DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

UNION R-XI SCHOOL DISTRICT

002818688

(636) 583-8621

2 E SPRINGFIELD AVE
UNION
MO  63084-1840

UNION R-XI SCHOOL DISTRICT



 

MEYER, ROBERTA A

fennke@unionrxi.org


LAUREN R RAYWARNKE

36 MONTHS - 6 YEARS

20

GROUP HOME AND CENTER

 
Inspection Information

10/19/2023

10:20 AM

11:41 AM

UNANNOUNCED

COMPLIANCE MONITORING

2456873420


DocumentDocument-Date
LOCAL ZONING APPROVAL 12/11/2019
SAMPLE FORMS 08/06/2020
APPLICATION 08/06/2020
LOCAL BUILDING APPROVAL 11/14/2019
LOCAL FIRE DEPARTMENT NOTIFICATION 07/08/2020
EQUIPMENT LIST 10/19/2023
FIRE/SAFETY INSPECTION 08/25/2023
ANNUAL DECLARATION 10/19/2023
DIRECTOR'S QUALIFICATIONS 08/06/2020
STAFF SHEET 08/06/2020
SAMPLE WEEKLY MENU 04/20/2020
POLICIES 06/11/2020
LOCAL BUILDING APPROVAL 11/14/2019
LINES OF ADMINISTRATIVE AUTHORITY 08/06/2020
JOB RESPONSIBILITIES 06/11/2020
DISCIPLINE POLICIES 06/11/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 01/06/2021
DIAGRAM/OUTDOOR 08/06/2020
DIAGRAM/INDOOR 08/06/2020
CHILD CARE PRACTICES 06/11/2020
DAILY SCHEDULE 08/06/2020
SANITATION INSPECTION 10/19/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 10/19/2023




Inspection determined facility to be in compliance with licensing rules.
Compliance 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 2
Total Children 18
StaffChildClass AgeNote
2 18 PRESCHOOL Roberta Meyer and Danielle Cooper with 18 children ages 3 through 5 year's old.

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
Violation
 Provider Comments
Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.
Correction Required
The facility shall submit the Annual Declaration as required.

Correction Verification
Corrected on Site

Compliance Date
10/19/2023
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
Violation
 Provider Comments
Violation
1 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
10/19/2023
Violation
1 child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
10/19/2023
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