MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
KIRKSVILLE R-III SCHOOL DISTRICT

Facility DVN
002011727

Phone
(660) 626-1459

Physical Address
1405 S COTTAGE GROVE
KIRKSVILLE
MO 63501

Owner
KIRKSVILLE R-III SCHOOL DISTRICT

Mailing Address

Provider/Director
KLOCKE, MELISSA ROSE

E-mail Address
mklocke@kirksville.k12.mo.us

Incorporated

Child Care Specialist
ELLEN DONOHO

Age Range
6 WEEKS - 6 YEARS

Capacity
175

Facility Type
GROUP HOME AND CENTER

Limitations
16 CHILDREN UNDER 24 MONTHS

Inspection Information

Date
06/13/2023

Arrival Time
9:43 AM

Departure Time
11:58 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2448948157

Document	Document-Date
SAMPLE WEEKLY MENU	02/27/2008
LINES OF ADMINISTRATIVE AUTHORITY	02/27/2008
DIRECTOR'S JOB RESPONSIBILITIES	02/27/2008
JOB RESPONSIBILITIES	02/27/2008
DAILY SCHEDULE	03/17/2010
CHILD CARE PRACTICES	04/11/2016
DISCIPLINE POLICIES	04/11/2016
POLICIES	04/11/2016
DIAGRAM/INDOOR	03/10/2008
DIAGRAM/OUTDOOR	03/10/2008
SAMPLE FORMS	03/04/2008
SAFE SLEEP POLICY	03/01/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN	11/06/2019
APPLICATION	03/10/2020
DIRECTOR'S QUALIFICATIONS	04/28/2008
STAFF SHEET	07/29/2020
SANITATION INSPECTION	03/08/2023
FIRE/SAFETY INSPECTION	03/28/2023
EQUIPMENT LIST	06/13/2023
ANNUAL DECLARATION	04/25/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	06/13/2023

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 12

Total Children 26

Staff	Child	Class Age	Note
7	6	MIXED	4-5 year old children Whitney Burns, Sara Ward, Shelia Smith, Alexis Lubring, Sarah Trauernicht, staff
2	10	PRESCHOOL	3-4 year old children Brittany Athon and Karen Burns, staff
3	10	PRESCHOOL	3-4 year old children Angel Grogan, Jimi Mater, Robert Bray, staff


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 25-500.087 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