DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

MALDEN UNITED PENTECOSTAL CHURCH

002294780

(573) 276-2889

22439 STATE HIGHWAY J
MALDEN
MO  63863

MALDEN UNITED PENECOSTAL CHURCH



 

MOORE, KIMBERLY ANN

mooreka07@yahoo.com


DAYNEEN GLASTETTER

BIRTH - 13 YEARS

49

LICENSE EXEMPT PROGRAM

16 CHILDREN UNDER 24 MONTHS
 
Inspection Information

03/02/2020

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2377006344


DocumentDocument-Date
SANITATION INSPECTION 12/23/2019
FIRE/SAFETY INSPECTION 01/16/2020
NOTICE OF PARENTAL RESPONSIBILITY 08/02/2019




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
Compliance
19 CSR 30-60.050 Staffing Requirements
Violation
 Provider Comments
Violation
The facility did not meet requirements for a criminal background check. Results were not on file for the following child care staff member(s): Eula Rodgers, and Bobby Moore.
Licensing Rule Reference
19 CSR 30-60.050 Staffing Requirements (4) states: Facilities operated by a religious organization and that receive federal funds for providing care for children shall have on file qualifying background screening results for child care staff members in accordance with19 CSR 30-63.020 General Requirements.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
3/2/2020
Violation
The facility did not meet requirements for requests/results of a criminal background check. A criminal background check on file is older than five years for the following staff member(s): Eula Rodgers and Bobby Moore.
Licensing Rule Reference
19 CSR 30-60.050 Staffing Requirements (6) states: Criminal background checks shall be completed every five (5) years for child care staff members of nursery schools and facilities operated by a religious organization and that receive federal funds for providing care for children in accordance with 19 CSR 30-63.020 General Requirements.
Correction Required
Required requests/results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
3/2/2020
19 CSR 30-60.060 Health Requirements
Violation
 Provider Comments
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 10-1-17.
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
1/16/2020
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
Violation
 Provider Comments
Violation
The equipment, a all the stationary play climbers that have mats around them, that is over 24 inches high, does not have sufficient impact absorbing material present as evidenced by need to be replaced with approved resilient materials.
Licensing Rule Reference
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment 4 (D) states: The fall-zone area under and around outdoor equipment over twenty-four inches (24") high covered with impact-absorbing materials that will effectively cushion the fall of a child. Materials may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.
Correction Required
Impact absorbent materials shall be in the fall zone for any equipment over 24 inches high.

Correction Verification
Submit Documentation

Compliance Date
2/27/2020
Violation
The equipment, a big tractor rubber tires, that is over 24 inches high, does not have sufficient impact absorbing material present as evidenced by viewing no approved resilient surfacing around it as required.
Licensing Rule Reference
19 CSR 30-60.100 Physical Plant, Space, Supplies and Equipment 4 (D) states: The fall-zone area under and around outdoor equipment over twenty-four inches (24") high covered with impact-absorbing materials that will effectively cushion the fall of a child. Materials may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.
Correction Required
Impact absorbent materials shall be in the fall zone for any equipment over 24 inches high.

Correction Verification
Submit Documentation

Compliance Date
2/27/2020
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