DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

VILLAGE LUTHERAN CHURCH PRESCHOOL

000471190

(314) 993-6743

9237 CLAYTON RD
ST LOUIS
MO  63124

EVANGELICAL LUTHERAN VILLAGE C



 

CHAMBERLAIN, ELIZABETH IRENE

vlcpre@yahoo.com


NANCY SMITH

24 MONTHS - 5 YEARS

52

LICENSE EXEMPT PROGRAM

52 CHILDREN UNDER 24 MONTHS
 
Inspection Information

04/17/2018

9:45 AM

11:30 AM

ANNOUNCED

ANNUAL

2329331192


DocumentDocument-Date
FIRE/SAFETY INSPECTION 02/08/2018
SANITATION INSPECTION 02/24/2017
NOTICE OF PARENTAL RESPONSIBILITY 09/13/2017




Inspection determined facility to be in compliance with rules.
Open Violations: 7
Attendance at Time of Inspection
Total Staff 4
Total Children 18
StaffChildClass AgeNote
1 4 MIXED Meredith Arns with children ages 2-3 years.
1 0 NO CHILDREN IN ATTENDANCE Elizabeth Chamberlain present.
1 8 PRESCHOOL Cindy Verseman with children ages 4-5 years.
1 6 PRESCHOOL Kim Luongo with children ages 3-4 years.

 
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
Compliance
19 CSR 30-60.060 Health Requirements
Violation
 Provider Comments
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 September 2017.
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

19 CSR 30-60.070 Responsibilities of Caregivers
Compliance
19 CSR 30-60.080 Fire Safety Requirements
Violation
 Provider Comments
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
Corrected on Site

Compliance Date
4/17/2018
19 CSR 30-60.090 Sanitation Requirements
Compliance
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment
Violation
 Provider Comments
Violation
Emergency numbers for the police, fire department, poison control, and ambulance were not posted.
Licensing Rule Reference
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment 2 (D) states: Police, fire department, poison control, ambulance and other emergency numbers posted near the telephone.
Correction Required
Emergency numbers shall be posted near the telephone.

Correction Verification
Corrected on Site

Compliance Date
4/17/2018
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 5 child files did not have the name, address and telephone number of another individual (friend or relative) who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-60.120 Admission Procedures and Required Reports and Records 2 (C) states: Full name, address and phone number of a friend or relative who might be reached in an emergency when a parent, guardian or legal custodian cannot be reached.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 3 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

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 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

Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by one child's file was missing this acknowledgment.
Licensing Rule Reference
19 CSR 30-60.120 Admission Procedures and Required Reports and Records 4 (A) states: S/he has been informed of the required health and safety inspections and that the inspection forms are available for review.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by one child's file was missing this acknowledgment.
Licensing Rule Reference
19 CSR 30-60.120 Admission Procedures and Required Reports and Records 4 (B) states: S/he understands and agrees that the child may not be accepted for care when ill.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date

RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Violation
 Provider Comments
Violation
Parent and/or guardian was not notified upon request of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.
Licensing Rule Reference
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when. 7. states: All public, private, and parochial day care centers, preschools, and nursery schools shall notify the parent or guardian of each child at the time of initial enrollment in or attendance at the facility that the parent or guardian may request notice of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed. Beginning December 1, 2015, all public, private, and parochial day care centers, preschools, and nursery schools shall notify the parent or guardian of each child currently enrolled in or attending the facility that the parent or guardian may request notice of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed. Any public, private, or parochial day care center, preschool, or nursery school shall notify the parent or guardian of a child enrolled in or attending the facility, upon request, of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.
Correction Required
Parent and/or guardian shall be notified upon request of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.

Correction Verification
Corrected on Site

Compliance Date
4/17/2018
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.
Compliance
RSMo 210.254 Religious organization operating facilities exempt under licensing laws required to file parental notice of responsibility and fire, safety inspections annually.
Violation
 Provider Comments
Violation
Background screening was not on file for pastor, Kevin Golden, as evidenced by screening results were not current within two years.
Licensing Rule Reference
RSMo 210.254 Religious organization operating facilities exempt under licensing laws required to file parental notice of responsibility and fire, safety inspections annually. 2 (4) states: Notification that background checks have been conducted on each individual caregiver and all other personnel at the facility. The background check shall be conducted upon employment and every two years thereafter on each individual caregiver and all other personnel at the facility. Such background check shall include a screening for child abuse or neglect through the division of family services, and a criminal record review through the Missouri highway patrol pursuant to section 43.540, RSMo. The fee for the criminal record review shall be limited to the actual costs incurred by the Missouri highway patrol in conducting such review not to exceed ten dollars.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Corrected on Site

Compliance Date
4/17/2018
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 was not approved.
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