DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

WAVERLY FOREST ACADEMY, LLC

002140516

(636) 940-0550

3545 FRANKS DR
ST CHARLES
MO  63301-4041

WAVERLY FOREST ACADEMY, LLC



 

NESSLAGE, ANGELA

INFO@WAVERLYFOREST.COM


KATHERINE D SIMS

6 WEEKS - 12 YEARS

93

GROUP HOME AND CENTER

9 CHILDREN UNDER 12 MONTHS; 25 CHILDREN UNDER 24 MONTHS
 
Inspection Information

02/20/2020

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2376082970


DocumentDocument-Date
SAMPLE WEEKLY MENU 03/10/2009
POLICIES 03/10/2009
LINES OF ADMINISTRATIVE AUTHORITY 03/10/2009
JOB RESPONSIBILITIES 03/10/2009
DISCIPLINE POLICIES 03/10/2009
DAILY SCHEDULE 03/10/2009
CHILD CARE PRACTICES 03/10/2009
DIRECTOR'S QUALIFICATIONS 03/23/2009
SAMPLE FORMS 03/19/2009
DIAGRAM/OUTDOOR 03/10/2009
DIAGRAM/INDOOR 03/10/2009
LOCAL ZONING APPROVAL 03/19/2009
LLC OPERATING AGREEMENT 03/10/2009
LLC ARTICLES OF ORGANIZATION 03/10/2009
LOCAL BUILDING APPROVAL 01/11/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 03/10/2009
SAFE SLEEP POLICY 10/22/2018
CERTIFICATE OF GOOD STANDING 01/17/2019
APPLICATION 10/23/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 01/02/2019
STAFF SHEET 01/18/2019
EQUIPMENT LIST 01/18/2019
FIRE/SAFETY INSPECTION 12/11/2019
SANITATION INSPECTION 12/18/2019




Inspection determined facility to be in compliance with licensing rules.
Open Violations: NA
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

 
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
Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
19 CSR 30-62.087 Fire Safety
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
Requirements for safe sleep training were not met in that the following staff did not complete department-approved safe sleep training within the past three years: Janice Kopecky and Renee Knobbe.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (4) . states: Safe Sleep Training. Every three (3) years the center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 128, No. 5, November 1, 2011, and available from the University of Vermont College of Medicine, Given Building S261, 89 Beaumont Avenue, Burlington, Vermont 05405-0068, telephone number 802-656-2505, fax number 802-656-4844, or at www.pediatrics.aapublications.org/content/128/5/1030.full. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Center director, group child care home provider, and other caregivers, and those volunteers counted in staff/child ratios shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date
1/24/2020
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. The staff listed need the following information: Jamie Brockway needs 6hrs, Amie Richter needs 1hr, Karla Vierdag needs 1hrs, and Mckenna Willbrand needs 2hrs all for 2019.
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
2/20/2020
Violation
Prospective child care staff member(s), Halley Widel, Mya Schnettler, Alexandria Phillips, Kaylee Cates, and Brianna Harper, was/were working without having requested a criminal background check.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (O) states: A prospective child care staff member may begin work for a child care provider after the criminal background check has been requested from the department; however, pending completion of the criminal background check, the prospective child care staff member shall be supervised at all times by another child care staff member who received a qualifying result on the criminal background check within the past five (5) years.
Correction Required
All prospective child care staff member(s) who have requested a criminal background check shall be supervised at all times by another child care staff member who has received a qualifying result on the criminal background check within the past five years.

Correction Verification
Submit Documentation

Compliance Date
1/23/2020
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Ashley Large, Halley Widel, Mya Schnetter, and Kaylee Cates 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
2/6/2020
Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Halley Widel, Mya Schnettler, Alexandria Phillips, and Kaylee Cates.
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
2/7/2020
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for 1 child(ren).
Licensing Rule Reference
19 CSR 30-62.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
1/17/2020
19 CSR 30-62.202 Nutrition and Food Service
Violation
 Provider Comments
Violation
The provider did not meet requirements for a written diet plan for each infant and toddler as evidenced by the written diet plan was not updated for a child in that Child 3 and Child 5 needs the second page of the diet plans updated.
Licensing Rule Reference
19 CSR 30-62.202 Nutrition and Food Service (2) (B) states: The written diet plan for each infant/toddler shall be followed. The parent(s) shall update the plan according to the individual needs of the child until they grant permission in writing for the child to eat table foods.
Correction Required
A written diet plan shall be on file for each infant/toddler, updated as needed and followed by caregivers.

Correction Verification
Submit Documentation

Compliance Date
1/17/2020
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
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 — report made to another state, when. —
Compliance
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance