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
06/22/2022

Arrival Time
9:58 AM

Departure Time
11:35 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2425796503

Document	Document-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	04/25/2022
ANNUAL DECLARATION	04/25/2022
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	05/14/2022
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	03/02/2022

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 18

Total Children 52

Staff	Child	Class Age	Note
2	9	MIXED	Room 105. Staff: Angel Grogan and Rashanea Rusk. Age range 3 years through 5 years.
2	10	MIXED	Room 119. Staff: Lisa Lambert and Karen Burns. Age range 3 years through 5 years.
3	5	MIXED	Room 116. Staff: Sheila Smith, Crystal Wilcox, and Whitney Burns. Age range 3 years through 5 years.
2	0	NO CHILDREN IN ATTENDANCE	Staff: Melissa Klocke, Director, and Mary Elam, Secretary. Not counted in child/staff ratio.
2	12	PRESCHOOL	Room 128. Staff: Jill Scheurer and Stacy Xander. Age range 3 years through 4 years.
2	5	PRESCHOOL	Room 131. Staff: Mikki Cowan and Kaitlyn Benson. Age range 3 years through 4 years.
3	6	PRESCHOOL	Room 118. Staff: Kara Schwend, Michelle Stonecipher, and Jimi Motter. All children 4 years old.
2	5	TWO YEAR OLDS	Room 127. Staff: Catherine Tyler and Jennifer Potter. All 2 year old children.

5 CSR 25-500.032 Organization and Administration

Compliance

5 CSR 25-500.042 Licensing Process

Compliance

5 CSR 25-500.052 Annual Requirements

Violation

	Provider Comments
Violation The annual fire safety inspection was not conducted. Licensing Rule Reference 5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee. Correction Required The facility shall submit evidence of compliance with annual fire safety requirements. Correction Verification Submit Documentation Compliance Date

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

Compliance

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 25-500.162 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