DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

CAMPBELL UNITED METHODIST CHURCH

001465703

(417) 881-5762

1747 E REPUBLIC RD
SPRINGFIELD
MO  65804

CAMPBELL UNITED METHODIST CHURCH



 

KERNS, SHIRLEY

SKERNS@CAMPBELLUMC.ORG


PENNY KREITZER

6 Weeks - 11 Years

150

LICENSE EXEMPT PROGRAM

 
Inspection Information

07/02/2013

10:00 AM

12:57 PM

ANNOUNCED

ANNUAL

2203086541


DocumentDocument-Date
NOTICE OF PARENTAL RESPONSIBILITY 06/24/2013
FIRE/SAFETY INSPECTION 04/09/2013
SANITATION INSPECTION 04/23/2013




Inspection determined facility to be in compliance with rules.
Open Violations: 3
Attendance at Time of Inspection
Total Staff 17
Total Children 65
StaffChildClass AgeNote
2 6 INFANTS AND TODDLERS 1's and 2's
2 5 INFANTS AND TODDLERS Room 122 1's and 2's
2 6 INFANTS AND TODDLERS Room 111
2 6 PRESCHOOL Room 213
2 9 PRESCHOOL Room 212
2 9 PRESCHOOL Room 118
2 11 PRESCHOOL Room 119/120
1 7 TWO YEAR OLDS Room 115
2 6 TWO YEAR OLDS Room 114

 
19 CSR 30-60.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures
Violation
 Provider Comments
Violation
Background screening was not on file for personnel as evidenced by a screening was not requested within 10 days of working with children.
Licensing Rule Reference
19 CSR 30-60.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures 5 states: The facility director shall request a child abuse/neglect screening from the Department of Social Services for each employee who may come into contact with children during child care hours. The request shall be made within ten (10) days of employment. The results of the screenings shall be maintained in the facility's files.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-60.050 Staffing Requirements
Compliance
19 CSR 30-60.060 Health Requirements
Violation
 Provider Comments
Violation
Medical examination reports including TB testing were not on file for caregivers as evidenced by a TB report on file is older than 24 months.
Licensing Rule Reference
19 CSR 30-60.060 Health Requirements 1 (D) 3 states: After the initial physical assessment, all caregivers working in a facility during child care hours shall be tested for tuberculosis at least every two (2) years. Caregivers with previously positive tuberculin tests shall be under the management of a physician.
Correction Required
Medical/TB reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Medical examination reports including TB testing were not on file for caregivers as evidenced by the medical form did not contain all required information in that two staff members had medicals on file that must state that they are in good physical and emotional health, are free of communicable diseases and whether they have any physical limitations in order to work with children.
Licensing Rule Reference
19 CSR 30-60.060 Health Requirements 1 (D) 2 states: The facility may use the department's physical assessment form, MO 580-1879 (6- 94), or the facility may use its own form if it contains all the information on the department's form.
Correction Required
Medical/TB reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-60.070 Responsibilities of Caregivers
Compliance
19 CSR 30-60.080 Fire Safety Requirements
Compliance
19 CSR 30-60.090 Sanitation Requirements
Compliance
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment
Compliance
19 CSR 30-60.110 Transportation and Field Trip Requirements
Compliance
19 CSR 30-60.120 Admission Procedures and Required Reports and Records
Compliance
RSMo 210.254 Religious organization operating facilities exempt under licensing laws required to file parental notice of responsibility and fire, safety inspections annually.
Compliance
RSMo 210.255 Religious organizations operating facility in violation, procedure - noncompliance after notice, prosecutor may act or attorney general.
Compliance
RSMo 252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance