DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT
Facility Information

IXL ACADEMY PRESCHOOL & AFTER SCHOOL PROGRAM

002360403

(573) 468-8044

444 BEEMAN ST
SULLIVAN
MO  63080-1802

TEMPLE BAPTIST CHURCH OF SULLIVAN, FRANKLIN COUNTY, MISSOURI



 

MALLORI, PEREGOY

mallori@tbcsullivan.com

Incorporated

LAUREN R RAYWARNKE

24 MONTHS - 14 YEARS

165

LICENSE EXEMPT PROGRAM

 
Inspection Information

05/07/2026

9:25 AM

11:35 AM

ANNOUNCED

ANNUAL

2512906229


DocumentDocument-Date
NOTICE OF PARENTAL RESPONSIBILITY 06/04/2025
FIRE/SAFETY INSPECTION 03/11/2026
SANITATION INSPECTION 02/25/2026




Inspection determined facility to be in compliance with rules.
Compliance Licensing Rules
Open Violations: 1
Attendance at Time of Inspection
Total Staff 5
Total Children 45
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Additional Staff Present: Director Mallori Peregoy in the main office with 0 children.
1 11 PRESCHOOL Caregiver Savannah Huber with 11 children ages 3 through 4 years old. NPR 1:13
1 10 PRESCHOOL Caregiver Alicia Bishop with 10 children ages 4 through 5 year's old. NPR 1:13 (4's) NPR 1:16 (5's)
1 12 PRESCHOOL Caregiver Victoria Wall with 12 children ages 4 through 5 year's old. NPR 1:13 (4's) and NPR 1:16 (5's)
1 12 PRESCHOOL Caregiver Addie Kilburn with 12 children ages 3 through 4 year's old. NPR 1:13

Compliance List
5 CSR 25-300.020 Application for Annual Fire Safety and Health and Sanitation Inspections and Inspection Procedures
Compliance
5 CSR 25-300.040 Staffing Requirements
Compliance
5 CSR 25-300.050 Health Requirements
Violation
 Provider Comments
Violation
Requirements for children's medical examination reports were not met as evidenced by the medical form did not contain all required information in that albuterol was indicated on the medical examination form "as needed" there were no specialized care instructions indicated on the form.
Licensing Rule Reference
5 CSR 25-300.050 Health Requirements (2) states: Within thirty (30) days following the admission of an infant, toddler or preschool child, a physical assessment report signed by a licensed physician or registered professional nurse shall be on file at the facility. The facility may use the department's physical assessment form, MO 580-1878 (6-94), or the facility may use its own form if it contains all the information on the department's form. The report shall have been completed not more than twelve (12) months before admission.
Correction Required
Children's physical assessment reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-300.060 Responsibilities of Caregivers
Compliance
5 CSR 25-300.070 Fire Safety Requirements
Compliance
5 CSR 25-300.080 Sanitation Requirements
Compliance
5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment
Violation
 Provider Comments
Violation
Children were not restricted to approved space as evidenced by the preschool office door was open allowing children to have access to unapproved space.
Licensing Rule Reference
5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 1 (A) states: Children shall have no access to areas not approved for child care.
Correction Required
Caregivers shall restrict children to approved space.

Correction Verification
Corrected on Site

Compliance Date
5/7/2026
Violation
Hazardous items as follows were accessible to children: Hand Sanitizer. The item(s) was/were located in the 2nd 3's classroom under a cabinet unlocked.
Licensing Rule Reference
5 CSR 25-300.090 Physical Plant, Space, Supplies and Equipment 1 (D) states: Hazardous materials such as cleaning supplies, poisonous materials, medicines, alcoholic beverages or hazardous personal care items shall be inaccessible to children and stored to prevent cross-contamination of food and food-related materials.
Correction Required
Hazardous material(s) shall be inaccessible to children and stored to prevent cross-contamination of food and food-related items.

Correction Verification
Corrected on Site

Compliance Date
5/7/2026
5 CSR 25-300.110 Admission Procedures and Required Reports and Records
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child files did not have the full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.
Licensing Rule Reference
5 CSR 25-300.110 Admission Procedures and Required Reports and Records 2 (B) states: The full name of the parent(s), guardian or legal custodian, home address, work schedule, home and work telephone numbers, and employer's name and address.
Correction Required
An individual file with required information for each child shall be maintained.

Correction Verification
Corrected on Site

Compliance Date
5/7/2026
5 CSR 25-600.020 General Requirements
Compliance
5 CSR 25-600.040 Background Screening Findings
Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
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.
Compliance
RSMo 210.201. Definitions. — As used in sections 210.201 to 210.257, the following terms mean:
Compliance
RSMo 210.254 Religious organization operating facilities exempt under licensing laws required to file parental notice of responsibility and fire, safety inspections annually.
Compliance
RSMo 210.255 Religious organizations operating facility in violation, procedure - noncompliance after notice, prosecutor may act or attorney general.
Compliance
RSMo 252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance
Subsidy Requirements
Compliance