MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
APPLE BLOSSOM LEARNING CENTER LLC

Facility DVN
002813807

Phone
(417) 349-0063

Physical Address
1505A N MAIN ST
MOUNTAIN GROVE
MO 65711-1038

Owner
APPLE BLOSSOM LEARNING CENTER LLC

Mailing Address

Provider/Director
SMART, SHANNON DAWN

E-mail Address
dsmart1304@hotmail.com

Incorporated

Child Care Specialist
ELAINE S COX

Age Range
BIRTH - 12 YEARS

Capacity
28

Facility Type
GROUP HOME AND CENTER

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

Inspection Information

Date
12/10/2021

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2413910690

Document	Document-Date
LICENSING ORIENTATION	12/12/2019
ARTICLES OF INCORPORATION	11/11/2019
LINES OF ADMINISTRATIVE AUTHORITY	03/03/2020
JOB RESPONSIBILITIES	02/10/2020
SAMPLE WEEKLY MENU	02/10/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN	01/30/2020
POLICIES	02/10/2020
CHILD CARE PRACTICES	01/02/2020
SANITATION INSPECTION	12/15/2020
STAFF SHEET	01/02/2020
DISCIPLINE POLICIES	01/02/2020
SAMPLE FORMS	01/02/2020
LOCAL FIRE DEPARTMENT NOTIFICATION	01/02/2020
DIAGRAM/OUTDOOR	01/02/2020
DIAGRAM/INDOOR	01/02/2020
LLC ARTICLES OF ORGANIZATION	11/11/2019
DIRECTOR'S QUALIFICATIONS	03/23/2020
FIRE/SAFETY INSPECTION	01/21/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	05/20/2021
EQUIPMENT LIST	05/20/2021
ANNUAL DECLARATION	05/05/2021
DAILY SCHEDULE	01/23/2020
LLC OPERATING AGREEMENT	03/03/2020
LOCAL BUILDING APPROVAL	03/03/2020
LOCAL ZONING APPROVAL	03/03/2020

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:30PM	9/16/2021

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.


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
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 Violation
5 CSR 25-500.102 Personnel Violation
5 CSR 25-500.112 Staff/Child Ratios Compliance
5 CSR 25-500.122 Medical Examination Reports Violation
5 CSR 25-500.132 Admission Policies and Procedures Compliance
5 CSR 25-500.142 Nighttime Care Compliance
5 CSR 25-500.152 Hourly Care Facilities Compliance
5 CSR 25-500.162 Overlap Care of Children Compliance
5 CSR 25-500.172 Emergency School Closings Compliance
5 CSR 25-500.182 Child Care Program Compliance
5 CSR 25-500.192 Health Care Violation
5 CSR 25-500.202 Nutrition and Food Service Compliance
5 CSR 25-500.212 Transportation and Field Trips Compliance
5 CSR 25-500.222 Records and Reports Compliance
5 CSR 25-600.020 General Requirements Compliance
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