DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

UPPER ROOM KC

003009185

(816) 363-3819

6903 OAK ST
KANSAS CITY
MO  64113-2530

UPPER ROOM KC

300 E 39TH ST
KANSAS CITY
MO  64111-1531

STEGALL, GREGORY S

info@upperroomkc.org

Incorporated

PENNY SNODGRASS

5 YEARS - 10 YEARS

90

SCHOOL AGE

 
Inspection Information

05/16/2024

3:40 PM

4:58 PM

UNANNOUNCED

POST LICENSING

2470901723


DocumentDocument-Date
DIRECTOR'S JOB RESPONSIBILITIES 05/09/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 05/09/2023
SAMPLE FORMS 05/09/2023
CERTIFICATE OF INCORPORATION 05/09/2023
DIRECTOR'S QUALIFICATIONS 05/30/2023
LINES OF ADMINISTRATIVE AUTHORITY 05/09/2023
JOB RESPONSIBILITIES 05/09/2023
ARTICLES OF INCORPORATION 05/09/2023
EQUIPMENT LIST 11/01/2023
SAMPLE WEEKLY MENU 10/30/2023
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/30/2023
DAILY SCHEDULE 10/30/2023
CHILD CARE PRACTICES 10/30/2023
DISCIPLINE POLICIES 10/30/2023
POLICIES 10/30/2023
APPLICATION 10/31/2023




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 14
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 5
Total Children 62
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Designated in charge: Terry Ford
4 62 SCHOOL AGE Kindergarten through 5th grade in cafeteria for snack after school Staff: Calvin Jones, Dixie Jones, Vernon Winfrey and Orlandra Brown

Compliance List
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Compliance
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
5 CSR 25-500.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
Requirements of the facility's participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.092 Furniture, Equipment and Materials
Compliance
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
Documentation of caregiver completion of the facility orientation was not on file for the following staff: Terry Ford, Calvin Jones, Dixie Jones, Vernon Winfrey and Orlandra Brown.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (L) states: The child care provider shall ensure that documentation of caregiver completion of the facility orientation is maintained and on file for review by the department.
Correction Required
Documentation of caregiver completion of the facility orientation shall be maintained and on file for review by the department.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not conduct a Family Care Safety Registry screening for Terry Ford, Calvin Jones, Dixie Jones, Vernon Winfrey and Orlandra Brown, who was hired on unknown exact dates.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.
Correction Required
Required results of the Family Care Safety Registry screening shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid/CPR were not met as evidenced by there was no documentation on file showing completion of age-appropriate first aid certification for the requested/licensed capacity.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be [and] approved by the department.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date

Violation
A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Terry Ford, Calvin Jones, Dixie Jones, Vernon Winfrey and Orlandra brown.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number from the department.
Correction Required
All caregivers shall obtain a MOPD ID.

Correction Verification
Submit Documentation

Compliance Date

Violation
The director is not routinely on duty, as evidenced by no sign in and out sheets to show hours of director who is listed as Gregory Stegall.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 2. states: Center directors and group child care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group child care home provider shall be on duty at least fifty percent (50%) of the operating hours.
Correction Required
The director/group home provider shall be routinely on duty, as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The department did not receive notification of a director change.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 6. states: The center owner(s), or the board president or chairperson, shall notify the department immediately when there is a change of directors and shall have a qualifying criminal background check on file as required by 5 CSR 25-600.020 General Requirements.
Correction Required
The facility shall notify the department immediately when there is a change of directors and submit required background check request.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid/CPR were not met as evidenced by there was no documentation on file showing completion of age-appropriate CPR certification for the requested/licensed capacity.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be [and] approved by the department.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate CPR was not on site.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be [and] approved by the department.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate first aid was not on site.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be [and] approved by the department.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Terry Ford, Calvin Jones, Dixie Jones, Vernon Winfrey and Orlandra Brown 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 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
A medical examination report did not include either a completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: Terry Ford, Calvin Jones, Dixie Jones, Vernon Winfrey and Orlandra Brown.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberulin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Records were not available for inspection by the department upon request as evidenced by the staff present could not locate the staff files in the locked cabinet.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (10) states: All records shall be available in the facility for inspection by the department upon request.
Correction Required
Records shall be available at the facility for inspection.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Terry Ford, Calvin Jones, Dixie Jones, Vernon Winfrey and Orlandra Brown.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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