DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

HERBERT HOOVER BOYS AND GIRLS CLUB - ADAMS PARK UNIT

002068711

(314) 633-7900

4317 VISTA AVE
ST LOUIS
MO  63110

THE HERBERT HOOVER BOYS AND GIRLS CLUB OF ST. LOUIS, INC.



 

JEFFRIES, MARLA

KEISHA@BGCSTL.ORG

Incorporated

KATHERINE D SIMS

5 YEARS - 16 YEARS

256

SCHOOL AGE

 
Inspection Information

05/25/2021

7:40 AM

9:04 AM

UNANNOUNCED

COMPLIANCE MONITORING

2400737317


DocumentDocument-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/01/2021
SAMPLE WEEKLY MENU 02/28/2008
LINES OF ADMINISTRATIVE AUTHORITY 11/01/2007
JOB RESPONSIBILITIES 02/28/2008
DISCIPLINE POLICIES 02/28/2008
DIRECTOR'S QUALIFICATIONS 07/02/2012
DIRECTOR'S JOB RESPONSIBILITIES 02/28/2012
DAILY SCHEDULE 02/28/2008
CHILD CARE PRACTICES 02/28/2008
SAMPLE FORMS 02/28/2008
POLICIES 02/28/2008
CERTIFICATE OF INCORPORATION 11/01/2007
ARTICLES OF INCORPORATION 11/01/2007
CERTIFICATE OF GOOD STANDING 05/18/2018
EQUIPMENT LIST 04/01/2021
STAFF SHEET 08/21/2020
REGISTERING FICTITIOUS NAMES 07/02/2012
APPLICATION 05/04/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 05/25/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 8
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 4
Total Children 8
StaffChildClass AgeNote
3 0 NO CHILDREN IN ATTENDANCE Natalie Wathen, Kemonica Green, and Marla Jefferies (arrived at 8:10am) present with no children in attendance
1 8 SCHOOL AGE Teri Bascom present with 8 children, ages 6-14yrs old

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Licensing Process
Compliance
19 CSR 30-62.052 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Marla Jefferies 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 Declaration was not completed as evidenced by the name of the owner on the Annual Declaration is incorrect.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, promulgated as of 2020 and incorporated by reference in this rule. As published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102-0570 and available by the department at https://health.mo.gov/safety/childcare/forms.php indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.
Correction Required
The facility shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Nakesia Daugherty and Jamie Downs.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (K) . 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
Clock hour training records were not available for review.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (F) 2. states: All clock hour training records shall be recorded in the Missouri Professional Development Registry (MOPD Registry) at www.OPENInitiative.org. A summary of training from the MOPD System will serve as documentation of training hours completed.
Correction Required
Required training hours shall be documented for each employee on the MOPD Registry.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2020, the staff listed need the following information: Marla Jefferies needs 7hrs, Natalie Wathen needs 3hrs, Benjamin Fulcher needs 2hrs, KeMonica Green needs 1hr, Dana Jones needs 12hrs, Charles Jackson needs 8hrs,Henry Johnson needs 8hrs, Brandy Sanford needs 12hrs, Matthew Conner needs 12hrs, and Brenisha Banks needs 5hrs .
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (A) states: The center director, group child 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 caregiver.

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 form did not contain all required information as evidenced by Fredrick Hamilton 's medical exam needs the yes/no box completed.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (D) states: The medical examination report form shall be supplied by the department or the facility may use its own form if it contains all the information on the department's form.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.132 Admission Policies and Procedures
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
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

19 CSR 30-63.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Mark Bulanda, Nakesia Daugherty, Brandy Sanford, Matthew Conner, Jamie Downs, and Brenisha Banks.
Licensing Rule Reference
19 CSR 30-63.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a family child care home, group child care home, child care center, or license-exempt facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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