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) 881-3203

1747 E REPUBLIC RD
SPRINGFIELD
MO  65804

THE CAMPBELL UNITED METHODIST CHURCH



 

KERNS, SHIRLEY

shirleykerns@campbellumc.org


ANGEL DONSON

6 WEEKS - 6 YEARS

150

LICENSE EXEMPT PROGRAM

 
Inspection Information

07/12/2018

9:13 AM

11:54 AM

ANNOUNCED

ANNUAL

2335304957


DocumentDocument-Date
FIRE/SAFETY INSPECTION 03/26/2018
SANITATION INSPECTION 06/12/2018
NOTICE OF PARENTAL RESPONSIBILITY 07/18/2017




Inspection determined facility to be in compliance with rules.
Open Violations: 2
Attendance at Time of Inspection
Total Staff 22
Total Children 89
StaffChildClass AgeNote
2 6 INFANTS AND TODDLERS
2 6 INFANTS AND TODDLERS
2 5 INFANTS AND TODDLERS
2 8 MIXED
2 8 MIXED
2 13 PRESCHOOL
2 13 PRESCHOOL
2 9 PRESCHOOL
2 12 PRESCHOOL
2 4 TWO YEAR OLDS
2 5 TWO YEAR OLDS

 
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
Medical examination reports including TB testing were not on file for caregivers as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
19 CSR 30-60.060 Health Requirements 1 (D) states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.
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
Violation
 Provider Comments
Violation
The facility was not clean, free of unsanitary conditions and free of pests as evidenced by there were two dusty fans that were located in the preschool classrooms (room 119 and room 118).
Licensing Rule Reference
19 CSR 30-60.090 Sanitation Requirements 1 states: The premises of facilities shall be clean and free of unsanitary conditions and observable insects, spiders and rodents.
Correction Required
The facility shall be clean, sanitary and pest free.

Correction Verification
Corrected on Site

Compliance Date
7/12/2018
Violation
The facility was not clean, free of unsanitary conditions and free of pests as evidenced by the refrigerator in the infant classroom (111) was dirty.
Licensing Rule Reference
19 CSR 30-60.090 Sanitation Requirements 1 states: The premises of facilities shall be clean and free of unsanitary conditions and observable insects, spiders and rodents.
Correction Required
The facility shall be clean, sanitary and pest free.

Correction Verification
Corrected on Site

Compliance Date
7/12/2018
Violation
The facility was not clean, free of unsanitary conditions and free of pests as evidenced by the sink in the preschool classroom was dirty (room 117).
Licensing Rule Reference
19 CSR 30-60.090 Sanitation Requirements 1 states: The premises of facilities shall be clean and free of unsanitary conditions and observable insects, spiders and rodents.
Correction Required
The facility shall be clean, sanitary and pest free.

Correction Verification
Corrected on Site

Compliance Date
7/12/2018
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment
Violation
 Provider Comments
Violation
The premises were not safe and suitable as evidenced by the infant feeding table was observed to not have lap restrains as required by the manufacture .
Licensing Rule Reference
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment 1 states: The premises of all facilities shall be safe and suitable for the care of children.
Correction Required
The premises shall be safe and suitable for the care of children.

Correction Verification
Corrected on Site

Compliance Date
7/12/2018
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's admitting procedure did not include an individualized special care plan for a child with special needs to ensure that those needs were being met as evidenced by the plan needs to be updated according to the child's age.
Licensing Rule Reference
19 CSR 30-60.120 Admission Procedures and Required Reports and Records 1 states: The facility director shall have an admitting procedure for each child in care that includes a plan for caring for the child if s/he becomes ill or needs emergency medical treatment. The director shall maintain an individual file on each child in order to communicate with the parent(s), guardian or legal custodian. The director shall have a plan for any child with special health needs, identified through a physical assessment by a licensed physician or an advance practice nurse, to ensure that those needs are met during care.
Correction Required
The facility shall have an admitting procedure for each child in care which includes a plan for ill children, emergency medical care, and special health needs.

Correction Verification
Submit Documentation

Compliance Date

RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance
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.
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