DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

LUCKY LANE NURSERY SCHOOL ASSOCIATION-BENEVOLENT

000522607

(314) 434-4462

12546 CONWAY RD
ST LOUIS
MO  63141

LUCKY LANE EARLY CHILDHOOD ASSOCIATION



 

SIRLES, VICTORIA HOPE

director@luckylane.org

Incorporated

LAUREN A LEON

24 MONTHS - 5 YEARS

80

GROUP HOME AND CENTER

 
Inspection Information

05/30/2024

8:45 AM

10:26 AM

UNANNOUNCED

COMPLIANCE MONITORING

2471607196


DocumentDocument-Date
DIRECTOR'S QUALIFICATIONS 01/10/2006
SAMPLE FORMS 09/02/1993
POLICIES 09/02/1993
LOCAL ZONING APPROVAL 09/02/1993
LOCAL FIRE DEPARTMENT NOTIFICATION 03/01/2011
LOCAL BUILDING APPROVAL 09/02/1993
LINES OF ADMINISTRATIVE AUTHORITY 09/02/1993
JOB RESPONSIBILITIES 09/02/1993
DISCIPLINE POLICIES 09/02/1993
DIAGRAM/OUTDOOR 09/02/1993
DIAGRAM/INDOOR 09/02/1993
CHILD CARE PRACTICES 09/02/1993
ARTICLES OF INCORPORATION 09/02/1993
SAMPLE WEEKLY MENU 04/02/2015
DAILY SCHEDULE 04/02/2015
APPLICATION 04/02/2019
STAFF SHEET 04/26/2021
REGISTERING FICTITIOUS NAMES 05/17/2023
EQUIPMENT LIST 03/11/2024
FIRE/SAFETY INSPECTION 03/14/2024
SANITATION INSPECTION 03/15/2024
ANNUAL DECLARATION 03/11/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/11/2024
CERTIFICATE OF GOOD STANDING 05/17/2023




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 1
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 2
StaffChildClass AgeNote
2 0 NO CHILDREN IN ATTENDANCE Director, Victoria Sirles, and assistant director, Julianne Stillman, present with no children in care.

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
Violation
 Provider Comments
Violation
The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that 2 outlets in the music room did not have protective covers.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.
Correction Required
The facility shall use outlet covers or twist-lock outlets as required.

Correction Verification
Corrected on Site

Compliance Date
5/30/2024
5 CSR 25-500.087 Fire Safety
Compliance
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
Compliance
5 CSR 25-500.112 Staff/Child Ratios
Not Observed
5 CSR 25-500.122 Medical Examination Reports
Compliance
5 CSR 25-500.132 Admission Policies and Procedures
Compliance
5 CSR 25-500.142 Nighttime Care
Compliance
5 CSR 25-500.162 Overlap Care of Children
Compliance
5 CSR 25-500.172 Emergency School Closings
Not Observed
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
Not Observed
5 CSR 25-500.212 Transportation and Field Trips
Compliance
5 CSR 25-500.222 Records and Reports
Violation
 Provider Comments
Violation
1 child(ren) records did not include name of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
5/30/2024
Violation
1 child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
5/30/2024
5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Rebecca O'Brien.
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