DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

HERMITAGE R-IV SCHOOL DISTRICT

002802033

(417) 745-6277

23824 POLK ST
HERMITAGE
MO  65668-8213

HERMITAGE R-IV SCHOOL DISTRICT



 

VENANCIO, DIANE CHRISTINE

skobe@hermitage.k12.mo.us


ALISON MICHELE EVANS

5 YEARS - 15 YEARS

32

SCHOOL AGE

AFTER SCHOOL CARE ONLY
 
Inspection Information

03/03/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2419511706


DocumentDocument-Date
DIRECTOR'S JOB RESPONSIBILITIES 06/24/2020
LINES OF ADMINISTRATIVE AUTHORITY 06/24/2020
DIRECTOR'S QUALIFICATIONS 01/22/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 06/23/2020
LOCAL FIRE DEPARTMENT NOTIFICATION 06/29/2020
POLICIES 06/23/2020
EQUIPMENT LIST 10/18/2021
JOB RESPONSIBILITIES 02/02/2020
DISCIPLINE POLICIES 06/24/2020
STAFF SHEET 06/24/2020
SAMPLE WEEKLY MENU 02/02/2020
CHILD CARE PRACTICES 06/23/2020
DAILY SCHEDULE 02/02/2020
APPLICATION 06/24/2020




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
Violation
 Provider Comments
Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 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
3/1/2022
Violation
The staff sheet was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (D) states: A current staff sheet.
Correction Required
The facility shall submit a current staff sheet as required.

Correction Verification
Submit Documentation

Compliance Date
3/1/2022
Violation
The Family Care Safety Registry check was not conducted for Linda Rhine and Diane Veriancio within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 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
3/1/2022
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
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
Compliance
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 25-500.172 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
Compliance
5 CSR 25-600.020 General Requirements
Compliance
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