DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

WAVERLY FOREST ACADEMY, LLC

002140516

(636) 940-0550

3545 FRANKS DR
ST CHARLES
MO  63301-4041

WAVERLY FOREST ACADEMY, LLC



 

COMBS, ALYSSA ANN

INFO@WAVERLYFOREST.COM


KATHERINE D SIMS

6 WEEKS - 12 YEARS

93

GROUP HOME AND CENTER

9 CHILDREN UNDER 12 MONTHS; 25 CHILDREN UNDER 24 MONTHS
 
Inspection Information

09/21/2021

11:10 AM

12:19 PM

UNANNOUNCED

COMPLIANCE MONITORING

2408793954


DocumentDocument-Date
SAMPLE WEEKLY MENU 03/10/2009
POLICIES 03/10/2009
LINES OF ADMINISTRATIVE AUTHORITY 03/10/2009
JOB RESPONSIBILITIES 03/10/2009
DISCIPLINE POLICIES 03/10/2009
DAILY SCHEDULE 03/10/2009
CHILD CARE PRACTICES 03/10/2009
DIRECTOR'S QUALIFICATIONS 03/23/2009
SAMPLE FORMS 03/19/2009
DIAGRAM/OUTDOOR 03/10/2009
DIAGRAM/INDOOR 03/10/2009
LOCAL ZONING APPROVAL 03/19/2009
LLC OPERATING AGREEMENT 03/10/2009
LLC ARTICLES OF ORGANIZATION 03/10/2009
LOCAL BUILDING APPROVAL 01/11/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 03/10/2009
SAFE SLEEP POLICY 10/22/2018
CERTIFICATE OF GOOD STANDING 01/17/2019
APPLICATION 10/23/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 01/02/2019
STAFF SHEET 01/18/2019
EQUIPMENT LIST 02/21/2021
SANITATION INSPECTION 11/30/2020
FIRE/SAFETY INSPECTION 12/15/2020
ANNUAL DECLARATION 02/25/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/21/2021




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 4
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 13
Total Children 61
StaffChildClass AgeNote
2 8 INFANTS AND TODDLERS Hailey Schroer and Jaelyn Blake present with 8 children, all 1yr old
1 4 INFANTS AND TODDLERS Leanna Isaacson present with 4 children, all 1yr old
2 7 INFANTS AND TODDLERS Mary Shepardson and Amanda Williams present with 7 children, ages 6w-12m old
3 0 NO CHILDREN IN ATTENDANCE Alyssa Combs, Amber Schomaker, and Michelle Fischer present with no children in attendance
2 17 PRESCHOOL Tonya Vaughn and Callie Lutz present with 17 children, ages 3-4yrs old Mara Arnold from Dance Time also present
1 10 PRESCHOOL Ashley Smith present with 10 children, ages 4-5yrs old
2 15 TWO YEAR OLDS Amy Richter and Missy Holmes present with 15 children, all 2yrs 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
Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
19 CSR 30-62.087 Fire Safety
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
The facility did not conduct a Family Care Safety Registry screening for Callie Lutz, who was hired on 8/23/21.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.
Correction Required
Required results of the Family Care Safety Registry screening shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Callie Lutz, Madison Wedekin, and Jaelyn Blake.
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
Corrected on Site

Compliance Date
9/21/2021
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
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
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 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

Violation
2 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
Submit Documentation

Compliance Date

19 CSR 30-63.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Claire Chase.
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