MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
MISSOURI VALLEY COMMUNITY ACTION AGENCY

Facility DVN
000749300

Phone
(660) 388-5911

Physical Address
618 S WEBER AVE
SALISBURY
MO 65281-1326

Owner
MISSOURI VALLEY COMMUNITY ACTION AGENCY

Mailing Address

Provider/Director
PEGELOW, JACQUELYIN MICHELE

E-mail Address
turnerl@mvcaa.net

Incorporated
Incorporated

Child Care Specialist
CHRISTINA BRUCE

Age Range
6 WEEKS - 5 YEARS

Capacity
38

Facility Type
GROUP HOME AND CENTER

Limitations
5 CHILDREN UNDER 12 MONTHS; 8 CHILDREN UNDER 24 MONTHS

Inspection Information

Date
09/01/2020

Arrival Time
10:45 AM

Departure Time
11:35 AM

Notice
ANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2385858872

Document	Document-Date
STAFF SHEET	07/30/2020
EQUIPMENT LIST	06/30/2020
APPLICATION	05/20/2020
FIRE/SAFETY INSPECTION	06/03/2020
ARTICLES OF INCORPORATION	07/13/2018
CERTIFICATE OF GOOD STANDING	07/20/2018
DAILY SCHEDULE	07/20/2018
CHILD CARE PRACTICES	07/20/2018
DIAGRAM/INDOOR	07/13/2018
DIAGRAM/OUTDOOR	07/20/2018
LINES OF ADMINISTRATIVE AUTHORITY	07/20/2018
DIRECTOR'S QUALIFICATIONS	07/20/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	07/20/2018
JOB RESPONSIBILITIES	07/20/2018
LOCAL BUILDING APPROVAL	07/20/2018
SAMPLE FORMS	07/20/2018
SAFE SLEEP POLICY	07/20/2018
SAMPLE WEEKLY MENU	07/20/2018
LOCAL ZONING APPROVAL	07/20/2018
DISCIPLINE POLICIES	07/20/2018
POLICIES	07/20/2018
LLC ARTICLES OF ORGANIZATION	07/20/2018
SANITATION INSPECTION	06/11/2020

Inspection determined facility to be in compliance with licensing rules.

Open Violations: NA

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 20

Staff	Child	Class Age	Note
1	4	INFANTS AND TODDLERS	3 - two year old, 1 - under 2 years old, staff present was Carlie Clevenger
2	2	INFANTS AND TODDLERS	Colbie Sawyer and McKayla King
2	14	PRESCHOOL	10- three year old children, 3- four year old children, 1- Five year old child, staff was Amber Gamlin and Madison Bushery


19 CSR 30-62.032 Organization and Administration Compliance
19 CSR 30-62.042 Initial Licensing Information Compliance
19 CSR 30-62.052 License Renewal Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers Compliance
19 CSR 30-62.087 Fire Safety Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials Compliance
19 CSR 30-62.102 Personnel Compliance
19 CSR 30-62.112 Staff/Child Ratios Compliance
19 CSR 30-62.122 Medical Examination Reports Compliance
19 CSR 30-62.132 Admission Policies and Procedures Compliance
19 CSR 30-62.142 Nighttime Care Compliance
19 CSR 30-62.152 Hourly Care Facilities Compliance
19 CSR 30-62.162 Overlap Care of Children Compliance
19 CSR 30-62.172 Emergency School Closings Compliance
19 CSR 30-62.182 Child Care Program Compliance
19 CSR 30-62.192 Health Care Compliance
19 CSR 30-62.202 Nutrition and Food Service Compliance
19 CSR 30-62.212 Transportation and Field Trips Compliance
19 CSR 30-62.222 Records and Reports Compliance
19 CSR 30-63.040 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