DHSS MO
MISSOURI DEPARTMENT OF HEALTH & SENIOR SERVICES

SECTION FOR CHILD CARE REGULATION

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

KIDS ZONE

002105457

(573) 438-5433

402 N MISSOURI
POTOSI
MO  63664

LIFE CHURCH OF POTOSI



 

KING, ANGELA RENEE


LIFEBUILTCHURCH@YAHOO.COM

Incorporated


LEATRICE L DIXON

24 MONTHS - 15 YEARS

60

LICENSE EXEMPT PROGRAM

 
Inspection Information

09/19/2018

11:00 AM

12:41 PM

ANNOUNCED

ANNUAL

2339894026


DocumentDocument-Date
NOTICE OF PARENTAL RESPONSIBILITY 08/13/2018
SANITATION INSPECTION 08/17/2018
FIRE/SAFETY INSPECTION 08/08/2018




Inspection determined facility to be in compliance with rules.
Open Violations: 8
Attendance at Time of Inspection
Total Staff 4
Total Children 24
StaffChildClass AgeNote
3 16 MIXED Crystal Borden, Megan Williams and Brandi DeClue with children ages 2 to 5 years (NPR ratio is 1:15 ages 2-4 years)
1 8 PRESCHOOL Angie King with children ages 3 to 4 years (NPR ratio is 1:15 2-4 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
Violation
 Provider Comments
Violation
There was no signed statement on file for Brandi DeClue 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

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 the medical form did not contain all required information in that Meghan Williamson's medical does not contain all required information.
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 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
Violation
 Provider Comments
Violation
The facility's evacuation/emergency plan is posted but does not include instructions for infants/nonambulatory children.
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

19 CSR 30-60.090 Sanitation Requirements
Compliance
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment
Violation
 Provider Comments
Violation
The equipment, a climber, that is over 24 inches high, does not have sufficient impact absorbing material present as evidenced by there is insufficient pea gravel in the fall zones.
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

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 a individualized special care plan for a child with special needs.
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

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 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

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