MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
PAPER MOON EARLY LEARNING CENTER LLC

Facility DVN
002838326

Phone
(573) 447-0131

Physical Address
4470 N HIGHWAY 763
COLUMBIA
MO 65202-1043

Owner
PAPER MOON EARLY LEARNING CENTER LLC

Mailing Address

Provider/Director
NICHOLS, JACQUELINE BEATRICE

E-mail Address
director@papermoonelc.com

Incorporated

Child Care Specialist
LU A GAINES

Age Range
BIRTH - 12 YEARS

Capacity
99

Facility Type
GROUP HOME AND CENTER

Limitations
24 CHILDREN UNDER 24 MONTHS

Inspection Information

Date
08/01/2023

Arrival Time
8:30 AM

Departure Time
12:16 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2451439872

Document	Document-Date
APPLICATION	06/23/2020
DIAGRAM/INDOOR	07/21/2020
DIAGRAM/OUTDOOR	07/21/2020
STAFF SHEET	07/21/2020
DIRECTOR'S QUALIFICATIONS	07/29/2020
LINES OF ADMINISTRATIVE AUTHORITY	07/21/2020
DISCIPLINE POLICIES	07/21/2020
SAMPLE WEEKLY MENU	07/21/2020
DAILY SCHEDULE	07/21/2020
JOB RESPONSIBILITIES	07/21/2020
CHILD CARE PRACTICES	07/21/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN	07/21/2020
POLICIES	07/21/2020
SAMPLE FORMS	07/21/2020
LLC ARTICLES OF ORGANIZATION	07/21/2020
LLC OPERATING AGREEMENT	07/21/2020
LOCAL ZONING APPROVAL	08/07/2020
LOCAL BUILDING APPROVAL	08/07/2020
EQUIPMENT LIST	07/12/2023
ANNUAL DECLARATION	07/11/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	07/12/2023
SANITATION INSPECTION	04/21/2023
FIRE/SAFETY INSPECTION	07/12/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:30PM	8/5/2020

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 1

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 17

Total Children 68

Staff	Child	Class Age	Note
2	5	INFANTS AND TODDLERS	Kristen Thompson and Jadyn Ayres present in the Twinkles room with children ages 7-10 months old.
2	6	INFANTS AND TODDLERS	Taylor Marshall and Michell Cowgill present in the Sunnies' room with children ages 16-23 months old.
2	5	INFANTS AND TODDLERS	Erica Newell and Megan Bishop present in the Sparkles' room with children ages 14-16 months.
2	16	MIXED	Kacy Bergfield and Jillian Gautcher present in Neptune's room with children 4-5 years old.
3	0	NO CHILDREN IN ATTENDANCE	Jackie Nichols, Megan Barte and cook Bianca Maldonado present on site.
2	14	PRESCHOOL	Savanna Terry and Maddison Speiss present in the Stars' room with children ages 2-4 years old.
2	11	PRESCHOOL	Amanda Brill and Kaylee Drysdale present in the Saturns' room with children ages 2-3 years old.
1	5	PRESCHOOL	Faith Reusch present in the Mercury room with children ages 3-4 years old.
1	6	PRESCHOOL	Lauren Farris present in the Comet room with children ages 3-4 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

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

Violation

	Provider Comments
Violation Bianca Maldonado start date 4/27/23 did not complete safe sleep training within 30 days of employment or volunteering at the facility. Licensing Rule Reference 5 CSR 25-500.102 Personnel (4) (A) 3. states: The child care provider, group child care home provider, child care staff members, and volunteers shall complete safe sleep training described in subsection (4)(A) of this rule within thirty (30) days of employment or volunteering at the facility. Correction Required The department-approved safe sleep training must be completed within 30 days of employment or volunteering. Correction Verification Submit Documentation Compliance Date

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

Not Observed

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