DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

BELTON SCHOOL DISTRICT 124

000656311

(816) 348-1527

109 W CAMBRIDGE RD
BELTON
MO  64012-3160

BELTON SCHOOL DISTRICT 124

614 MILL ST
BELTON
MO  64012-3403

ST HELENE, MARY ANN

msthelene@bsd124.org


MARY C MALOID

5 YEARS - 10 YEARS

60

SCHOOL AGE

 
Inspection Information

04/11/2023

8:15 AM

9:03 AM

UNANNOUNCED

COMPLIANCE MONITORING

2444852638


DocumentDocument-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: 4
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 31
StaffChildClass AgeNote
4 31 SCHOOL AGE Director Mary Ann St Helene, Caregivers Mary Davis, Joxpy Chavez Pascual, and Jada Middaugh with 31 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
Violation
 Provider Comments
Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.
Correction Required
The facility shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The Family Care Safety Registry check was not conducted for Jopxilin Chavez- Pascual, Mary Davis, Jada Middaugh, and Mary Ann St. Helene 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

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
The premises were not safe and suitable as evidenced by end of electrical outlet strip has come loose exposing electrical wires.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (A) states: The premises shall be safe and suitable for the care of children.
Correction Required
The premises shall be safe and suitable for the care of children.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: Jada Middaugh needs 8 hours.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

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