DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

UNLEASHING POTENTIAL

002535859

(314) 269-7502

1500 82ND BLVD
ST LOUIS
MO  63132-2606

UNLEASHING POTENTIAL

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

JOHNSON, RACHELE CELESTE

ghampton@upstl.org

Incorporated

SHALINDA WALLACE

5 YEARS - 12 YEARS

60

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

02/28/2022

2:19 PM

2:19 PM

UNANNOUNCED

SUPPLEMENTAL

2418715021


DocumentDocument-Date
ARTICLES OF INCORPORATION 05/22/2015
CERTIFICATE OF GOOD STANDING 05/22/2015
CHILD CARE PRACTICES 06/18/2015
DAILY SCHEDULE 06/18/2015
DIAGRAM/INDOOR 06/18/2015
DIAGRAM/OUTDOOR 06/18/2015
DIRECTOR'S QUALIFICATIONS 06/18/2015
DISCIPLINE POLICIES 06/18/2015
JOB RESPONSIBILITIES 06/18/2015
LINES OF ADMINISTRATIVE AUTHORITY 05/22/2015
POLICIES 06/18/2015
SAMPLE FORMS 06/18/2015
SAMPLE WEEKLY MENU 06/18/2015
REGISTERING FICTITIOUS NAMES 05/20/2015
APPLICATION 03/25/2019
STAFF SHEET 04/02/2019
ANNUAL DECLARATION 04/07/2021
EQUIPMENT LIST 04/07/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 05/27/2021




Inspection determined facility to be in compliance with licensing rules.
Compliance 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.

Compliance List
5 CSR 25-500.032 Organization and Administration
Not Observed
5 CSR 25-500.042 Licensing Process
Not Observed
5 CSR 25-500.052 Annual Requirements
Not Observed
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Not Observed
5 CSR 25-500.090 Disaster and Emergency Preparedness
Not Observed
5 CSR 25-500.092 Furniture, Equipment and Materials
Not Observed
5 CSR 25-500.102 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: Makia Hoormann, Kevin Norman, and Perrin Crouch.
Licensing Rule Reference
5 CSR 25-500.102 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

5 CSR 25-500.112 Staff/Child Ratios
Not Observed
5 CSR 25-500.122 Medical Examination Reports
Not Observed
5 CSR 25-500.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information as evidenced by four children's files did not have authorization for emergency medical care documented in the files.
Licensing Rule Reference
5 CSR 25-500.132 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 CSR 25-500.172 Emergency School Closings
Not Observed
5 CSR 25-500.182 Child Care Program
Not Observed
5 CSR 25-500.192 Health Care
Not Observed
5 CSR 25-500.202 Nutrition and Food Service
Not Observed
5 CSR 25-500.212 Transportation and Field Trips
Not Observed
5 CSR 25-500.222 Records and Reports
Violation
 Provider Comments
Violation
Five child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the 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

5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Makia Hoormann, .
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

5 CSR 25-600.040 Background Screening Findings
Not Observed
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. —
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed