DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

CALIFORNIA UNITED METHODIST PLAYSCHOOL

001407203

(573) 796-2792

201 S OAK ST
CALIFORNIA
MO  65018

UNITED METHODIST CHURCH



 

KINCHENS, EMILY

kinchens6@aol.com


AMY BANNING

24 MONTHS - 4 YEARS

25

LICENSE EXEMPT PROGRAM

 
Inspection Information

02/27/2020

9:40 AM

10:40 AM

ANNOUNCED

ANNUAL

2376791001


DocumentDocument-Date
SANITATION INSPECTION 01/14/2020
FIRE/SAFETY INSPECTION 01/06/2020
NOTICE OF PARENTAL RESPONSIBILITY 02/27/2020




Inspection determined facility to be in compliance with rules.
Open Violations: 10
Attendance at Time of Inspection
Total Staff 2
Total Children 14
StaffChildClass AgeNote
2 14 PRESCHOOL Emily & Melanie NPR 1:12

 
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 form was not filed annually, during the month of August, with the department.
Licensing Rule Reference
19 CSR 30-60.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures (6) (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
The Notice of Parental Responsibility form shall be filed annually, during the month of August, with the department.

Correction Verification
Corrected on Site

Compliance Date
2/27/2020
19 CSR 30-60.050 Staffing Requirements
Compliance
19 CSR 30-60.060 Health Requirements
Violation
 Provider Comments
Violation
TB reports on file were older than 24 months for Emily Kinchens.
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
Medical examination reports, including TB testing, were not on file for Melanie Porter 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 30-60.060 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

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 8/2019.
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

Violation
Requirements for immunization reports on file were not met as evidenced by verification of required immunizations was not satisfactory in that an immunization record was missing for one child.
Licensing Rule Reference
19 CSR 30-60.060 Health Requirements (3) states: Child care facilities shall meet immunization requirements for children as defined by section 210.003, RSMo.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Medical examination reports, including TB testing, were not on file for Melanie Porter 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

19 CSR 30-60.070 Responsibilities of Caregivers
Compliance
19 CSR 30-60.080 Fire Safety Requirements
Violation
 Provider Comments
Violation
Requirements of 19 CSR 30-60.080 Fire Safety were not met as evidenced by tornado drills were not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-60.080 Fire Safety Requirements 5 states: Fire and tornado drills shall be conducted at least every three (3) months and shall include all children in care. Unscheduled drills shall be held at the discretion of the state fire marshal or department. Each fire drill shall include a complete evacuation of all persons from the building.
Correction Required
Fire and tornado drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Requirements of 19 CSR 30-60.080 Fire Safety were not met as evidenced by fire drills were not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-60.080 Fire Safety Requirements 5 states: Fire and tornado drills shall be conducted at least every three (3) months and shall include all children in care. Unscheduled drills shall be held at the discretion of the state fire marshal or department. Each fire drill shall include a complete evacuation of all persons from the building.
Correction Required
Fire and tornado drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-60.090 Sanitation Requirements
Compliance
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment
Violation
 Provider Comments
Violation
Emergency numbers for the police, fire department, poison control, and ambulance were not posted.
Licensing Rule Reference
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment 2 (D) states: Police, fire department, poison control, ambulance and other emergency numbers posted near the telephone.
Correction Required
Emergency numbers shall be posted near the telephone.

Correction Verification
Submit Documentation

Compliance Date

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 one 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 one child files did not have the name and phone number of the family physician, or hospital, or both.
Licensing Rule Reference
19 CSR 30-60.120 Admission Procedures and Required Reports and Records 2 (D) states: Name and phone number of a physician and preferred hospital to be used in an emergency.
Correction Required
An individual file with required information for each child shall be maintained.

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 210.115 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