MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
REXROAT, NICCI ANN

Facility DVN
003011725

Phone
(573) 409-4060

Physical Address
328 STATE ROAD AE
NEW BLOOMFIELD
MO 65063-5402

Owner
REXROAT, NICCI ANN

Mailing Address
482 KAREN DR
HOLTS SUMMIT
MO 65043-1543

Provider/Director
LACEFIELD, SAMANTHA C

E-mail Address
trexinvestmentsllc@gmail.com

Incorporated

Child Care Specialist
JOY LYNN NICHOLS

Age Range
BIRTH - 6 YEARS

Capacity
44

Facility Type
GROUP HOME AND CENTER

Limitations
16 CHILDREN UNDER 24 MONTHS

Inspection Information

Date
01/25/2024

Arrival Time
12:23 PM

Departure Time
12:23 PM

Notice
UNANNOUNCED

Inspection Type
SUPPLEMENTAL

Inspection ID
2462973298

Document	Document-Date
LOCAL ZONING APPROVAL	06/23/2023
LOCAL BUILDING APPROVAL	06/23/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	05/25/2023
LINES OF ADMINISTRATIVE AUTHORITY	05/25/2023
SAFE SLEEP POLICY	05/25/2023
EQUIPMENT LIST	06/23/2023
DISCIPLINE POLICIES	05/25/2023
DIAGRAM/INDOOR	06/23/2023
APPLICATION	04/28/2023
SAMPLE WEEKLY MENU	07/12/2023
POLICIES	07/12/2023
JOB RESPONSIBILITIES	07/12/2023
DISASTER AND EMERGENCY PREPAREDNESS PLAN	07/12/2023
DIAGRAM/OUTDOOR	07/12/2023
DAILY SCHEDULE	07/12/2023
CHILD CARE PRACTICES	07/12/2023
SAMPLE FORMS	07/12/2023
DIRECTOR'S QUALIFICATIONS	11/08/2023
SANITATION INSPECTION	12/19/2023
FIRE/SAFETY INSPECTION	11/09/2023

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.