DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

ST. JOHN'S EVANGELICAL LUTHERAN CHURCH OF HANNIBAL, MISSOURI

000354101

(573) 221-0615

1317 LYON
HANNIBAL
MO  63401

ST. JOHN'S EVANGELICAL LUTHERAN CHURCH OF HANNIBAL, MISSOURI



 

PAGE, SUMMER

spage@stjohnshannibal.org

Incorporated

BETHANY DUCKWORTH

24 MONTHS - 12 YEARS

71

GROUP HOME AND CENTER

 
Inspection Information

03/16/2026

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2509781204


DocumentDocument-Date
APPLICATION 10/11/2018
STAFF SHEET 11/15/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/11/2016
ARTICLES OF INCORPORATION 09/12/1960
CHILD CARE PRACTICES 08/01/2011
DAILY SCHEDULE 11/12/1996
SAMPLE WEEKLY MENU 11/13/1990
DISCIPLINE POLICIES 08/01/2011
LINES OF ADMINISTRATIVE AUTHORITY 08/31/2007
JOB RESPONSIBILITIES 11/13/1990
POLICIES 08/01/2011
LLC ARTICLES OF ORGANIZATION 09/01/1990
DIAGRAM/INDOOR 07/27/2018
DIAGRAM/OUTDOOR 12/17/2008
CERTIFICATE OF GOOD STANDING 05/12/2020
DIRECTOR'S QUALIFICATIONS 10/02/2019
EQUIPMENT LIST 12/29/2025
SANITATION INSPECTION 09/08/2025
FIRE/SAFETY INSPECTION 01/13/2026
ANNUAL DECLARATION 12/29/2025
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 12/29/2025




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
Violation
 Provider Comments
Violation
The annual fire safety inspection was not approved.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.
Correction Required
The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification
Submit Documentation

Compliance Date
1/13/2026
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
The walls located on the northwest walls of the Rangers and Trailblazers rooms was/were not in good condition as evidenced by there was a half dollar size hole on the walls with busted drywall and peeling paint in both rooms. One spot on the northwest wall in Rangers room and one spot on northwest wall in the Trailblazers room.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
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
Violation
 Provider Comments
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2025, the staff listed need the following information: Shantel Hinton needs 3 hours of training, Amber Keys needs 1 hour of training, Elizabeth Miles needs 5.75 hours of training and Shelby Patterson needs 2.25 hours of training.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date
2/12/2026
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Michaela Gander as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
3/2/2026
Violation
A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Amber Keys and Michaela Gander.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberculin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date
3/2/2026
5 CSR 25-500.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information as evidenced by one child's file was missing an enrollment form.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 4. states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
Written permission was not on file for transportation to and from school.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 6. states: Permission for field trips, transportation to and from school and other transportation;
Correction Required
Written permission for field and transportation shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
Written permission was not on file for field trips.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 6. states: Permission for field trips, transportation to and from school and other transportation;
Correction Required
Written permission for field and transportation shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider's policies.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. A. states: They have received a copy of the provider's policies pertaining to the admission, care and discharge of children;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
The provider did not have parental acknowledgement on file indicating the parent has been informed that Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available for review.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. B. states: They have been informed that the Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available in the facility for their review;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
The provider did not have parental acknowledgement on file indicating the parent and provider have agreed on a plan for continuing communication.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. C. states: They and the provider have agreed on a plan for continuing communication regarding the child's development, behavior and individual needs;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
The provider did not have parental acknowledgement on file indicating the parent understands and agrees that the child may not be accepted for care when ill.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. D. states: They understand and agree that the child may not be accepted for care when ill.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by one child(s) file did not have the parental acknowledgement they have received a copy of the provider's safe sleep policy.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. E. states: They have received a copy of the provider's safe sleep policy when enrolling children less than one (1) year of age.
Correction Required
Child enrollment information shall be completed and on file as requested.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by one child(s) file(s) did not have the parental acknowledgement they have been notified that they may request whether there are children for whom an immunization exemption has been filed for currently enrolled in or attending the facility.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. F. states: They have been notified that they may request notice at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility
Correction Required
Child enrollment information shall be completed and on file as requested.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
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
The provider failed to maintain accurate records to meet administrative requirements as evidenced by one child's enrollment form was not on file.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (1) states: The child care provider shall maintain accurate records to meet administrative requirements and to ensure knowledge of the individual needs of children and their families.
Correction Required
Accurate records shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
One child(ren) records did not include child's full name, address, date of birth and date care begins and ends.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
Onw child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the 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
Submit Documentation

Compliance Date
2/19/2026
Violation
One child(ren) records did not include name, address and telephone number 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
Submit Documentation

Compliance Date
2/19/2026
Violation
One child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
One child(ren) records did not include name of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
ONE child(ren) records did not include name of individual authorized to take the child from the facility.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (E) states: Name of the individual(s) authorized to take the child from the facility;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
Violation
Enrollment, medical and attendance records were not accessible at all times as evidenced by one child;s file did not obtain an enrollment form in the file and staff was unable to locate the enrollment form.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (7) states: All enrollment records, medical examination records and attendance records shall be filed in a place known to caregivers and shall be accessible at all times. Records shall not be in a locked area or removed from the facility during the hours the facility is open and operating.
Correction Required
All required records shall be kept on file at the facility and accessible at all times.

Correction Verification
Submit Documentation

Compliance Date
2/19/2026
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