MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
THE GODDARD SCHOOL - LAKEWOOD

Facility DVN
002796701

Phone
(816) 293-9393

Physical Address
3301 NE RALPH POWELL RD
LEES SUMMIT
MO 64064-2368

Owner
TEN FIVE LLC

Mailing Address
309 NE DARTMORE CT
LEES SUMMIT
MO 64064-1601

Provider/Director
MICEK, MELISSA M

E-mail Address
LEESSUMMIT3MO@GODDARDSCHOOLS.COM

Incorporated

Child Care Specialist
ROBYN EMBREE

Age Range
6 WEEKS - 12 YEARS

Capacity
174

Facility Type
GROUP HOME AND CENTER

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

Inspection Information

Date
02/16/2023

Arrival Time
12:00 PM

Departure Time
1:14 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2441361457

Document	Document-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
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
FIRE/SAFETY INSPECTION	05/19/2022
ANNUAL DECLARATION	08/26/2022
SANITATION INSPECTION	05/04/2022
CERTIFICATE OF GOOD STANDING	07/07/2022
EQUIPMENT LIST	08/26/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	08/26/2022

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 32

Total Children 131

Staff	Child	Class Age	Note
2	6	INFANTS AND TODDLERS	Danielle Atchison and Yancy Dryer (both staff) present with six children age 4-9 months.
2	7	INFANTS AND TODDLERS	Ashley Pointer and Makayla Hicks (both staff) present with seven children age 10-15 months.
2	8	MIXED	Heidi Rose-Holly and Micha Allen (both staff) present with eight children age 1-2 years.
2	8	MIXED	Kayla Kaycee and Isabel Sirna (both staff) present with eight children age 1-2 years.
2	16	MIXED	Amanda Kirby and Brittany Casey (both staff) present with sixteen children age 2-3 years.
5	0	NO CHILDREN IN ATTENDANCE	Mitzi (Melissa) Micek (director of education), Laura Neely (director of operations), Jenny Kerly (cook), Brandi Backas (health and safety) and Abigail Hendren (owner) present with no children in attendance.
6	0	NO CHILDREN IN ATTENDANCE	Goldie Hoy, Hailey Whitten, Kimberly Witt, Caitlyn Shellnut, Alyssa Jensen and Libby Davidson (all staff) present with no children in attendance.
2	14	PRESCHOOL	Brooklyn Jones and Kathy McCool (both staff) present with fourteen children age 3-5 years.
2	16	PRESCHOOL	Alyssa Jensen and Meara Edwards (both staff) present with sixteen children age 3-4 years.
2	16	PRESCHOOL	Pam Barrett and Katherine (both staff) present with sixteen children age 4-5 years.
2	15	PRESCHOOL	Jessica Adams and Kelly Price (both staff) present with fifteen children age 4-5 years.
2	17	PRESCHOOL	Tiffany Galvan and Brea Baggs (both staff) present with seventeen children age 4-5 years.
1	8	TWO YEAR OLDS	Amy Dehghani (staff) present with eight children age 2 years.

Compliance List

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

Violation

	Provider Comments
Violation Bathroom supplies were not available and accessible to children as evidenced by there was no toilet paper. Licensing Rule Reference 5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (3) (A) 4. states: Paper towels, soap and toilet paper shall be provided and easily accessible so the children can reach them without assistance. Correction Required The facility shall provide paper towels, soap and toilet paper, accessible for children's use. Correction Verification Corrected on Site Compliance Date 2/16/2023

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

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

Not Observed

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