MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
KIRKSVILLE R-III SCHOOL DISTRICT

Facility DVN
002011727

Phone
(660) 626-1459

Physical Address
1405 S COTTAGE GROVE
KIRKSVILLE
MO 63501

Owner
KIRKSVILLE R-III SCHOOL DISTRICT

Mailing Address

Provider/Director
KLOCKE, MELISSA ROSE

E-mail Address
mklocke@kirksville.k12.mo.us

Incorporated

Child Care Specialist
BETHANY C DUCKWORTH

Age Range
6 WEEKS - 6 YEARS

Capacity
175

Facility Type
GROUP HOME AND CENTER

Limitations
16 CHILDREN UNDER 24 MONTHS

Inspection Information

Date
11/30/2020

Arrival Time
9:20 AM

Departure Time
10:38 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2388710534

Document	Document-Date
SAMPLE WEEKLY MENU	02/27/2008
LINES OF ADMINISTRATIVE AUTHORITY	02/27/2008
DIRECTOR'S JOB RESPONSIBILITIES	02/27/2008
JOB RESPONSIBILITIES	02/27/2008
DAILY SCHEDULE	03/17/2010
DIRECTOR'S QUALIFICATIONS	04/28/2008
CHILD CARE PRACTICES	04/11/2016
DISCIPLINE POLICIES	04/11/2016
POLICIES	04/11/2016
EQUIPMENT LIST	04/27/2020
STAFF SHEET	07/29/2020
FIRE/SAFETY INSPECTION	06/16/2020
DIAGRAM/INDOOR	03/10/2008
DIAGRAM/OUTDOOR	03/10/2008
SAMPLE FORMS	03/04/2008
SAFE SLEEP POLICY	03/01/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN	11/06/2019
APPLICATION	03/10/2020
SANITATION INSPECTION	03/06/2020

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 34

Total Children 103

Staff	Child	Class Age	Note
1	3	INFANTS AND TODDLERS	Room 109 Age range 6 months through 12 months.
1	4	INFANTS AND TODDLERS	Room 109 Age range 1 year and 2 year.
2	9	PRESCHOOL	Room 103 Children ages 3 and 4 years.
2	8	PRESCHOOL	Room 105 Ages 4 and 5 years.
2	9	PRESCHOOL	Room 106 Ages 3 and 4 years.
3	1	PRESCHOOL	Room 114 Three staff to one child. Child is 4 years old.
3	16	PRESCHOOL	Room 116 Ages 4 and 5 years.
4	11	PRESCHOOL	Room 118 3 and 4 year old children.
3	15	PRESCHOOL	Room 119 Ages 4 and 5 years.
4	2	PRESCHOOL	Room 127 4 staff with 2 children. Children ages 4 and 5 years old.
3	11	PRESCHOOL	Room 128 4 and 5 year old children.
2	7	PRESCHOOL	Room 131 Ages 3 and 4 years old.
3	2	PRESCHOOL	Room 132 Three staff with 2 children. Children ages 3 and 4 years old.
1	5	TWO YEAR OLDS	Room 109 All 2 year old children.


19 CSR 30-62.032 Organization and Administration Compliance
19 CSR 30-62.042 Initial Licensing Information Compliance
19 CSR 30-62.052 Annual Requirements 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 30-63.020 General Requirements 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