DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

GRAY SUMMIT CHRISTIAN SCHOOL

000202579

(636) 742-3628

2705 HIGHWAY 100
GRAY SUMMIT
MO  63039

FIRST BAPTIST CHURCH OF GRAY SUMMIT

PO BOX 68
GRAY SUMMIT
MO  63039-0068

SCHNEIDER, SARA

fbcgspreschool@gmail.com


LEATRICE L DIXON

24 MONTHS - 11 YEARS

80

LICENSE EXEMPT PROGRAM

 
Inspection Information

07/31/2018

9:00 AM

10:28 AM

ANNOUNCED

ANNUAL

2336532353


DocumentDocument-Date
FIRE/SAFETY INSPECTION 05/23/2018
SANITATION INSPECTION 04/30/2018
NOTICE OF PARENTAL RESPONSIBILITY 08/29/2017




Inspection determined facility to be in compliance with rules.
Open Violations: 5
Attendance at Time of Inspection
Total Staff 7
Total Children 23
StaffChildClass AgeNote
1 5 MIXED Alex Yocom with children ages 2 to 3 years
1 4 MIXED Michelle Tickner with children ages 2 to 3 yeras
1 0 NO CHILDREN IN ATTENDANCE Joyce Lemay (cook) with no children
1 0 NO CHILDREN IN ATTENDANCE Sara Schneider (director) with no children
1 6 PRESCHOOL Courtney Null with children ages 4 to 5 years
1 6 PRESCHOOL Karl Nichols with children ages 4 to 5 years
1 2 TWO YEAR OLDS Lexie Patton with children ages 2 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 the medical form did not contain all required information in that it does not state that child #1 is able to participate in child care.
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

Violation
Medical examination reports including TB testing were not on file for caregivers as evidenced by a cleared TB report was not on file for caregivers within 30 days of working in the facility.
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

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 Alexis Patton's medical does not state that she is in good physical and mental condition to provide child care/Alex Yocum medical states she is ok to be a server, does not states she is in good mental/physical condition to provide child care.
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

Violation
Medical examination reports including TB testing were not on file for caregivers as evidenced by the medical examination on file is older than 12 months before the individual's begin date at the facility.
Licensing Rule Reference
19 CSR 30-60.060 Health Requirements 1 (D) 1 states: Physical assessment reports shall be completed not more than twelve (12) months before beginning work in the facility. The reports may be transferred to another facility for future 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
Compliance
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment
Violation
 Provider Comments
Violation
Equipment in the outdoor play area, the the metal train and the metal car, was not in good condition as evidenced by paint is chipping off the metal area.
Licensing Rule Reference
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment 4 (G) states: Outdoor equipment shall be safely constructed, in good condition, and free of sharp, loose or pointed parts. Stationary equipment such as swings, slides and climbers shall be anchored securely.
Correction Required
Play equipment shall be well maintained, safely constructed, free of sharp, loose or pointed parts; stationary equipment shall be anchored.

Correction Verification
Submit Documentation

Compliance Date

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 210.003 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