DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

KIRKSVILLE R-III SCHOOL DISTRICT

002011727

(660) 626-1459

1405 S COTTAGE GROVE
KIRKSVILLE
MO  63501

KIRKSVILLE R-III SCHOOL DISTRICT



 

KLOCKE, MELISSA ROSE

mklocke@kirksville.k12.mo.us


BETHANY C DUCKWORTH

6 WEEKS - 6 YEARS

175

GROUP HOME AND CENTER

16 CHILDREN UNDER 24 MONTHS
 
Inspection Information

06/23/2021

9:10 AM

12:47 PM

UNANNOUNCED

COMPLIANCE MONITORING

2402783403


DocumentDocument-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 05/04/2021
ANNUAL DECLARATION 05/04/2021
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 05/11/2021
STAFF SHEET 07/29/2020
FIRE/SAFETY INSPECTION 03/30/2021
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 03/25/2021




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 4
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 22
Total Children 60
StaffChildClass AgeNote
1 1 INFANTS AND TODDLERS Room 109. Staff: Cathrine Tyler. One child 5 months old.
1 4 INFANTS AND TODDLERS Room 109. Staff: Dawn Brawner. Age range 13 months through 2 years. One 2 year old child.
1 0 NO CHILDREN IN ATTENDANCE Staff: Melissa Klocke, Director
2 12 PRESCHOOL Room 119. Stff: Lynn Kizzire and Robert Bray. Age range 3 years through 4 years.
4 3 PRESCHOOL Room 127. Staff: Alisha Claybrook, Pam Kilmer, Amber Gamblin, and Alexis Luebbering. All children 5 years of age. Classroom has one on one teaching.
2 6 PRESCHOOL Room 131. Staff: Mikki Cowan and Stacy Xander. Age range 3 years through 4 years.
3 4 PRESCHOOL Room 132. Staff: Brittney Athon, Kristen Gunnels, and Haylee Baker. Age range 3 years through 4 years.
2 8 PRESCHOOL Room 105. Staff: Angel Grogan and Rashanea Rusk. Age range 3 years to 4 years.
3 7 PRESCHOOL Room 106. Staff: Anne Bethel, Whitney Truitt, and Kristal Willcox. Age range 3 years through 4 years.
2 11 PRESCHOOL Room 118. Staff: Laney Partin and Karen Burns. Age range 3 years through 4 years.
1 4 TWO YEAR OLDS Room 109. Staff: Jennifer Potter. All children 2 years of age.

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Licensing Process
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
Violation
 Provider Comments
Violation
Rachel McLachlan did not complete safe sleep training within 30 days of employment or volunteering at the facility.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (4) (C) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall complete safe sleep training described in section (4) of this rule within thirty (30) days of employment or volunteering at the facility.
Correction Required
The department approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification
Submit Documentation

Compliance Date

Violation
A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Laney Partin.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering and before being left alone with children that caregivers receive a facility orientation. The child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by one (1) child(s) file(s) did not have the parental acknowledgement they have been notified that they may request whether there are children for whom an immunization exemption has been filed for currently enrolled in or attending the facility.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (8) (E) 8. F. states: They have been notified that they may request notice at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility
Correction Required
Child enrollment information shall be completed and on file as requested.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not have parental acknowledgement on file indicating the parent understands and agrees that the child may not be accepted for care when ill.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (8) (E) 8. D. states: They understand and agree that the child may not be accepted for care when ill.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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