MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
GRACE LUTHERAN CHURCH, HOLTS SUMMIT MO

Facility DVN
002351753

Phone
(573) 896-8824

Physical Address
618 HALIFAX RD
HOLTS SUMMIT
MO 65043

Owner
GRACE LUTHERAN CHURCH, HOLTS SUMMIT MO

Mailing Address

Provider/Director
DIENER, MICHAEL J

E-mail Address
revmjdiener@gmail.com

Incorporated
Incorporated

Child Care Specialist
JOY LYNN NICHOLS

Age Range
24 MONTHS - 10 YEARS

Capacity
40

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
11/01/2022

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2434254540

Document	Document-Date
FIRE/SAFETY INSPECTION	10/26/2022
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
STAFF SHEET	08/05/2020
APPLICATION	08/05/2020

Inspection determined facility to be in compliance with licensing rules.

Open Violations: NA

NOTE

The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.


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
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