DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

UPPER ROOM KC

002482282

(816) 923-3689

121 N QUINCY AVE
KANSAS CITY
MO  64123-1319

UPPER ROOM KC

300 E 39TH ST
KANSAS CITY
MO  64111-1531

HENN, SHELLEY S.

shenn@hcskcmo.org

Incorporated

SUNDEE BUMGARNER

5 YEARS - 13 YEARS

90

SCHOOL AGE

 
Inspection Information

09/23/2024

3:47 PM

4:16 PM

UNANNOUNCED

COMPLIANCE MONITORING

2479995918


DocumentDocument-Date
DIRECTOR'S JOB RESPONSIBILITIES 08/04/2014
CERTIFICATE OF INCORPORATION 08/04/2014
SAMPLE FORMS 08/04/2014
POLICIES 08/04/2014
JOB RESPONSIBILITIES 08/04/2014
LINES OF ADMINISTRATIVE AUTHORITY 08/04/2014
SAMPLE WEEKLY MENU 08/04/2014
DAILY SCHEDULE 08/04/2014
CHILD CARE PRACTICES 08/04/2014
DISCIPLINE POLICIES 08/04/2014
APPLICATION 05/31/2016
CERTIFICATE OF GOOD STANDING 06/02/2016
ANNUAL DECLARATION 03/22/2022
EQUIPMENT LIST 03/22/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/23/2024
LOCAL FIRE DEPARTMENT NOTIFICATION 01/31/2022




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 6
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 3
Total Children 23
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Shelley Henn with no children in attendance.
1 15 SCHOOL AGE Caregiver Roxanne Myers with 15 children all school aged.
1 8 SCHOOL AGE Caregiver Mark Santoro with 8 children all school aged.

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
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Tonia Gilbert and Roxanne Myers 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

Violation
The equipment list was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (C) states: A current list of available equipment.
Correction Required
The facility shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date

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
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 2023, the staff listed need the following information: Aurora Castaneda needs 12 hours, Shelley Henn needs 9.5 hours, and Mark Santoro needs 9.5 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

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 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

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
Not Observed
5 CSR 25-500.172 Emergency School Closings
Not Observed
5 CSR 25-500.182 Child Care Program
Not Observed
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
Not Observed
5 CSR 25-500.222 Records and Reports
Not Observed
5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Roxanne Myers and Mark Santoro.
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
Not Observed
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