MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
PAYNE HOME DAYCARE

Facility DVN
002546187

Phone
(417) 883-9665

Physical Address
1225 S ESTATE AVE
SPRINGFIELD
MO 65804-0642

Owner
PAYNE HOME DAYCARE, LLC

Mailing Address

Provider/Director

E-mail Address
wsrtmed@outlook.com

Incorporated

Child Care Specialist
DEANA DICKENS

Age Range
BIRTH - 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
06/05/2017

Arrival Time
8:15 AM

Departure Time
9:22 AM

Notice
ANNOUNCED

Inspection Type
RENEWAL

Inspection ID
2307011996

Document	Document-Date
SANITATION INSPECTION	05/18/2017
FIRE/SAFETY INSPECTION	03/29/2017
EQUIPMENT LIST	03/28/2017
APPLICATION	03/28/2017
LLC ARTICLES OF ORGANIZATION	08/01/2015
CHILD CARE/DISCIPLINE POLICIES	06/14/2005
DIAGRAM/OUTDOOR	05/21/2001
DIAGRAM/INDOOR	05/21/2001
DAILY SCHEDULE	05/14/2001
SAMPLE WEEKLY MENU	05/14/2001
OWNER/PROVIDER REFERENCES	05/14/2001
ASSISTANT APPROVAL REQUEST	03/23/2015

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.

Attendance at Time of Inspection

Total Staff 1

Total Children 8

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


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 Compliance
19 CSR 30-61.115 Day Care Family and Household Compliance
19 CSR 30-61.125 Medical Examination Reports Compliance
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