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
08/02/2024

Arrival Time
12:20 PM

Departure Time
4:09 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2475302528

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	07/17/2024
ANNUAL DECLARATION	06/27/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	06/27/2024
SANITATION INSPECTION	06/27/2024
FIRE/SAFETY INSPECTION	05/29/2024

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: 2

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 14

Total Children 53

Staff	Child	Class Age	Note
2	8	INFANTS AND TODDLERS	Caregivers Jalyn King and Zoe Scoggins with eight children 18-23 months old.
1	4	INFANTS AND TODDLERS	Caregiver Kayln Thomas with four children 13-19 months old.
2	7	INFANTS AND TODDLERS	Caregivers Megan Bishop and Gracee Gooding with seven children 3-11 months old.
2	13	MIXED	Caregivers Kacy Bergfeld and Chloe Kauffman with one child-3-years-old, six children-4-years-old, five children-5-years-old, and one child-6-years-old.
4	0	NO CHILDREN IN ATTENDANCE	Director Jackie Nichols, LLC member Elizabeth Snyder, Cook Jeanpoul Vela'zquez, Assistant Megan Barte present on site.
1	10	PRESCHOOL	Caregiver Audrey Peterson with ten children-all 3-years-old.
2	11	TWO YEAR OLDS	Caregivers Amanda Brill and Gracie Perkins with eleven children-all 2-years-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

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

Violation

	Provider Comments
Violation Outdoor equipment, the wooden walking pad, in the preschool playground was not in good condition as evidenced by a broken plank was sticking up with a pointed sharp edge.. Licensing Rule Reference 5 CSR 25-500.092 Furniture, Equipment and Materials (3) (A) states: All outdoor equipment shall be constructed safely, in good condition and free of sharp, loose or pointed parts. Only lead-free paint shall be used. Correction Required Outdoor play equipment shall be safe and in good repair. Correction Verification Submit Documentation Compliance Date

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

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

Violation

	Provider Comments
Violation Criminal background check results were older than five (5) years for Director Jackie Nichols and LLC member Elizabeth Snyder. Licensing Rule Reference 5 CSR 25-600.020 General Requirements (5) states: Criminal background checks shall be completed for each child care staff member every five (5) years. Correction Required Required results of criminal background checks shall be on file. Correction Verification Submit Documentation Compliance Date

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