DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

CALVARY CHURCH MOTHERS DAY OUT

000842708

(636) 939-4343

3998 MID RIVERS MALL DR
ST PETERS
MO  63376

CALVARY CHURCH



 

NORWINE, JULIE

MANORWINE@YAHOO.COM

Incorporated

KATHERINE D SIMS

24 MONTHS - 5 YEARS

87

LICENSE EXEMPT PROGRAM

 
Inspection Information

06/03/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2424665863


DocumentDocument-Date
SANITATION INSPECTION 02/17/2022
FIRE/SAFETY INSPECTION 02/16/2022
NOTICE OF PARENTAL RESPONSIBILITY 08/25/2021




Inspection determined facility to be in compliance with rules.
Open Violations: NA

 
5 CSR 25-300.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures
Compliance
5 CSR 25-300.040 Staffing Requirements
Compliance
5 CSR 25-300.050 Health Requirements
Violation
 Provider Comments
Violation
Medical examination reports, including TB testing, were not on file for Jennifer Lumpa and Megan Robins as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
5 CSR 25-300.050 Health Requirements (1) (D) . states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.
Correction Required
Medical/TB reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
6/2/2022
Violation
Medical examination reports, including TB testing, were not on file for Jennifer Lumpa and Megan Robins as evidenced by a cleared TB report was not on file for caregivers within 30 days of working in the facility.
Licensing Rule Reference
5 CSR 25-300.050 Health Requirements (1) (D) . states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.
Correction Required
Medical/TB reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
6/2/2022
5 CSR 25-300.060 Responsibilities of Caregivers
Compliance
5 CSR 25-300.070 Fire Safety Requirements
Compliance
5 CSR 25-300.080 Sanitation Requirements
Compliance
5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment
Compliance
5 CSR 25-300.110 Admission Procedures and Required Reports and Records
Violation
 Provider Comments
Violation
The facility's admitting procedure did not include an individualized special care plan for a child with special needs from a qualified professional source.
Licensing Rule Reference
5 CSR 25-300.110 Admission Procedures and Required Reports and Records 1 states: The facility director shall have an admitting procedure for each child in care that includes a plan for caring for the child if s/he becomes ill or needs emergency medical treatment. The director shall maintain an individual file on each child in order to communicate with the parent(s), guardian or legal custodian. The director shall have a plan for any child with special health needs, identified through a physical assessment by a licensed physician or an advance practice nurse, to ensure that those needs are met during care.
Correction Required
The facility shall have an admitting procedure for each child in care which includes a plan for ill children, emergency medical care, and special health needs.

Correction Verification
Submit Documentation

Compliance Date
6/3/2022
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child files did not have the child’s full name, address, birth date and the date care begins and ends.
Licensing Rule Reference
5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (A) states: The child's full name, address, birth date and the date care begins and ends.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
6/3/2022
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child files did not have the full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.
Licensing Rule Reference
5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (B) states: The full name of the parent(s), guardian or legal custodian, home address, work schedule, home and work telephone numbers, and employer's name and address.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
6/3/2022
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child files did not have the name and phone number of the family physician, or hospital, or both.
Licensing Rule Reference
5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (D) states: Name and phone number of a physician and preferred hospital to be used in an emergency.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
6/3/2022
5 CSR 25-600.020 General Requirements
Compliance
5 CSR 25-600.040 Background Screening Findings
Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Violation
 Provider Comments
Violation
Parent and/or guardian was not notified upon request of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.
Licensing Rule Reference
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when. 7. states: All public, private, and parochial day care centers, preschools, and nursery schools shall notify the parent or guardian of each child at the time of initial enrollment in or attendance at the facility that the parent or guardian may request notice of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed. Beginning December 1, 2015, all public, private, and parochial day care centers, preschools, and nursery schools shall notify the parent or guardian of each child currently enrolled in or attending the facility that the parent or guardian may request notice of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed. Any public, private, or parochial day care center, preschool, or nursery school shall notify the parent or guardian of a child enrolled in or attending the facility, upon request, of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.
Correction Required
Parent and/or guardian shall be notified upon request of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.

Correction Verification
Submit Documentation

Compliance Date
6/3/2022
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.
Compliance
RSMo 210.254 Religious organization operating facilities exempt under licensing laws required to file parental notice of responsibility and fire, safety inspections annually.
Compliance
RSMo 210.255 Religious organizations operating facility in violation, procedure - noncompliance after notice, prosecutor may act or attorney general.
Compliance
RSMo 252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance