DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

HOLY CROSS LUTHERAN CHURCH OF KANSAS CITY

000186383

(816) 452-9113

2003 NE ENGLEWOOD RD
KANSAS CITY
MO  64118

HOLY CROSS LUTHERAN CHURCH OF KANSAS CITY



 

PURL, CHRISTINE DAWN

ecc@holycrosskc.org

Incorporated

BIONICA D SMITHJACKSON

6 WEEKS - 12 YEARS

99

GROUP HOME AND CENTER

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

11/15/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2435492340


DocumentDocument-Date
POLICIES 06/17/1985
LOCAL ZONING APPROVAL 10/21/1991
LOCAL BUILDING APPROVAL 10/21/1991
LINES OF ADMINISTRATIVE AUTHORITY 06/28/1993
JOB RESPONSIBILITIES 06/28/1993
DIRECTOR'S QUALIFICATIONS 06/19/2007
DIAGRAM/OUTDOOR 09/20/2010
DIAGRAM/INDOOR 01/19/2010
DAILY SCHEDULE 06/17/1985
DISASTER AND EMERGENCY PREPAREDNESS PLAN 05/01/2018
SAFE SLEEP POLICY 05/01/2018
SAMPLE FORMS 06/05/1985
APPLICATION 03/04/2019
STAFF SHEET 05/06/2019
SAMPLE WEEKLY MENU 05/06/2019
CHILD CARE PRACTICES 07/12/2021
DISCIPLINE POLICIES 07/12/2021
ANNUAL DECLARATION 06/13/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 06/13/2022
EQUIPMENT LIST 06/13/2022
FIRE/SAFETY INSPECTION 04/13/2022
CERTIFICATE OF GOOD STANDING 06/13/2022
SANITATION INSPECTION 07/11/2022




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.

 
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 Family Care Safety Registry check was not conducted for David Beck, Carl Piggers, Shara Piggers, Brandi Schaunaman within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Submit Documentation

Compliance Date
10/7/2022
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
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
Requirements for feeding equipment for infants and toddlers who are unable to sit at a table were not met as evidenced by the restraints were not available.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (1) (C) 2. states: Infants and toddlers. Infants and toddlers who are unable to sit at a table shall have one (1) piece of mealtime feeding equipment for every four (4) infant/toddlers which may include feeding tables, high chairs, infant seats or other safely designed infant seating equipment. Equipment shall be provided which will allow the child to sit comfortably and securely while being fed. Appropriate restraints shall be used.
Correction Required
Safe and secure feeding equipment shall be provided as required.

Correction Verification
Submit Documentation

Compliance Date
11/15/2022
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
The facility did not conduct a Family Care Safety Registry screening for MaKayla Rystrom, who was hired on 7/18/2022.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.
Correction Required
Required results of the Family Care Safety Registry screening shall be on file.

Correction Verification
Submit Documentation

Compliance Date
10/17/2022
Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Hazel Speer, Carol Wilson, MaKayla Rystrom
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering and before being left alone with children that caregivers receive a facility orientation. The facility orientation shall include:
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

Correction Verification
Submit Documentation

Compliance Date
10/17/2022
Violation
Safe sleep training was not completed within the past 3 years for the following staff Alesia Kendall, Staci Williams, Carol Wilson, David Beck, Carl Piggers, Shara Piggers, Brandi Schaunaman, .
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) . states: Safe Sleep Training. Every three (3) years the center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 138, No. 5, November 1, 2016 and available at http://pediatrics.aappublications.org/content/pediatrics/early/2016/10/20/peds.2016-2938.full.pdf. This rule does not incorporate any subsequent amendments or additions.
Correction Required
The director, group home provider, other caregivers, and those volunteers counted in staff/child ratio, shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date
11/1/2022
Violation
Hazel Speer did not complete safe sleep training within 30 days of employment or volunteering at the facility.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) (C) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall complete safe sleep training described in section (4) of this rule within thirty (30) days of employment or volunteering at the facility.
Correction Required
The department approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification
Submit Documentation

Compliance Date
10/17/2022
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for McKenzie Newsom, Carly Purl, Brandi Schaunaman as evidenced by a medical examination was not on file at the facility at the time of initial licensure.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
11/14/2022
Violation
A medical examination report did not include either a completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: McKenzie Newsom, Carly Purl, Brandi Schaunaman.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberulin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date
11/14/2022
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
Compliance
5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Siobhan Leinen, David Beck, MaKayla Rystrom.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
10/17/2022
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