DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

KIDDOS KORNER PACIFIC

003009845

(636) 393-0181

413 W UNION ST
PACIFIC
MO  63069-1343

PACIFIC CHILDCARE, LLC

6209 YELLOW BRICK RD
WASHINGTON
MO  63090-4345

HORN, MAKALYNN

kiddoskornerpacific@gmail.com


LAUREN R RAYWARNKE

6 WEEKS - 12 YEARS

140

GROUP HOME AND CENTER

BUILDING 1: CAPACITY 74 CHILDREN AGES 6 WEEKS THROUGH 5 YEARS WITH 15 UNDER 24 MONTHS; BUILDING 2: CAPACITY 86 CHILDREN AGES 2 YEARS THROUGH 12 YEARS
 
Inspection Information

04/25/2025

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2492018409


DocumentDocument-Date
APPLICATION 04/20/2023
FIRE/SAFETY INSPECTION 05/02/2024
JOB RESPONSIBILITIES 06/24/2024
LICENSING ORIENTATION 12/07/2022
LLC ARTICLES OF ORGANIZATION 02/21/2023
REGISTERING FICTITIOUS NAMES 12/01/2023
CHILD CARE PRACTICES 05/23/2024
DISCIPLINE POLICIES 05/23/2024
POLICIES 05/23/2024
SAFE SLEEP POLICY 05/30/2024
SAMPLE WEEKLY MENU 05/31/2024
DISASTER AND EMERGENCY PREPAREDNESS PLAN 06/06/2024
SAMPLE FORMS 06/24/2024
DIAGRAM/INDOOR 05/23/2024
DIAGRAM/OUTDOOR 05/23/2024
EQUIPMENT LIST 06/24/2024
DAILY SCHEDULE 06/25/2024
LINES OF ADMINISTRATIVE AUTHORITY 06/25/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 06/25/2024
LLC OPERATING AGREEMENT 06/25/2024
LOCAL BUILDING APPROVAL 06/25/2024
LOCAL ZONING APPROVAL 06/25/2024
LOCAL FIRE DEPARTMENT NOTIFICATION 06/25/2024
STAFF SHEET 06/25/2024
DIRECTOR'S QUALIFICATIONS 08/01/2024
SANITATION INSPECTION 08/02/2024




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.

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
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
Violation
 Provider Comments
Violation
Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 2 children enrolled 8/12/2024 and 1 child enrolled 8-21-2024. A supplemental inspection was conducted on 1/28/2025 and only 1 child enrolled 8-12-2024 is still needing a medical examination report.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (2) (A) states: The provider, within thirty (30) days following the admission of each infant, toddler or preschool child, shall require a medical examination report signed by a licensed physician or registered nurse who is under the supervision of a licensed physician and completed not more than twelve (12) months prior to admission. The provider may use the department’s medical assessment form or the provider may use its own form if it contains all the information on the department’s form. The Child Medical Examination Report (Infant/Toddler/Pre-School)form, revised 2021, is 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. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
4/25/2025
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 1 child's immunization record(s) was/were not on file.
Licensing Rule Reference
5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
4/25/2025
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
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