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
05/22/2023

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2447706448

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.