DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

RESTORATION TEMPLE

002103057

(314) 869-2713

2002 CHAMBERS RD
ST LOUIS
MO  63136

RESTORATION TEMPLE



 

STRONG, ERIN MICHELE

ERIN.STRONG26@YAHOO.COM

Incorporated

KATHERINE D SIMS

6 WEEKS - 12 YEARS

44

LICENSE EXEMPT PROGRAM

 
Inspection Information

08/15/2018

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2337547658


DocumentDocument-Date
NOTICE OF PARENTAL RESPONSIBILITY 07/31/2017
SANITATION INSPECTION 07/16/2018
FIRE/SAFETY INSPECTION 07/19/2018




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 April Harris 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
8/14/2018
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 3/10/10 and unknown.
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
7/20/2018
Violation
Requirements for immunization reports on file were not met as evidenced by verification of required immunizations was not satisfactory in that Child 1 does not have updated immunization record on file.
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
7/20/2018
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
The facility's outdoor space was not safe for children's activities as evidenced by the presence of the castle climber is falling apart and not properly assembled, there is a broken basketball hoop in the play area, there is a white tarp coming through the pea gravel, causing a tripping hazard.
Licensing Rule Reference
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment 4 (C) states: The play area shall be safe for children's activities. It shall be well-maintained and free of hazards such as poisonous plants, broken glass, barbed wire, open wells, rocks and other debris, and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
8/14/2018
Violation
The equipment, a outside climber, that is over 24 inches high, does not have sufficient impact absorbing material present as evidenced by there is grass/weeds coming through the pea gravel throughout the play area.
Licensing Rule Reference
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment 4 (D) states: The fall-zone area under and around outdoor equipment over twenty-four inches (24") high covered with impact-absorbing materials that will effectively cushion the fall of a child. Materials may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.
Correction Required
Impact absorbent materials shall be in the fall zone for any equipment over 24 inches high.

Correction Verification
Submit Documentation

Compliance Date
8/14/2018
19 CSR 30-60.110 Transportation and Field Trip Requirements
Violation
 Provider Comments
Violation
The driver of a vehicle used to transport children was not qualified as evidenced by Patricia Brown did not have a valid driver's license (Class E or CDL).
Licensing Rule Reference
19 CSR 30-60.110 Transportation and Field Trip Requirements 2 states: The driver of any vehicle used to transport children shall be no less than eighteen (18) years of age and shall have a valid driver's license.
Correction Required
The driver of any vehicle used to transport children shall meet age and licensing requirements.

Correction Verification
Submit Documentation

Compliance Date
7/26/2018
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 2 child files did not have the child’s full name, address, birth date and the date care begins and ends.
Licensing Rule Reference
19 CSR 30-60.120 Admission Procedures and Required Reports and Records 2 (A) states: The child's full name, address, birth date and the date care begins and ends.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
7/20/2018
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
7/20/2018
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 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
7/20/2018
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
7/20/2018
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by Child 5 need parental acknowledgements completed.
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
7/20/2018
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.
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
7/16/2018
Violation
Requirements for fire/safety 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
7/19/2018