DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

GRACE LUTHERAN CHURCH, HOLTS SUMMIT MO

002351753

(573) 896-8824

618 HALIFAX RD
HOLTS SUMMIT
MO  65043

GRACE LUTHERAN CHURCH, HOLTS SUMMIT MO



 

DIENER, MICHAEL J

revmjdiener@gmail.com

Incorporated

JOY LYNN NICHOLS

24 MONTHS - 10 YEARS

40

GROUP HOME AND CENTER

 
Inspection Information

09/14/2022

8:35 AM

9:46 AM

UNANNOUNCED

COMPLIANCE MONITORING

2430821678


DocumentDocument-Date
SANITATION INSPECTION 07/07/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 09/14/2022
EQUIPMENT LIST 09/14/2022
ANNUAL DECLARATION 09/14/2022
LICENSING ORIENTATION 08/24/2012
DIRECTOR'S QUALIFICATIONS 09/12/2012
LINES OF ADMINISTRATIVE AUTHORITY 08/24/2012
JOB RESPONSIBILITIES 08/24/2012
CERTIFICATE OF GOOD STANDING 05/07/2011
ARTICLES OF INCORPORATION 08/24/2012
CHILD CARE PRACTICES 08/24/2012
DAILY SCHEDULE 08/24/2012
POLICIES 08/24/2012
DIAGRAM/OUTDOOR 07/15/2013
DIAGRAM/INDOOR 07/15/2013
SAMPLE WEEKLY MENU 01/13/2014
DISASTER AND EMERGENCY PREPAREDNESS PLAN 05/07/2011
DISCIPLINE POLICIES 05/07/2011
LOCAL BUILDING APPROVAL 05/07/2011
LOCAL FIRE DEPARTMENT NOTIFICATION 05/07/2011
LOCAL ZONING APPROVAL 05/07/2011
SAMPLE FORMS 05/07/2011
FIRE/SAFETY INSPECTION 06/14/2021
STAFF SHEET 08/05/2020
APPLICATION 08/05/2020




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 3
Total Children 12
StaffChildClass AgeNote
1 6 MIXED children ages two and three; Joy Krumm
1 6 MIXED 1 child age two; 5 children ages four and five; Cindy Reed
1 0 NO CHILDREN IN ATTENDANCE Michael Diener, facility director

 
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