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
11/14/2023

Arrival Time
3:42 PM

Departure Time
5:06 PM

Notice
UNANNOUNCED

Inspection Type
CLOSE SUPERVISION

Inspection ID
2458786987

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: 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 16

Total Children 61

Staff	Child	Class Age	Note
2	7	INFANTS AND TODDLERS	Staff Gracie Perkins and Alexia Todd present in the Sunnies room with children ages 16 months - 22 months.
2	7	INFANTS AND TODDLERS	Staff Joannmarie Romirez and Kristen Thompson present in the Twinkles room with 7 children ages 2 months - 13 months old.
2	7	INFANTS AND TODDLERS	Staff Kayln Thomas and Megan Bishop present in the Sparkles room with children ages 13 months - 18 months old.
2	12	MIXED	Staff Kacy Bergfeld and Hayli Merideth present on the playground with the Neptunes class consisting of children ages 3 - 5 years old.
1	8	MIXED	Staff Kaylee Drysdale present on the playground with the Saturns class consisting of children ages 2 - 5 years old, with five of those children age 2 years old.
2	0	NO CHILDREN IN ATTENDANCE	Director Jackie Nichols and Amanda Brill present on site.
1	6	PRESCHOOL	Staff Faith Edwards was present on the playground with the Mercuries class consisting of children all 3 years old.
2	6	PRESCHOOL	Staff Taryn Richards present on the playground with the Comets class consisting of children all age 3 years old.
2	8	TWO YEAR OLDS	Staff Ellyse Edwards and Lexi Crocker present on the playground with the Stars class consisting of all 2 year old children.


5 CSR 25-500.032 Organization and Administration Compliance
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Not Observed
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 Not Observed
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 Not Observed
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 Not Observed
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