MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT

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Facility Information

Facility Name
BUILDING BLOCKS EARLY CHILDHOOD CENTER AND PRESCHOOL

Facility DVN
000707499

Phone
(636) 391-6685

Physical Address
327 WOODS MILL RD
MANCHESTER
MO 63011-4343

Owner
GOOD SHEPHERD LUTHERAN CHURCH OF MANCHESTER

Mailing Address

Provider/Director
REBHOLZ, KATHY

E-mail Address
KREBHOLZ@GSLCELCA.ORG

Incorporated
Incorporated

Child Care Specialist
SHALINDA WALLACE

Age Range
12 MONTHS - 12 YEARS

Capacity
76

Facility Type
LICENSE EXEMPT PROGRAM

Limitations
6 CHILDREN IN THE INFANT/TODDLER UNIT

Inspection Information

Date
04/13/2022

Arrival Time
9:30 AM

Departure Time
11:19 AM

Notice
ANNOUNCED

Inspection Type
ANNUAL

Inspection ID
2421592429

Document	Document-Date
SANITATION INSPECTION	02/07/2022
FIRE/SAFETY INSPECTION	02/22/2022
NOTICE OF PARENTAL RESPONSIBILITY	08/02/2021

Inspection determined facility to be in compliance with rules.

Open Violations: NA

Attendance at Time of Inspection

Total Staff 11

Total Children 42

Staff	Child	Class Age	Note
2	5	INFANTS AND TODDLERS	Ms. Jennifer Sullivan & Ms. Julie Avise (Teachers)- Five children, 21-months-old to 28-months- old.
2	11	MIXED	Ms. Susan Klemm & Ms. Michele Dolan (Teachers)- Eleven children, two-years-old to three-years- old.
2	0	NO CHILDREN IN ATTENDANCE	Ms. Kathy Rebholz (Director) Taira Price (Music Teachers)
2	11	PRESCHOOL	Ms. Patty Geurkink & Ms. Carolyn Miller (Teachers)- Eleven children, 3-years-old to 4-years- old.
2	7	PRESCHOOL	Ms. Jennifer Rieves & Ms. Shannon Callis (Teachers)- Seven children, 4-years-old to 5-years-old.
1	8	PRESCHOOL	Ms. Susan Mayer (Teacher)- Eight children, 4-years-old to 5-years-old.


5 CSR 25-300.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures Compliance
5 CSR 25-300.040 Staffing Requirements Compliance
5 CSR 25-300.050 Health Requirements Compliance
5 CSR 25-300.060 Responsibilities of Caregivers Compliance
5 CSR 25-300.070 Fire Safety Requirements Compliance
5 CSR 25-300.080 Sanitation Requirements Compliance
5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment Compliance
5 CSR 25-300.100 Transportation and Field Trip Requirements Compliance
5 CSR 25-300.110 Admission Procedures and Required Reports and Records Compliance
5 CSR 25-600.020 General Requirements Compliance
5 CSR 25-600.040 Background Screening Findings Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when. 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. Compliance
RSMo 210.254 Religious organization operating facilities exempt under licensing laws required to file parental notice of responsibility and fire, safety inspections annually. Compliance
RSMo 210.255 Religious organizations operating facility in violation, procedure - noncompliance after notice, prosecutor may act or attorney general. Compliance
RSMo 252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance