MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
BELTON SCHOOL DISTRICT 124

Facility DVN
000656311

Phone
(816) 348-1527

Physical Address
109 W CAMBRIDGE RD
BELTON
MO 64012-3160

Owner
BELTON SCHOOL DISTRICT 124

Mailing Address
614 MILL ST
BELTON
MO 64012-3403

Provider/Director
ST HELENE, MARY ANN

E-mail Address
msthelene@bsd124.org

Incorporated

Child Care Specialist
MARY C MALOID

Age Range
5 YEARS - 10 YEARS

Capacity
60

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
10/26/2022

Arrival Time
3:30 PM

Departure Time
4:14 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2433985728

Document	Document-Date
JOB RESPONSIBILITIES	03/23/2012
CHILD CARE PRACTICES	03/23/2012
DISCIPLINE POLICIES	03/23/2012
POLICIES	03/23/2012
DAILY SCHEDULE	03/23/2012
DIAGRAM/OUTDOOR	03/23/2012
DIAGRAM/INDOOR	03/23/2012
DIRECTOR'S QUALIFICATIONS	04/05/2016
DIRECTOR'S JOB RESPONSIBILITIES	09/07/2011
SAMPLE FORMS	09/07/2011
SAMPLE WEEKLY MENU	09/07/2011
APPLICATION	01/08/2018
STAFF SHEET	03/23/2018
EQUIPMENT LIST	04/11/2022
ANNUAL DECLARATION	03/22/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/22/2022

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.

Attendance at Time of Inspection

Total Staff 4

Total Children 34

Staff	Child	Class Age	Note
4	34	SCHOOL AGE	Director MSH and Caregivers JP, MD, and JM with 34 children all school age


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 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