DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

BIRTH ACADEMY

002829630

(314) 696-2613

4523 N 19TH ST
ST LOUIS
MO  63107-1433

JESUS IS ALL CHURCH OF GOD APOSTOLIC



 

BRUCE, MARLISHA

birtheca@gmail.com

Incorporated

KATHERINE D SIMS

6 WEEKS - 12 YEARS

33

LICENSE EXEMPT PROGRAM

16 CHILDREN UNDER 24 MONTHS
 
Inspection Information

10/21/2022

7:45 AM

8:37 AM

ANNOUNCED

ANNUAL

2433575323


DocumentDocument-Date
FIRE/SAFETY INSPECTION 09/14/2022
SANITATION INSPECTION 08/09/2022
NOTICE OF PARENTAL RESPONSIBILITY 02/08/2021




Inspection determined facility to be in compliance with rules.
Compliance Licensing Rules
Open Violations: 6
Attendance at Time of Inspection
Total Staff 1
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Caregiver, JP present with no children in attendance

Compliance List
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
Violation
 Provider Comments
Violation
Background screening information received by the provider was not available for review as evidenced by TP.
Licensing Rule Reference
5 CSR 25-300.040 Staffing Requirements (8) states: Background screening information received by the provider shall be retained in the individual’s file in a confidential manner and made available for review when requested by the department.
Correction Required
Background screening information shall be retained in the individual file, kept confidential, and made available for review when requested by the department.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-300.050 Health Requirements
Violation
 Provider Comments
Violation
Medical examination reports including TB testing were not on file for caregivers as evidenced by the medical form did not contain all required information in that JP needs the yes/no box completed on the medical exam.
Licensing Rule Reference
5 CSR 25-300.050 Health Requirements (1) (D) 2. states: The facility may use the department's physical assessment form, MO 580-1879 (6- 94), or the facility may use its own form if it contains all the information on the department's form.
Correction Required
Medical/TB reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Requirements for children's medical examination reports were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 9/15/22.
Licensing Rule Reference
5 CSR 25-300.050 Health Requirements (2) states: Within thirty (30) days following the admission of an infant, toddler or preschool child, a physical assessment report signed by a licensed physician or registered professional nurse shall be on file at the facility. The facility may use the department's physical assessment form, MO 580-1878 (6-94), or the facility may use its own form if it contains all the information on the department's form. The report shall have been completed not more than twelve (12) months before admission.
Correction Required
Children's physical assessment reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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 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

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

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.
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.
Compliance
RSMo 210.254 Religious organization operating facilities exempt under licensing laws required to file parental notice of responsibility and fire, safety inspections annually.
Violation
 Provider Comments
Violation
A copy of the notice of parental responsibility was not filed annually during the month of August to the department of health and senior services.
Licensing Rule Reference
RSMo 210.254 Religious organization operating facilities exempt under licensing laws required to file parental notice of responsibility and fire, safety inspections annually. 3. states: A copy of notice of parental responsibility, signed by the principal operating officer of the exempt child-care facility and the individual primarily responsible for the religious organization conducting the child-care facility and copies of the annual fire and safety inspections shall be filed annually during the month of August with the director of the department of health and senior services.
Correction Required
A copy of notice of parental responsibility shall be signed by the principal operating officer of the exempt child-care facility and the individual primarily responsible for the religious organization conducting the child-care facility and copies of the annual fire and safety inspections shall be filed annually during the month of August with the director of the department of health and senior services.

Correction Verification
Submit Documentation

Compliance Date

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