MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
BLOOM AFTER SCHOOL AT MINNIE CLINE

Facility DVN
002903424

Phone
(816) 324-3976

Physical Address
808 W PRICE AVE
SAVANNAH
MO 64485-1671

Owner
BLOOM FINE ARTS PRESCHOOL LLC

Mailing Address
801 STATE RTE E
SAVANNAH
MO 64485-9427

Provider/Director
GIRTZ-TALLIE, ANGELIQUE

E-mail Address
mary@inspirationsdancecenter.com

Incorporated

Child Care Specialist
ROBYN EMBREE

Age Range
5 YEARS - 13 YEARS

Capacity
80

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
11/02/2022

Arrival Time
2:55 PM

Departure Time
3:48 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2434676203

Document	Document-Date
APPLICATION	07/22/2021
CERTIFICATE OF GOOD STANDING	07/21/2021
REGISTERING FICTITIOUS NAMES	07/21/2021
EQUIPMENT LIST	10/21/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	10/21/2022
SAMPLE WEEKLY MENU	07/21/2021
LLC ARTICLES OF ORGANIZATION	07/21/2021
LLC OPERATING AGREEMENT	07/21/2021
DAILY SCHEDULE	07/21/2021
CHILD CARE PRACTICES	08/06/2021
DISCIPLINE POLICIES	08/06/2021
LINES OF ADMINISTRATIVE AUTHORITY	08/09/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/13/2021
DIAGRAM/INDOOR	07/21/2021
DIAGRAM/OUTDOOR	08/13/2021
DIRECTOR'S QUALIFICATIONS	09/01/2021
LICENSING ORIENTATION	07/15/2021
LOCAL FIRE DEPARTMENT NOTIFICATION	09/24/2021
POLICIES	05/24/2022
ANNUAL DECLARATION	10/21/2022

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.

Attendance at Time of Inspection

Total Staff 6

Total Children 56

Staff	Child	Class Age	Note
1	0	NO CHILDREN IN ATTENDANCE	AG (director) present with no children in attendance.
1	11	SCHOOL AGE	MI (owner) present with eleven school age children.
1	10	SCHOOL AGE	CE (staff) present with ten school age children.
1	11	SCHOOL AGE	LS (staff) present with eleven school age children.
1	13	SCHOOL AGE	BS (staff) present with thirteen school age children.
1	11	SCHOOL AGE	SG (staff) present with eleven school age 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 Compliance
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers 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 25-500.172 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