DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

GOOD SHEPHERD ACADEMY

001837169

(314) 351-5437

5500 VIRGINIA AVE
ST LOUIS
MO  63111-1939

GOOD SHEPHERD PRE-SCHOOL AND DAY CARE, LLC



 

FISHER, TAMMY

GOODSHEPHERDSTL@ATT.NET


JOYCE E GREEN

BIRTH - 12 YEARS

70

GROUP HOME AND CENTER

14 CHILDREN IN THE INFANT/TODDLER UNIT; 8 CHILDREN UNDER 12 MONTHS; 14 CHILDREN UNDER 24 MONTHS
 
Inspection Information

08/24/2022

10:20 AM

12:29 PM

UNANNOUNCED

COMPLIANCE MONITORING

2429721038


DocumentDocument-Date
ANNUAL DECLARATION 01/31/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/31/2022
ANNUAL DECLARATION 12/28/2021
LOCAL FIRE DEPARTMENT NOTIFICATION 11/07/2011
LINES OF ADMINISTRATIVE AUTHORITY 04/22/2004
DAILY SCHEDULE 04/22/2004
DISCIPLINE POLICIES 04/22/2004
CHILD CARE PRACTICES 04/22/2004
LOCAL ZONING APPROVAL 12/14/2017
LLC ARTICLES OF ORGANIZATION 12/24/2003
CERTIFICATE OF GOOD STANDING 12/24/2019
DIAGRAM/INDOOR 04/22/2004
DIAGRAM/OUTDOOR 04/22/2004
DIRECTOR'S QUALIFICATIONS 04/07/2005
DISASTER AND EMERGENCY PREPAREDNESS PLAN 06/07/2013
POLICIES 04/22/2004
LLC OPERATING AGREEMENT 01/07/2004
SAMPLE WEEKLY MENU 03/19/2004
JOB RESPONSIBILITIES 04/28/2004
REGISTERING FICTITIOUS NAMES 12/24/2019
LOCAL BUILDING APPROVAL 12/30/2019
FIRE/SAFETY INSPECTION 10/27/2021
SANITATION INSPECTION 11/20/2020
STAFF SHEET 12/28/2021
EQUIPMENT LIST 01/31/2022
APPLICATION 12/29/2020




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 10
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 3
Total Children 9
StaffChildClass AgeNote
1 3 INFANTS AND TODDLERS Tikina Jones, teacher, was present with three children, aged 14-months old to 18-months old.
1 0 NO CHILDREN IN ATTENDANCE Tammy Fisher, director, was present with no children.
1 6 PRESCHOOL Kathryn Jefferson, teacher, was present with six children, aged 2-years old to 5-years old.

Compliance List
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 facility is owned by a legal entity and evidence of good standing was not available.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (D) states: Documentation as required by the Missouri Secretary of State and state law to verify the legal entity is in good standing, if a group child care home or child care center is owned by a legal entity.
Correction Required
The facility shall submit evidence that the legal entity is in good standing with the Missouri Secretary of State and state law.

Correction Verification
Submit Documentation

Compliance Date
7/6/2022
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
The walls located in the infant room was/were not in good condition as evidenced by there was chipping paint on the white wall.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date
7/6/2022
Violation
The walls located preschool space was/were not in good condition as evidenced by there was chipping paint on the corners of the pillars..
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date
7/6/2022
Violation
The facility's outdoor space was not safe for children's activities as evidenced by there were grass and weeds growing throughout and around the perimeter of the I/T and preschool/school age play area .
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
7/6/2022
Violation
The facility's outdoor space was not safe for children's activities as evidenced by there were weeds growing throughout the pea gravel on the play space and underneath the jungle gym equipment. A black cloth material was also observed coming through the pea gravel.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 4. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The walls located in the Pre-K Restroom underneath the sink was/were not in good condition as evidenced by a hole (approximately 3 -4 inches in size) was observed in the wall.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

Violation
The floors located in the School Age Restroom was/were not in good condition as evidenced by as broken tile was observed and presented a hazard to children.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

Violation
The floors located in the 2-Year Old Room Restroom was/were not clean as evidenced by a build up pf dirt was observed on the floor.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Outdoor equipment, two basketball hoops , in the preschool/school age play area was not in good condition as evidenced by the hoops were not fully assemebled or had missing parts and could not be used.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.
Correction Required
Outdoor play equipment shall be safe and in good repair.

Correction Verification
Submit Documentation

Compliance Date

Violation
Outdoor equipment, chair, in in the preschool/school age play area was not in good condition as evidenced by the back of the chair was cracked and presented a hazard to children.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.
Correction Required
Outdoor play equipment shall be safe and in good repair.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
Background screening information was not available for review for Tammy Fisher, Kathryn Jefferson, Wanda Ray and Tikina Jones.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (Q) states: Background screening information received by the provider shall be retained in the individual’s file in a confidential manner and available for review.
Correction Required
Background screening information shall be available and kept confidential.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
The medical examination report and/or the school-age health report form(s) used was not supplied by the department or did not contain all the required information as evidenced by the form did not state the children could participate in a child care program.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (2) (E) states: The medical examination report form and the health history report for school-age children shall be supplied by the department or the facility may use its own form if it contains all the information on the department’s form. The School-Age Child Health Report form, revised 2021, is incorporated by reference in this rule, as published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department athttps://dese.mo.gov/childhood/forms. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.132 Admission Policies and Procedures
Compliance
5 CSR 25-500.142 Nighttime Care
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
One child(ren) records did not include name of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
One child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
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
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