MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
APPLE BLOSSOM LEARNING CENTER LLC

Facility DVN
002813807

Phone
(417) 349-0063

Physical Address
1505A N MAIN ST
MOUNTAIN GROVE
MO 65711-1038

Owner
APPLE BLOSSOM LEARNING CENTER LLC

Mailing Address

Provider/Director
SMART, SHANNON DAWN

E-mail Address
smartshannon50@gmail.com

Incorporated

Child Care Specialist
KATHLEEN WILSON

Age Range
BIRTH - 12 YEARS

Capacity
40

Facility Type
GROUP HOME AND CENTER

Limitations
21 CHILDREN UNDER 24 MONTHS

Inspection Information

Date
05/02/2023

Arrival Time
11:45 AM

Departure Time
1:24 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2446420441

Document	Document-Date
LLC ARTICLES OF ORGANIZATION	11/11/2019
DIAGRAM/INDOOR	01/02/2020
DIAGRAM/OUTDOOR	01/02/2020
LOCAL FIRE DEPARTMENT NOTIFICATION	01/02/2020
SAMPLE FORMS	01/02/2020
DAILY SCHEDULE	01/23/2020
CHILD CARE PRACTICES	01/02/2020
POLICIES	02/10/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN	01/30/2020
SAMPLE WEEKLY MENU	02/10/2020
JOB RESPONSIBILITIES	02/10/2020
LINES OF ADMINISTRATIVE AUTHORITY	03/03/2020
LOCAL ZONING APPROVAL	03/03/2020
LOCAL BUILDING APPROVAL	03/03/2020
LLC OPERATING AGREEMENT	03/03/2020
DISCIPLINE POLICIES	01/02/2020
STAFF SHEET	01/02/2020
DIRECTOR'S QUALIFICATIONS	03/23/2020
ARTICLES OF INCORPORATION	11/11/2019
LICENSING ORIENTATION	12/12/2019
DIAGRAM/INDOOR	01/02/2020
FIRE/SAFETY INSPECTION	03/09/2023
ANNUAL DECLARATION	01/11/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	01/11/2022
EQUIPMENT LIST	01/11/2023
SANITATION INSPECTION	02/28/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:30PM	9/16/2021

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 5

Total Children 26

Staff	Child	Class Age	Note
1	3	INFANTS AND TODDLERS	Kortnie Bunch with three children ages eighteen months to 2 years old.
1	6	INFANTS AND TODDLERS	Stephanie Pearce and Jana Atkinson with six children ages 0-1 years old.
1	4	INFANTS AND TODDLERS	Megan Boyd with four children ages 1-2 years old.
2	13	PRESCHOOL	Shannon Smart and Danny Smart with thirteen children ages 3-5 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 MA, JA, MB, KB, SK, SM, SS 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 Corrected on Site Compliance Date 5/2/2023

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