DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

CALIFORNIA UNITED METHODIST PLAYSCHOOL

001407203

(573) 796-2792

201 S OAK ST
CALIFORNIA
MO  65018

UNITED METHODIST CHURCH



 

KINCHENS, EMILY





TERESA A WINEMILLER

24 Months - 4 Years

15

LICENSE EXEMPT PROGRAM

 
Inspection Information

04/23/2014

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2223127370


DocumentDocument-Date
NOTICE OF PARENTAL RESPONSIBILITY 03/11/2014
FIRE/SAFETY INSPECTION 02/19/2014
SANITATION INSPECTION 03/18/2014




Inspection determined facility to be in compliance with rules.
Open Violations: NA

 
19 CSR 30-60.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures
Compliance
19 CSR 30-60.050 Staffing Requirements
Violation
 Provider Comments
Violation
There was no signed statement on file for Emily Kinchens as evidence that license rules had been read.
Licensing Rule Reference
19 CSR 30-60.050 Staffing Requirements 1 (C) states: Prior to starting work, all caregivers shall read the rules of this chapter and sign a statement that they have read the rules. The statements shall be maintained on file at the facility.
Correction Required
Caregivers' signed statements shall be on file.

Correction Verification
Submit Documentation

Compliance Date
4/22/2014
19 CSR 30-60.060 Health Requirements
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 2013-2014 annual summary report showing immunization status of each child enrolled was not submitted by January 15.
Licensing Rule Reference
19 CSR 30-60.060 Health Requirements 3 states: Child care facilities shall meet immunization requirements for children as defined by section 210.003, RSMo.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
4/2/2014
Violation
Requirements for children's medical examination reports 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 3/11/13 and 8/18/13.
Licensing Rule Reference
19 CSR 30-60.060 Health Requirements 2 states: Within thirty (30) days following the admission of an infant, toddler or preschool child, a physical assessment report signed by a licensed physician or registered professional nurse shall be on file at the facility. The facility may use the department's physical assessment form, MO 580-1878 (6-94), or the facility may use its own form if it contains all the information on the department's form. The report shall have been completed not more than twelve (12) months before admission.
Correction Required
Children's physical assessment reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
4/21/2014
19 CSR 30-60.070 Responsibilities of Caregivers
Compliance
19 CSR 30-60.080 Fire Safety Requirements
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-60.080 Fire Safety were not met as evidenced by tornado drills were not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-60.080 Fire Safety Requirements 5 states: Fire and tornado drills shall be conducted at least every three (3) months and shall include all children in care. Unscheduled drills shall be held at the discretion of the state fire marshal or department. Each fire drill shall include a complete evacuation of all persons from the building.
Correction Required
Fire and tornado drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date
4/21/2014
Violation
Requirements of 19 CSR 30-60.080 Fire Safety were not met as evidenced by fire drills were not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-60.080 Fire Safety Requirements 5 states: Fire and tornado drills shall be conducted at least every three (3) months and shall include all children in care. Unscheduled drills shall be held at the discretion of the state fire marshal or department. Each fire drill shall include a complete evacuation of all persons from the building.
Correction Required
Fire and tornado drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date
4/21/2014
Violation
Requirements of 19 CSR 30-60.080 Fire Safety were not met as evidenced by the date and/or type of drill were not recorded.
Licensing Rule Reference
19 CSR 30-60.080 Fire Safety Requirements 5 (B) states: A written record shall be kept of the dates and types of drills conducted.
Correction Required
Fire and tornado drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date
4/21/2014
Violation
The facility's evacuation/emergency plan is not posted.
Licensing Rule Reference
19 CSR 30-60.080 Fire Safety Requirements 5 (A) states: An emergency plan for fires and tornadoes shall be posted conspicuously and shall include the route for the drills and special instructions for nonambulatory infants and children.
Correction Required
Evacuation/emergency plan must be posted/complete as required.

Correction Verification
Submit Documentation

Compliance Date
4/21/2014
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
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child files did not have the name of the individual(s) authorized to take the child.
Licensing Rule Reference
19 CSR 30-60.120 Admission Procedures and Required Reports and Records 2 (E) states: The name of the individual(s) authorized to take the child from the premises.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
4/22/2014
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child files did not have the name and phone number of the family physician, or hospital, or both.
Licensing Rule Reference
19 CSR 30-60.120 Admission Procedures and Required Reports and Records 2 (D) states: Name and phone number of a physician and preferred hospital to be used in an emergency.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
4/22/2014
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 2 child files did not have the full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.
Licensing Rule Reference
19 CSR 30-60.120 Admission Procedures and Required Reports and Records 2 (B) states: The full name of the parent(s), guardian or legal custodian, home address, work schedule, home and work telephone numbers, and employer's name and address.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
4/22/2014
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.
Violation
 Provider Comments
Violation
Requirements for sanitation inspection were not met as evidenced by the inspection has not been conducted
Licensing Rule Reference
RSMo 252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. 1 states: All buildings and premises used by a child-care facility to care for more than four children except those exempted from the licensing provisions of the department of health and senior services pursuant to subdivisions (1), (2), (3), (4) and (6) of section 210.211, shall be inspected annually for fire and safety by the state fire marshal, the marshal's designee or officials of a local fire district and for health and sanitation by the department of health and senior services or officials of the local health department. Evidence of compliance with the inspections required by this section shall be kept on file and available to parents of children enrolling in the child-care facility.
Correction Required
An approved sanitation and fire/safety inspection shall be kept on file and be available as required.

Correction Verification
Submit Documentation

Compliance Date
4/1/2014