted for care: ...3. Instructions for action to be taken if the parent(s} or
physician designated by the parent(s} cannot be reached in an emergency and permission for emergency
medical care...
• One of the forty-one children's files reviewed was missing emergency medical authorization
19 CSR30-61.125(2)(D} The parent(s} of a school-age child shall provide a report at the time of
enrollment indicating the child's health history, any current health problems and any restriction
necessary for the child's care.
• Four of the forty-one children's files reviewed were missing a school-age health report
19 CSR30-61.185(4)(A} 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-preveJtable
childhood illnesses specified by the department in accordance with recommendations of the
Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall pro.~ide
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 tha ,the

Page 7 of 7
required immunizations have been given to the child and verifying the type of vaccine and the month,
day and year of administration.
• One of the forty-one children's files reviewed was missing an immunization record
CORRECTIONS
On November 1, 2011, Ms. Weaver submitted documentation to CCFSPoskin showing that the to n
diaper changing pad had been removed, that the chipping/peeling paint in the back room had been
corrected, that the fan that was accessible to the children had been removed and that the loose clords
accessible to the children had been removed and the phone cord attached to the wall.
Ms. Weaver submitted documentation on November 7, 2011 showing corrections to some of the
children's files as well as documentation noting that staff have been reminded to sanitize the diapering
surface after each diaper change and that all staff know the location of the children's records.
Ms. Weaver submitted documentation on November 8, 2011 noting that Ms. Franklin will no longer be
transporting children for the day care.
Ms. Weaver submitted the final documentation needed to correct the remaining child file violations on
November 10, 2011.
A Facility Review Conference will be scheduled with Ms. Weaver to review the above violations a ' d to
discuss corrective action.
Verification of corrections will be filed in the public record as they occur and/or verified.
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Details ofthis investigation, the substantiated licensing rule violations, and all supporting documents
have been submitted to CO for review.