DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

PROVIDENT, INC.

002657576

(314) 653-8170

8420 SUNBURY AVE
JENNINGS
MO  63136-1337

PROVIDENT, INC.



 

JACKSON, SHAUNA LOUISE

sjackson@providentstl.org

Incorporated

DENISE ELAYNE KOCH

5 YEARS - 12 YEARS

60

SCHOOL AGE

 
Inspection Information

05/10/2019

4:20 PM

5:43 PM

ANNOUNCED

RENEWAL

2356602639


DocumentDocument-Date
APPLICATION 05/09/2019
EQUIPMENT LIST 05/10/2019
STAFF SHEET 05/10/2019
LINES OF ADMINISTRATIVE AUTHORITY 05/04/2017
SAMPLE FORMS 06/20/2017
DIRECTOR'S JOB RESPONSIBILITIES 06/20/2017
DIRECTOR'S QUALIFICATIONS 06/20/2017
DAILY SCHEDULE 06/20/2017
JOB RESPONSIBILITIES 06/20/2017
DISCIPLINE POLICIES 06/20/2017
POLICIES 06/20/2017
SAMPLE WEEKLY MENU 06/20/2017
CHILD CARE PRACTICES 06/20/2017
CERTIFICATE OF GOOD STANDING 05/10/2019
CERTIFICATE OF INCORPORATION 05/04/2017
ARTICLES OF INCORPORATION 05/04/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN 05/10/2019




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 5
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.
Attendance at Time of Inspection
Total Staff 3
Total Children 19
StaffChildClass AgeNote
3 19 SCHOOL AGE Gail Sharpe, Shauna Jackson, and Ashley Dew present with 19 children, ages 5-9yrs old

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Initial Licensing Information
Compliance
19 CSR 30-62.052 License Renewal
Violation
 Provider Comments
Violation
The provider did not meet requirements for a criminal background check. Results were missing for: Kevin Drollinger and Shauna Jackson (waiting for results from SCCR).
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (3) states: The facility owner(s), board president or chairperson, and the center director or group day care home provider, shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not meet requirements for a criminal background check. Results were missing for: Esmerlda Baker, Ashley Dew, Donisha Dunn, and Dalberta Johnson( all waiting for results from SCCR).
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (4) states: Child care staff members shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
The facility's emergency procedure plan did not include isolation of a fire.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (1) (C) 4. D. states: Isolation of a fire, including confinement by closing doors to the fire area;
Correction Required
Facilities emergency procedure must include required components.

Correction Verification
Return Inspection

Compliance Date
5/10/2019
Violation
The facility's disaster plan did not include exit routes to a safe location within the facility.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (1) (C) 2. states: Diagrams that identify exit routes from each area of the facility used for child care to a safe location out of the facility and to a safe location within the facility where children and staff members can stay until the threat of danger passes;
Correction Required
Facilities disaster plan shall include required components.

Correction Verification
Return Inspection

Compliance Date
5/10/2019
Violation
The facility's disaster plan did not include exit routes to a safe location out of the facility.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (1) (C) 2. states: Diagrams that identify exit routes from each area of the facility used for child care to a safe location out of the facility and to a safe location within the facility where children and staff members can stay until the threat of danger passes;
Correction Required
Facilities disaster plan shall include required components.

Correction Verification
Return Inspection

Compliance Date
5/10/2019
Violation
The facility's disaster plan did not include the location of child's attendance record.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (1) (C) 1. states: The location of the child's attendance record and emergency information and emergency supplies;
Correction Required
Facilities disaster plan shall include required components.

Correction Verification
Return Inspection

Compliance Date
5/10/2019
Violation
The facility's written emergency plan did not include plans for evacuation from a vehicle used to transport children.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (1) (A) 4. states: Evacuation from a vehicle used to transport children.
Correction Required
Facility emergency plan must include required components.

Correction Verification
Return Inspection

Compliance Date
5/10/2019
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Compliance
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
A school-age child's health report was not on file at the time of enrollment as evidenced by Child 3 and Child 4 need school age health report completed.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (2) (D) states: The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child's health history, any current health problems, and any restrictions necessary for the child's care.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Medical examination report form did not contain all required information as evidenced by Donisha Dunn's medical exam is not fully complete.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (D) states: The medical examination report form shall be supplied by the department or the facility may use its own form if it contains all the information on the department's form.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Ashley Dew, Carolyn White, and Esmeralda Baker.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (B) states: Medical examination reports shall include a “Risk Assessment for Tuberculosis” form, included herein, completed and signed by a health care professional, as provided by the Missouri Department of Health and Senior Services (MDHSS). If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
TB reports shall be on file as required

Correction Verification
Return Inspection

Compliance Date
5/10/2019
Violation
Medical examination report was not on file for Ashley Dew and Esmeralda Baker 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 30-62.122 Medical Examination Reports (1) (A) states: All persons working in a day care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Return Inspection

Compliance Date
5/10/2019
19 CSR 30-62.132 Admission Policies and Procedures
Compliance
19 CSR 30-62.172 Emergency School Closings
Compliance
19 CSR 30-62.182 Child Care Program
Compliance
19 CSR 30-62.192 Health Care
Compliance
19 CSR 30-62.202 Nutrition and Food Service
Compliance
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Violation
 Provider Comments
Violation
1 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Return Inspection

Compliance Date
5/10/2019
Violation
1 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Return Inspection

Compliance Date
5/10/2019
Violation
1 child(ren) records did not include work schedule of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
1 child(ren) records did not include home address of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
5/10/2019
Violation
1 child(ren) records did not include child's address.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
5/10/2019
19 CSR 30-63.040 Background Screening Findings
Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance
RSMo 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules.
Compliance