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

11/16/2021

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2412559579


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: 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.

 
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Compliance
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
5 CSR 25-500.087 Fire Safety
Compliance
5 CSR 25-500.090 Disaster and Emergency Preparedness
Compliance
5 CSR 25-500.092 Furniture, Equipment and Materials
Compliance
5 CSR 25-500.102 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
5 CSR 25-500.102 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
10/29/2021
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Compliance
5 CSR 25-500.132 Admission Policies and Procedures
Compliance
5 CSR 25-500.142 Nighttime Care
Compliance
5 CSR 25-500.152 Hourly Care Facilities
Compliance
5 CSR 25-500.162 Overlap Care of Children
Compliance
5 CSR 25-500.172 Emergency School Closings
Compliance
5 CSR 25-500.182 Child Care Program
Compliance
5 CSR 25-500.192 Health Care
Compliance
5 CSR 25-500.202 Nutrition and Food Service
Compliance
5 CSR 25-500.212 Transportation and Field Trips
Compliance
5 CSR 25-500.222 Records and Reports
Violation
 Provider Comments
Violation
1 child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
5 CSR 25-500.222 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
9/24/2021
Violation
2 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 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
10/29/2021
5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Claire Chase.
Licensing Rule Reference
5 CSR 25-600.020 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
11/15/2021
5 CSR 25-600.040 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