DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

UNLEASHING POTENTIAL

002390710

(314) 762-9818

4300 MORGANFORD RD
ST LOUIS
MO  63116-1504

UNLEASHING POTENTIAL

1000 N VANDEVENTER AVE 2ND FL
ST LOUIS
MO  63113-3435

HOLLINGSWORTH, JEANIE LAKEASHA

ghampton@upstl.org

Incorporated

KATHERINE D SIMS

5 YEARS - 12 YEARS

60

SCHOOL AGE

 
Inspection Information

05/18/2021

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2400118841


DocumentDocument-Date
ANNUAL DECLARATION 10/19/2020
LINES OF ADMINISTRATIVE AUTHORITY 12/13/2012
DIRECTOR'S QUALIFICATIONS 10/13/2020
SAMPLE WEEKLY MENU 02/05/2013
SAMPLE FORMS 02/05/2013
POLICIES 02/05/2013
DISCIPLINE POLICIES 02/05/2013
DAILY SCHEDULE 02/05/2013
CHILD CARE PRACTICES 02/05/2013
CERTIFICATE OF GOOD STANDING 11/19/2018
APPLICATION 11/05/2018
EQUIPMENT LIST 11/12/2020
STAFF SHEET 10/19/2020
LOCAL FIRE DEPARTMENT NOTIFICATION 08/02/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 11/19/2018




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 Licensing Process
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
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
Compliance
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Compliance
19 CSR 30-62.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information as evidenced by Child A needs authorization for emergency medical care.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (8) (E) 4. states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
5/14/2021
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
Compliance
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
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
5/14/2021
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