DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

UNLEASHING POTENTIAL

002947753

(314) 831-4633

955 DERHAKE RD
FLORISSANT
MO  63033-5931

UNLEASHING POTENTIAL

1000 N VANDEVENTER AVE STE 2
ST LOUIS
MO  63113-3460

CAMPBELL, YOLANDA J

ghampton@upstl.org

Incorporated

DENISE ELAYNE KOCH

5 YEARS - 12 YEARS

32

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

10/04/2022

7:31 AM

8:06 AM

UNANNOUNCED

POST LICENSING

2432398245


DocumentDocument-Date
STAFF SHEET 07/28/2022
ARTICLES OF INCORPORATION 08/17/2022
CERTIFICATE OF INCORPORATION 08/17/2022
DIRECTOR'S QUALIFICATIONS 08/08/2022
LOCAL FIRE DEPARTMENT NOTIFICATION 04/13/2022
CERTIFICATE OF GOOD STANDING 04/13/2022
LINES OF ADMINISTRATIVE AUTHORITY 07/28/2022
POLICIES 07/28/2022
DISASTER AND EMERGENCY PREPAREDNESS PLAN 04/13/2022
DIRECTOR'S JOB RESPONSIBILITIES 07/28/2022
DISCIPLINE POLICIES 07/28/2022
CHILD CARE PRACTICES 07/28/2022
DAILY SCHEDULE 07/28/2022
APPLICATION 04/13/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 07/28/2022
EQUIPMENT LIST 07/28/2022




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
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 1
Total Children 10
StaffChildClass AgeNote
1 10 SCHOOL AGE Teacher E.G was present with ten children ages 8-years-old to 10-years-old.

 
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 25-500.090 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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by for children with birthdates 4/18/13 & 12/10/13 immunization record(s) was/were not on file .
Licensing Rule Reference
5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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