DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

CALVARY CHURCH MOTHERS DAY OUT

000842708

(636) 939-4343

3998 MID RIVERS MALL DR
ST PETERS
MO  63376

CALVARY CHURCH



 

NORWINE, JULIE

MANORWINE@YAHOO.COM

Incorporated

KATHERINE D SIMS

24 MONTHS - 5 YEARS

87

LICENSE EXEMPT PROGRAM

 
Inspection Information

04/19/2023

9:30 AM

10:15 AM

ANNOUNCED

ANNUAL

2445610467


DocumentDocument-Date
FIRE/SAFETY INSPECTION 03/09/2023
SANITATION INSPECTION 02/25/2023
NOTICE OF PARENTAL RESPONSIBILITY 09/09/2022




Inspection determined facility to be in compliance with rules.
Open Violations: 6
Attendance at Time of Inspection
Total Staff 9
Total Children 35
StaffChildClass AgeNote
3 10 MIXED Caregivers, Breanna Angell, Tara Boscia, and Buffy Cundiff present with ten children, ages 2-years-old to 3-years-old
1 0 NO CHILDREN IN ATTENDANCE Director, Julie Norwine present with no children in attendance
3 18 PRESCHOOL Caregivers, Michelle Kedney, Lori Fleming, and Amy Greco present with eighteen children, ages 4-years-old to 5-years-old
2 7 PRESCHOOL Caregivers, Nikki Key and Lisa Stetson present with seven children, ages 3-years-old to 4-years-old

 
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 Buffy Cundiff as evidenced by a cleared TB report was not on file for caregivers within 30 days of working in the facility.
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

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 Child C needs medical exam that shows cleared to be in childcare.
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

Violation
Medical examination reports, including TB testing, were not on file for Buffy Cundiff 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
Compliance
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 child’s full name, address, birth date and the date care begins and ends.
Licensing Rule Reference
5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (A) states: The child's full name, address, birth date and the date care begins and ends.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Submit Documentation

Compliance Date

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

Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 4 child files did not have the name and phone number of the family physician, or hospital, or both.
Licensing Rule Reference
5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (D) states: Name and phone number of a physician and preferred hospital to be used in an emergency.
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