DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

ST. MATTHEW PRESCHOOL

001620562

(816) 524-4354

700 NE CHIPMAN RD
LEES SUMMIT
MO  64063

ST. MATTHEW LUTHERAN CHURCH



 

RINEHART, TRACI RENEE

stmatthewps@gracefaithlove.org

Incorporated

BIONICA D SMITHJACKSON

24 MONTHS - 5 YEARS

61

LICENSE EXEMPT PROGRAM

 
Inspection Information

01/30/2023

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2440167665


DocumentDocument-Date
NOTICE OF PARENTAL RESPONSIBILITY 01/09/2023
SANITATION INSPECTION 11/07/2022
FIRE/SAFETY INSPECTION 11/18/2022




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

 
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
A caregiver has not reviewed the rules of this chapter as evidenced by no statement on file for Traci Rinehart.
Licensing Rule Reference
5 CSR 25-300.040 Staffing Requirements (2) states: All caregivers shall review the rules of this chapter.
Correction Required
All caregivers shall review the rules as required.

Correction Verification
Submit Documentation

Compliance Date
1/30/2023
5 CSR 25-300.050 Health Requirements
Violation
 Provider Comments
Violation
Medical examination reports, including TB testing, were not on file for Traci Rinehart 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
1/30/2023
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 one child report missing approved physician statement..
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
1/30/2023
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 no locks on kitchen door.
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
Submit Documentation

Compliance Date
1/30/2023
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