DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

LUCKY LANE NURSERY SCHOOL ASSOCIATION-BENEVOLENT

000522607

(314) 434-4462

12546 CONWAY RD
ST LOUIS
MO  63141

LUCKY LANE EARLY CHILDHOOD ASSOCIATION



 

CLOSSON, RACHEL LEAH

rachel@luckylane.org

Incorporated

JASMINE S COOLEY

24 MONTHS - 5 YEARS

80

GROUP HOME AND CENTER

 
Inspection Information

10/23/2019

12:40 PM

3:07 PM

UNANNOUNCED

COMPLIANCE MONITORING

2367669236


DocumentDocument-Date
DIRECTOR'S QUALIFICATIONS 01/10/2006
CERTIFICATE OF GOOD STANDING 03/26/2013
SAMPLE FORMS 09/02/1993
REGISTERING FICTITIOUS NAMES 03/26/2013
POLICIES 09/02/1993
LOCAL ZONING APPROVAL 09/02/1993
LOCAL FIRE DEPARTMENT NOTIFICATION 03/01/2011
LOCAL BUILDING APPROVAL 09/02/1993
LINES OF ADMINISTRATIVE AUTHORITY 09/02/1993
JOB RESPONSIBILITIES 09/02/1993
DISCIPLINE POLICIES 09/02/1993
DIAGRAM/OUTDOOR 09/02/1993
DIAGRAM/INDOOR 09/02/1993
CHILD CARE PRACTICES 09/02/1993
ARTICLES OF INCORPORATION 09/02/1993
SAMPLE WEEKLY MENU 04/02/2015
DAILY SCHEDULE 04/02/2015
APPLICATION 04/02/2019
EQUIPMENT LIST 04/11/2019
STAFF SHEET 04/11/2019
FIRE/SAFETY INSPECTION 03/27/2019
SANITATION INSPECTION 04/24/2019




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 8
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 8
Total Children 38
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Rachel Closson (Director)
2 13 PRESCHOOL Melissa Krause & Katie McCormick (4 & 5 year old's)
1 7 PRESCHOOL Laurie Boyer (3 & 4 year old's)
1 8 PRESCHOOL Julian Stillman (3 year old's)
1 3 PRESCHOOL Kellie Schilling (2 & 3year old's)
2 7 TWO YEAR OLDS Erica Farnsworth & Claudine Mourer

 
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: Deana Rothhaar, Julianne Stillman, Lori Boyer, Elaine Dalton, Melissa Briggs, Kellie Schilling, Dena Henry, Carrie Tremont, Victoria Waser, Claudine Mourer, Claire Lauer, Stephanie Waser, Aaliyaha Gladney, Maya Williams, Erica Farnsworth, Rachel Closson (Director), Sophie Craft, Casey Gutting and Kellie Pellechia (Board President).
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
10/22/2019
Violation
The sanitation inspection was not approved.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (1) (B) states: Evidence of compliance with local or state, or both, sanitation requirements;
Correction Required
The facility shall submit evidence of compliance with sanitation requirements for renewal.

Correction Verification
Submit Documentation

Compliance Date
5/30/2019
Violation
Evidence of local building approval was not received.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (1) (C) states: Evidence of compliance with local building and zoning requirements, if applicable;
Correction Required
The facility shall submit evidence of local building/zoning approval as required for renewal.

Correction Verification
Submit Documentation

Compliance Date
5/30/2019
Violation
The provider did not meet requirements for a criminal background check. Results were missing for: Jennifer Boyd (Board President).
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
Violation
 Provider Comments
Violation
The premises were not safe and suitable as evidenced by the fluorescent lightbulbs did not have a barrier for the following rooms; Red room, Yellow room, Blue room, Cafeteria Room, Orange Room, Light Blue Room.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.
Correction Required
The premises shall be safe and suitable for the care of children.

Correction Verification
Submit Documentation

Compliance Date
5/30/2019
Violation
Children were not restricted to approved space as evidenced by The Wheel toy building has easy access to kitchen area through swing door. Misc. items observed. .
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.
Correction Required
Caregivers shall restrict children to approved space.

Correction Verification
Submit Documentation

Compliance Date
5/30/2019
19 CSR 30-62.087 Fire Safety
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
Requirements of facilities participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
The facility did not meet requirements for a criminal background check. Results were not on file for the following staff member(s): Melissa Krause, Cindy Shapiro, Angela Ravouras & Kin Wan.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (M) states: Child care staff members shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for documentation of 12 clock hours of annual training were not met as evidenced by there were insufficient training documents on file. The staff listed need the following documentation: Megan Unger needs 4 clock hours for 2018. Melissa Briggs needs 1 clock hour for 2018. Kellie Schilling needs 4 clock hours for 2018. Sophie Craft needs 2 clock hours for 2018. Dena Henry needs 1 clock hour for 2018. Claire Lauer needs 3 clock hours for 2018. Stephanie Waser needs 8 clock hours for 2018. Carrie Tremont needs 5 clock hours for 2018. Aaliyaha Gladrey needs 3 clock hours for 2018. Maya Williams needs 7 clock hours for 2018. Erica Farnsworth needs 2 clock hours for 2018..
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (A) states: The center director, group day care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each employee.

Correction Verification
Submit Documentation

Compliance Date
6/20/2019
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Sophie Craft, Erica Farnsworth, Maya Williams, Aaliyaha Gladney, Stephanie Waser, Claire Lauer, 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
Submit Documentation

Compliance Date
5/30/2019
Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Sophie Craft , Elaine Dalton, Claire Lauer, Maya Williams, Erica Farnsworth.
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
Submit Documentation

Compliance Date
5/30/2019
Violation
Medical examination report form did not contain all required information as evidenced by the medical exam for Dena Henry does not contain all information on the departments form.
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
5/30/2019
Violation
Requirements for infant-toddler/preschool child medical examination reports on file 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 July 1, 2018 and October 29, 2018.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
5/30/2019
Violation
Medical examination report was not on file for Melissa Krause and Angela Ravouras 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
Submit Documentation

Compliance Date

Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Melissa Krause &Angela Ravouras .
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
Submit Documentation

Compliance Date

19 CSR 30-62.132 Admission Policies and Procedures
Compliance
19 CSR 30-62.142 Nighttime Care
Compliance
19 CSR 30-62.152 Hourly Care Facilities
Compliance
19 CSR 30-62.162 Overlap Care of Children
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 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
Submit Documentation

Compliance Date
5/30/2019
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
Submit Documentation

Compliance Date
5/30/2019
Violation
2 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
Submit Documentation

Compliance Date

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 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
Submit Documentation

Compliance Date

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 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance