MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
THE GODDARD SCHOOL - LAKEWOOD

Facility DVN
002796701

Phone
(816) 293-9393

Physical Address
3301 NE RALPH POWELL RD
LEES SUMMIT
MO 64064-2368

Owner
TEN FIVE LLC

Mailing Address
309 NE DARTMORE CT
LEES SUMMIT
MO 64064-1601

Provider/Director
MICEK, MELISSA M

E-mail Address
LEESSUMMIT3MO@GODDARDSCHOOLS.COM

Incorporated

Child Care Specialist
BEN NEWTON

Age Range
6 WEEKS - 12 YEARS

Capacity
174

Facility Type
GROUP HOME AND CENTER

Limitations
32 CHILDREN IN THE INFANT/TODDLER UNIT; 12 CHILDREN UNDER 12 MONTHS

Inspection Information

Date
02/04/2022

Arrival Time
8:15 AM

Departure Time
10:03 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2417273868

Document	Document-Date
APPLICATION	07/14/2020
DIAGRAM/INDOOR	06/22/2020
DIAGRAM/OUTDOOR	06/22/2020
STAFF SHEET	07/20/2020
SAFE SLEEP POLICY	07/16/2020
LOCAL BUILDING APPROVAL	07/15/2020
LOCAL ZONING APPROVAL	07/15/2020
LOCAL FIRE DEPARTMENT NOTIFICATION	07/15/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN	07/20/2020
DISCIPLINE POLICIES	07/16/2020
DAILY SCHEDULE	06/28/2020
CHILD CARE PRACTICES	07/16/2020
SAMPLE WEEKLY MENU	05/26/2020
FIRE/SAFETY INSPECTION	06/11/2020
LLC OPERATING AGREEMENT	05/07/2020
JOB RESPONSIBILITIES	07/15/2020
LINES OF ADMINISTRATIVE AUTHORITY	07/15/2020
LLC ARTICLES OF ORGANIZATION	09/08/2019
POLICIES	07/16/2020
SAMPLE FORMS	07/17/2020
DIRECTOR'S QUALIFICATIONS	08/08/2020
ANNUAL DECLARATION	06/09/2021
SANITATION INSPECTION	05/04/2021

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 1

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 24

Total Children 106

Staff	Child	Class Age	Note
2	7	INFANTS AND TODDLERS	Caregivers Danielle Steele and Morgan Stewart were present with seven (7) children, all under 12 months old.
2	6	INFANTS AND TODDLERS	Caregivers Ashley Bernardi and McKayla Hicks were present with six (6) children, including 1 under 12 months old and 5-1 year olds.
2	5	INFANTS AND TODDLERS	Caregivers Molly Wilton and Micah Allen were present with five (5) children, all 1 years old.
2	6	INFANTS AND TODDLERS	Caregivers Isabel Sirna and Ashley Pointer were present with six (6) children, all 1 years old.
2	14	MIXED	Caregivers Jacqueline Summer and Tiffany Galvin were present with fourteen (14) children, including 2-4 year olds and 12-5 year olds.
2	0	NO CHILDREN IN ATTENDANCE	Director Abby Hendron and Assistant Director Laura Neely were present with no children in attendance.
2	12	PRESCHOOL	Caregivers Alana Lorick and Holly Johnson were present with twelve (12) children, including 8-3 year olds and 4-4 year olds.
2	12	PRESCHOOL	Caregivers Kelly Price and Alyssa Jenson were present with twelve (12) children, including 10-3 year olds and 2-4 year olds.
2	12	PRESCHOOL	Caregivers McKenzie Rowell and Haley Witt were present with twelve (12) children, including 1-3 year old and 11-4 year olds.
2	13	PRESCHOOL	Caregivers Harper Stephens and Heather Miller were present with thirteen (13) children, including 6-4 year olds and 7-5 year olds.
2	9	TWO YEAR OLDS	Caregivers Harley Willems and Chelsea Green were present with nine (9) children, all 2 year olds.
2	10	TWO YEAR OLDS	Caregivers Rebecca Davidson and Amanda Kirby were present with ten (10 children, all two year olds.

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

Compliance

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

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 2021, the staff listed need the following information: Abigail Hendron (12 hours), Holly Johnson (8.25 hours), Alana Lorick (3 hours), Pamela McHenry-Barrett (1 hour), Kathy Randolph (3 hours), Alyssa Twadell (2.75 hours), Harley Willems (0.5 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

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

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

Compliance

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