DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

TRINITY LUTHERAN CHURCH PRESCHOOL

001876564

(660) 668-2364

104 E BUTTERFIELD TRL
COLE CAMP
MO  65325

TRINITY LUTHERAN CHURCH

PO BOX H
COLE CAMP
MO  65325

PETERSEN, CHERYL DIANE

CONNIE@TRINITYCOLECAMP.ORG


LACEY BERENDZEN

36 MONTHS - 5 YEARS

25

LICENSE EXEMPT PROGRAM

 
Inspection Information

01/17/2023

9:10 AM

10:05 AM

ANNOUNCED

ANNUAL

2439250909


DocumentDocument-Date
SANITATION INSPECTION 10/25/2022
NOTICE OF PARENTAL RESPONSIBILITY 08/30/2022
FIRE/SAFETY INSPECTION 01/11/2023




Inspection determined facility to be in compliance with rules.
Open Violations: 2
Attendance at Time of Inspection
Total Staff 4
Total Children 20
StaffChildClass AgeNote
2 12 PRESCHOOL Megan Garbuzor and Margie Myer with 12 children, children age 3 and 4 years old. NPR states the ratio for this age group is 1:25.
2 8 PRESCHOOL Marla Lange and Jo Heimsoth with 8 children, children age 4 and 5 years old. NPR states the ratio for this age group is 1:25.

 
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
Medical examination reports, including TB testing, were not on file for Margie Myer as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
5 CSR 25-300.050 Health Requirements (1) (D) . states: All caregivers working in a facility during child care hours shall be in good health. They shall have a physical assessment, including a tuberculosis status assessment by a licensed physician or registered professional nurse. A physical assessment report, signed by a licensed physician or registered professional nurse, shall be on file at the time of employment or within thirty (30) days following employment.
Correction Required
Medical/TB 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
Violation
 Provider Comments
Violation
Children were not restricted to approved space as evidenced by the mechanical room was unlocked, had reachable hazards such as ice melt on floor.
Licensing Rule Reference
5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 1 (A) states: Children shall have no access to areas not approved for child care.
Correction Required
Caregivers shall restrict children to approved space.

Correction Verification
Corrected on Site

Compliance Date
1/17/2023
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 2 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

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