DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

SHOAL CREEK COMMUNITY PRESCHOOL

001851607

(816) 775-1971

6816 N CHURCH RD
PLEASANT VALLEY
MO  64068

SHOAL CREEK COMMUNITY CHURCH



 

WOLDENGEN, TRACI

preschool@shoalcreek.org

Incorporated

MARY C MALOID

36 MONTHS - 6 YEARS

70

LICENSE EXEMPT PROGRAM

 
Inspection Information

09/14/2023

10:00 AM

10:55 AM

ANNOUNCED

ANNUAL

2454605521


DocumentDocument-Date
SANITATION INSPECTION 10/31/2022
FIRE/SAFETY INSPECTION 09/01/2022
NOTICE OF PARENTAL RESPONSIBILITY 09/20/2022




Inspection determined facility to be in compliance with rules.
Compliance Licensing Rules
Open Violations: 1
Attendance at Time of Inspection
Total Staff 3
Total Children 6
StaffChildClass AgeNote
0 0 NO CHILDREN IN ATTENDANCE Pre K Room - No children present
0 0 NO CHILDREN IN ATTENDANCE Pre K 2 - no children present
0 0 NO CHILDREN IN ATTENDANCE large group room - Pre K rest time and indoor large motor - no children in attendance
1 0 NO CHILDREN IN ATTENDANCE Director Traci Woldengren with no children in attendance
2 6 PRESCHOOL Preschool 1 - Caregivers Amy Hardy and Melissa Gann with six children all three and four years of age
0 0 PRESCHOOL Preschool 2 - no children in attendance
0 0 PRESCHOOL Preschool room - extra room - not in use - no children in attendance

Compliance List
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
Compliance
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
The facility's outdoor space was not safe for children's activities as evidenced by the presence of landscaping material coming up through playground surface.
Licensing Rule Reference
5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 4 (C) states: The play area shall be safe for children's activities. It shall be well-maintained and free of hazards such as poisonous plants, broken glass, barbed wire, open wells, rocks and other debris, and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date

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 two 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
Corrected on Site

Compliance Date
9/14/2023
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by two files 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
Corrected on Site

Compliance Date
9/14/2023
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