DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

ST PAULS LUTHERAN EARLY CHILDHOOD CENTER

002004995

(573) 885-4263

760 FLEENOR RD
CUBA
MO  65453

ST PAULS LUTHERAN CHURCH

730 FLEENOR RD
CUBA
MO  65453

WALLS, DONNA MARIE



WARSHIETA HAMMOND

24 MONTHS - 14 YEARS

24

LICENSE EXEMPT PROGRAM

 
Inspection Information

10/03/2018

10:00 AM

11:19 AM

ANNOUNCED

ANNUAL

2340829278


DocumentDocument-Date
SANITATION INSPECTION 08/28/2018
FIRE/SAFETY INSPECTION 09/26/2018
NOTICE OF PARENTAL RESPONSIBILITY 08/20/2018




Inspection determined facility to be in compliance with rules.
Open Violations: 5
Attendance at Time of Inspection
Total Staff 3
Total Children 15
StaffChildClass AgeNote
3 15 MIXED Donna Walls, Barbara Callahan, and Tina Evans with 15 children age two and up

 
19 CSR 30-60.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures
Violation
 Provider Comments
Violation
Background screening was not on file for personnel as evidenced by a screening was not requested within 10 days of working with children for employee(s): Joe Pederson.
Licensing Rule Reference
19 CSR 30-60.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures 5 states: The facility director shall request a child abuse/neglect screening from the Department of Social Services for each employee who may come into contact with children during child care hours. The request shall be made within ten (10) days of employment. The results of the screenings shall be maintained in the facility's files.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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 TB report on file is older than 24 months.
Licensing Rule Reference
19 CSR 30-60.060 Health Requirements 1 (D) 3 states: After the initial physical assessment, all caregivers working in a facility during child care hours shall be tested for tuberculosis at least every two (2) years. Caregivers with previously positive tuberculin tests shall be under the management of a physician.
Correction Required
Medical/TB reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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 7/23/18.
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
Compliance
19 CSR 30-60.090 Sanitation Requirements
Compliance
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment
Compliance
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 1 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, 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

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