MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
WORTHWINE, RANDI

Facility DVN
000444166

Phone
(816) 324-4631

Physical Address
201 W MAIN
SAVANNAH
MO 64485

Owner
WORTHWINE, RANDI

Mailing Address

Provider/Director

E-mail Address

Incorporated

Child Care Specialist
JILL ZEIGENBEIN

Age Range
BIRTH - 12 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations
UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 2 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER

Inspection Information

Date
02/09/2016

Arrival Time
12:15 PM

Departure Time
12:59 PM

Notice
ANNOUNCED

Inspection Type
RENEWAL

Inspection ID
2273505705

Document	Document-Date
FIRE/SAFETY INSPECTION	02/01/2016
OWNER/PROVIDER REFERENCES	08/07/1991
POLICIES	08/02/1993
SAMPLE WEEKLY MENU	09/23/1991
CHILD CARE/DISCIPLINE POLICIES	08/02/1993
DIAGRAM/OUTDOOR	04/22/1994
DAILY SCHEDULE	09/23/1991
DIAGRAM/INDOOR	04/22/1994
ASSISTANT APPROVAL REQUEST	02/03/2012
SANITATION INSPECTION	12/03/2015
APPLICATION	01/04/2016

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:00PM	5:00PM	2/25/2002

Inspection determined facility to be in compliance with 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.

Attendance at Time of Inspection

Total Staff 1

Total Children 8

Staff	Child	Class Age	Note
1	8	MIXED	1 under 2 years 1 relative