DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

KIRKWOOD UNITED METHODIST PRESCHOOL

000248075

(314) 966-5223

201 W ADAMS AVE
KIRKWOOD
MO  63122

KIRKWOOD UNITED METHODIST CHURCH



 

GOFF, JENNIFER ROBINS

jenny@kirkwoodumc.org

Incorporated

MICHELLE (SHELLEY) TRUESDALE

6 WEEKS - 6 YEARS

135

LICENSE EXEMPT PROGRAM

 
Inspection Information

11/01/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2434272690


DocumentDocument-Date
NOTICE OF PARENTAL RESPONSIBILITY 08/01/2022
FIRE/SAFETY INSPECTION 10/14/2022
SANITATION INSPECTION 09/16/2022




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

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
Compliance
5 CSR 25-300.050 Health Requirements
Violation
 Provider Comments
Violation
Requirements for children's medical examination reports were not met as evidenced by the medical form did not contain all required information in that there was no statement regarding the child's fitness for child care participation.
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
10/21/2022
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
Compliance
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.
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