DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

BOYS CLUBS OF GREATER KANSAS CITY

001872979

(816) 257-7010

16995 E DOVER LN
INDEPENDENCE
MO  64056-1591

BOYS CLUBS OF GREATER KANSAS CITY

4001 BLUE PKWY STE 102
KANSAS CITY
MO  64130-2350

MOORE, TYRONE

SDUNN@HELPKCKIDS.ORG

Incorporated

ROMENA FOX

5 YEARS - 12 YEARS

150

GROUP HOME AND CENTER

 
Inspection Information

12/30/2020

2:50 PM

5:38 PM

UNANNOUNCED

COMPLIANCE MONITORING

2390547881


DocumentDocument-Date
SANITATION INSPECTION 09/01/2020
ANNUAL DECLARATION 10/21/2020
SAMPLE WEEKLY MENU 03/24/2005
SAMPLE FORMS 08/20/2004
POLICIES 08/20/2004
LOCAL ZONING APPROVAL 08/20/2004
LOCAL BUILDING APPROVAL 08/20/2004
LINES OF ADMINISTRATIVE AUTHORITY 08/20/2004
JOB RESPONSIBILITIES 08/20/2004
DISCIPLINE POLICIES 08/20/2004
DIAGRAM/OUTDOOR 09/26/2007
DIAGRAM/INDOOR 03/26/2008
DAILY SCHEDULE 03/24/2005
CHILD CARE PRACTICES 08/20/2004
ARTICLES OF INCORPORATION 08/20/2004
REGISTERING FICTITIOUS NAMES 09/27/2013
DIRECTOR'S QUALIFICATIONS 08/27/2015
CERTIFICATE OF GOOD STANDING 06/29/2017
FIRE/SAFETY INSPECTION 08/26/2019
STAFF SHEET 09/05/2019
EQUIPMENT LIST 09/05/2019




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 12
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 6
Total Children 4
StaffChildClass AgeNote
3 0 NO CHILDREN IN ATTENDANCE Also present on premises was Chris Collier, Person In Charge; Angela Burns, Membership Coordinator; and Steve Elcyzyn, Maintenance
3 4 SCHOOL AGE Caregivers Ashley Deronville, Isaac Fue-King, and Evelyn Neal with four (4) children, all school age

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Initial Licensing Information
Compliance
19 CSR 30-62.052 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Chris Collier within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Submit Documentation

Compliance Date

Violation
The annual fire safety inspection was not conducted.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.
Correction Required
The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification
Submit Documentation

Compliance Date

Violation
The staff sheet was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (D) states: A current staff sheet.
Correction Required
The facility shall submit a current staff sheet as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The equipment list was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (C) states: A current list of available equipment.
Correction Required
The facility shall submit an equipment list as required.

Correction Verification
Return Inspection

Compliance Date

19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
Hazardous items as follows were accessible to children: chemicals. The item(s) was/were located in the storage room and in the third/fourth grade classroom.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (I) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
12/30/2020
Violation
The walls located in the kindergarten/second grade room, third/fourth grade room, fourth/fifth grade room, gym, and the hallway between the kindergarten/second grade room and the gym was/were not in good condition as evidenced by chipping paint and holes (in the hallway between kindergarten/second grade room and the gym).
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

Violation
The fall-zone area under and around outdoor equipment where children might fall and be injured was not covered with impact-absorbing materials to cushion a fall as evidenced by resilient material was not uniformly spread over the fall-zone area.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 7. states: Areas under and around outdoor equipment shall have continuous maintenance to ensure that the material remains in place and retains its cushioning properties. The resilient material shall be supplemented immediately or replaced as needed.
Correction Required
The facility shall maintain approved resilient material in all fall-zone areas.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility's outdoor space was not safe for children's activities as evidenced by trash in the play area.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.087 Fire Safety
Not Observed
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
The provider did not meet requirements for a criminal background check. The provider did not request the results of a criminal background check prior to employment or presence in the facility for the following staff: Chris Collier and Steve Elcyzyn.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (L) states: The provider shall request the results of a criminal background check for child care staff members as required by 19 CSR 30-63.020 General Requirements.
Correction Required
Required requests of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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 Evelyn Neal, Prentice Terrance and Chris Collier 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
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Chris Collier.
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
Violation
 Provider Comments
Violation
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.
Correction Required
An individualized plan from a professional source shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Not Observed
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 one (1) immunization record(s) was/were not on file.
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

19 CSR 30-62.202 Nutrition and Food Service
Not Observed
19 CSR 30-62.212 Transportation and Field Trips
Not Observed
19 CSR 30-62.222 Records and Reports
Violation
 Provider Comments
Violation
Two (2) child(ren) records did not include child's address.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
12/30/2020
Violation
One (1) child(ren) records did not include home 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
Corrected on Site

Compliance Date
12/30/2020
Violation
One (1) child(ren) records did not include employers' name 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
Corrected on Site

Compliance Date
12/30/2020
Violation
One (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
Corrected on Site

Compliance Date
12/30/2020
Violation
One (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
Corrected on Site

Compliance Date
12/30/2020
Violation
One (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
Corrected on Site

Compliance Date
12/30/2020
19 CSR 30-63.020 General Requirements
Compliance
19 CSR 30-63.040 Background Screening Findings
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