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

Inspection Information

Date
09/26/2016

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2289747107

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.

Compliance List
19 CSR 30-61.025 Organization and Administration Compliance
19 CSR 30-61.045 Initial Licensing Information Compliance
19 CSR 30-61.055 License Renewal Compliance
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home Compliance
19 CSR 30-61.086 Fire Safety Compliance
19 CSR 30-61.090 Disaster and Emergency Preparedness Compliance
19 CSR 30-61.095 Furniture, Equipment and Materials Compliance
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel Violation
19 CSR 30-61.115 Day Care Family and Household Compliance
19 CSR 30-61.125 Medical Examination Reports Violation
19 CSR 30-61.135 Admission Policies and Procedures Compliance
19 CSR 30-61.145 Nighttime Care Compliance
19 CSR 30-61.155 Overlap Care of Children Compliance
19 CSR 30-61.165 Emergency School Closings Compliance
19 CSR 30-61.175 Child Care Program Compliance
19 CSR 30-61.185 Health Care Compliance
19 CSR 30-61.190 Nutrition and Food Service Compliance
19 CSR 30-61.200 Transportation and Field Trips Compliance
19 CSR 30-61.210 Records and Reports Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when. Compliance
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance