DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

CAMPBELL UNITED METHODIST CHURCH

001465703

(417) 881-5762

1747 E REPUBLIC RD
SPRINGFIELD
MO  65804

THE CAMPBELL UNITED METHODIST CHURCH



 

KERNS, SHIRLEY

shirleykerns@campbellumc.org


ANGEL DONSON

6 WEEKS - 6 YEARS

150

LICENSE EXEMPT PROGRAM

 
Inspection Information

07/26/2019

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2359445887


DocumentDocument-Date
SANITATION INSPECTION 06/10/2019
FIRE/SAFETY INSPECTION 03/16/2019




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
Violation
 Provider Comments
Violation
A copy of the Notice of Parental Responsibility was not filed annually during the month of August with the Department of Health and Senior Services.
Licensing Rule Reference
19 CSR 30-60.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures 7 (D) states: A child care facility operated by a religious organization shall file the Notice of Parental Responsibility form with the department annually during the month of August.
Correction Required
A copy of the Notice of Parental Responsibility shall be filed annually during the month of August with the Department of Health and Senior Services.

Correction Verification
Submit Documentation

Compliance Date
7/2/2019
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 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
7/16/2019
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
Compliance
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
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