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

ALYSSA MARIE RILEY

24 MONTHS - 5 YEARS

80

GROUP HOME AND CENTER

 
Inspection Information

01/22/2021

8:25 AM

11:29 AM

UNANNOUNCED

COMPLIANCE MONITORING

2391874835


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
SANITATION INSPECTION 07/10/2020
APPLICATION 04/02/2019
EQUIPMENT LIST 04/11/2019
FIRE/SAFETY INSPECTION 08/20/2020
STAFF SHEET 04/11/2019




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 16
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 14
Total Children 38
StaffChildClass AgeNote
1 7 MIXED 2-3 years old in the blue room with teacher Alexa Capps
2 0 NO CHILDREN IN ATTENDANCE admin-Kin Wan and director=Rachel Closson
2 1 PRESCHOOL 4 year old in the green room with teacher Melissa Krause and Casey Gutting
2 8 PRESCHOOL 4-5 years old in the red room with teachers Tori Sirles and Ana Theerman
2 5 PRESCHOOL 3-4 years old with teachers Julianne Stillman and Deanna Rothhaar in the orange room
2 10 PRESCHOOL 3-4 years old with teachers Lori Boyer and teachers Stephanie Waser in the yellow room
3 7 TWO YEAR OLDS in the rainbow room with teachers Melissa Briggs, Claudine Mourer, and Isabella Mourer

 
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
Compliance
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: hand sanitizer, clorox wipes, and disinfectant aerosol sprays . The item(s) was/were located in the Music/Spanish room and throughout the building in stands.
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
Submit Documentation

Compliance Date

19 CSR 30-62.087 Fire Safety
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
The facility's disaster and emergency plan was not available in each room used for childcare as evidenced by the emergency plan was not available in the music/Spanish room.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster and emergency plan is readily available in the office area and in each room used for care of children;
Correction Required
The facilities disaster and emergency plan must be available in required locations.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility’s list of emergency numbers was not posted in each room.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility's evacuation route diagram was not posted in each room.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (B) 2. states: A diagram of evacuation routes from the room;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility's special instructions for infants and non-ambulatory children were not posted in each room.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (B) 3. states: Any special instructions for infants and non-ambulatory children;
Correction Required
Facility must post information 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
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Alexa Capps and Isabella Mourer.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (J) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering and before being left alone with children that caregivers receive a facility orientation. The child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not meet requirements for a criminal background check. Results were not on file for the following staff member(s): Alexa Capps and Isabella Mourer.
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 first aid and CPR training were not met as evidenced by at least one caregiver for every 20 children in capacity was not certified in first aid/CPR in that no staff members are currently certified in first aid/CPR. The facility needs at least 4 staff members on staff .
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (S) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be and approved by the department.
Correction Required
Required certification in first aid/CPR shall be on file. At least one caregiver with the certification shall be on site as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for obtaining 12 clock hours each calendar year were not met. The staff listed need the following information: Rachel Closson needs 2 hours, Erica Farnsworth needs 12 hours, Claudine Mourer needs 10 hours, Kellie Schilling needs 4.25 hours, Alexa Capps needs 1 hours, Ana Theerman needs 5 hours, and Julianne Stillman needs 1 hour. .
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

Violation
The requirements for first aid and CPR training were not met as evidenced by at least one caregiver certified in first aid/CPR was not on site.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (S) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be and approved by the department.
Correction Required
Required certification in first aid/CPR shall be on file. At least one caregiver with the certification shall be on site as required.

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 Alexa Capps 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 Alexa Capps.
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

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 8/26/20.
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
Corrected on Site

Compliance Date
1/22/2021
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

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
7 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 address of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
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 field trip and transportation authorization.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (F) states: Field trip and transportation authorization.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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