DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

THE GODDARD SCHOOL - LAKEWOOD

002796701

(816) 293-9393

3301 NE RALPH POWELL RD
LEES SUMMIT
MO  64064-2368

TEN FIVE LLC

309 NE DARTMORE CT
LEES SUMMIT
MO  64064-1601

MICEK, MELISSA M

LEESSUMMIT3MO@GODDARDSCHOOLS.COM


ROBYN EMBREE

6 WEEKS - 12 YEARS

174

GROUP HOME AND CENTER

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

08/26/2022

11:20 AM

1:06 PM

UNANNOUNCED

COMPLIANCE MONITORING

2430052268


DocumentDocument-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 05/19/2022
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 08/26/2022
SANITATION INSPECTION 05/04/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 08/26/2022
EQUIPMENT LIST 08/26/2022
CERTIFICATE OF GOOD STANDING 07/07/2022




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 2
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 27
Total Children 121
StaffChildClass AgeNote
2 6 INFANTS AND TODDLERS Danielle Atchison and Heidi Hewley (both staff) present with six children age 4-9 months old.
2 4 INFANTS AND TODDLERS Ashley Bernardi and Ziarriah Hernandez (both staff) present with four children age 13-15 months old.
2 6 INFANTS AND TODDLERS Molly Wilton and Micah Allen (both staff) present with six children age 1 year old.
2 7 MIXED Kayla Kaycee and Brittany Kaycee (both staff) present with seven children age 1-2 years old.
2 14 MIXED Libby Davidson and Shelby Atkin (both staff) were present with fourteen children age 2-4 years old.
2 18 MIXED Kelly Price and Katherine Randalf (both staff) were present with eighteen children age 2-4 with only two children being age 2.
7 0 NO CHILDREN IN ATTENDANCE Abigail Hendren (owner), Melissa Micek (director of education), Ashley Bingham (assistant director), Laura Neely (director of operations), Hailey Whitten (phonics), Jenny Kerley (cook) and Brandy Backus (cook and health/safety specialist) were present with no children in attendance.
2 20 PRESCHOOL Nazifa Shoaib and Kim Witt (both staff) present with twenty children age 3-5 years old.
2 18 PRESCHOOL Kathleen McCool and Tiffany Galvan (both staff) were present with eighteen children age 4-5 years old.
2 15 TWO YEAR OLDS Tessa Poterbin and Brea Baggs (both staff) present with fifteen children age 2 years old.
2 13 TWO YEAR OLDS Makayla Hicks and Chelsea Green (both staff) were present with thirteen children age 2 years old.

 
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 Family Care Safety Registry check was not conducted for Micha Allen, Danielle Atchison, Shelby Atkin, Brany Brackus, Brea Baggs, Ashley Bernardi, Ashley Bingham, Cara Bradley, Britney Casey, Cayla Casey, Elizabeth Davidson, Amy Dehghani, Tiffany Galvan, Chelsey Green, Heidi Hawley, Abigail Hendren, Ziarriah Hernandez, Makayla Hicks, Goldie Hoy, Alyssa Jensen, Holly Johnson, Brooklyn Jones, Jennifer Kerley, Amanda Kirby, Tanner Kremeier, Kathleen McCool, Pamela McHenry-Barrett, Mitzi Micek, Molly Moore, Laura Neely, Ashley Pointer, Tessa Poterbin, Kelly Price, Kathryn Randalph, Caitlyn Shelnutt, Nazifa Shoaib, Isabel Sirna, Alyssa Twaddell, Hailey Whitten and Kimberly Witt within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

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
Violation
 Provider Comments
Violation
Furniture/equipment, a finger guard, in on the infant/toddler classroom door was not free of pointed parts as evidenced by the finger guard was broken with jagged edges.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (1) (A) 1. states: All furniture and equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used.
Correction Required
The facility shall provide safe and clean furniture/equipment as required.

Correction Verification
Submit Documentation

Compliance Date

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
Not Observed
5 CSR 25-500.172 Emergency School Closings
Not Observed
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