MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
LEWIS, KATHIE L

Facility DVN
000255709

Phone
(573) 562-2994

Physical Address
1108 CAVINESS DR
LEADWOOD
MO 63653

Owner
LEWIS, KATHIE LANETTE

Mailing Address

Provider/Director

E-mail Address

Incorporated

Child Care Specialist
KELLY VIVIANO

Age Range
6 WEEKS - 12 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations
IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE 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; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER

Inspection Information

Date
02/24/2017

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2297447727

Document	Document-Date
SAMPLE WEEKLY MENU	05/18/1987
POLICIES	04/27/2012
OWNER/PROVIDER REFERENCES	03/16/1987
DAILY SCHEDULE	05/18/1987
CHILD CARE/DISCIPLINE POLICIES	04/27/2012
ASSISTANT REFERENCES	03/14/2013
ASSISTANT APPROVAL REQUEST	03/14/2013
DIAGRAM/OUTDOOR	05/06/1999
DIAGRAM/INDOOR	05/06/1999
FIRE/SAFETY INSPECTION	04/29/2015
EQUIPMENT LIST	04/17/2015
APPLICATION	04/17/2015
SANITATION INSPECTION	05/07/2015

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:15PM	5:15PM	5/4/2015

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.