MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
CALIFORNIA KIDS LLC

Facility DVN
002553204

Phone
(573) 796-2058

Physical Address
800 LAKE DR
CALIFORNIA
MO 65018-2022

Owner
CALIFORNIA KIDS LLC

Mailing Address

Provider/Director
WOLFORD, ANNY NICOLE

E-mail Address
californiakidsllc@gmail.com

Incorporated

Child Care Specialist
ALISON MICHELE EVANS

Age Range
6 WEEKS - 12 YEARS

Capacity
38

Facility Type
GROUP HOME AND CENTER

Limitations
12 CHILDREN IN THE INFANT/TODDLER UNIT

Inspection Information

Date
09/12/2017

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2313304659

Document	Document-Date
APPLICATION	07/12/2017
STAFF SHEET	07/12/2017
LLC OPERATING AGREEMENT	09/01/2015
LLC ARTICLES OF ORGANIZATION	09/01/2015
LINES OF ADMINISTRATIVE AUTHORITY	09/01/2015
DIRECTOR'S QUALIFICATIONS	09/11/2015
DIAGRAM/INDOOR	09/18/2015
DIAGRAM/OUTDOOR	09/18/2015
SAMPLE WEEKLY MENU	10/08/2015
SANITATION INSPECTION	07/26/2017
DISCIPLINE POLICIES	10/26/2015
CHILD CARE PRACTICES	10/26/2015
POLICIES	10/26/2015
SAMPLE FORMS	10/28/2015
FIRE/SAFETY INSPECTION	06/26/2017
JOB RESPONSIBILITIES	11/02/2015
DAILY SCHEDULE	11/04/2015
EQUIPMENT LIST	07/12/2017
OWNER/PROVIDER REFERENCES	11/04/2015
LOCAL FIRE DEPARTMENT NOTIFICATION	11/04/2015

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:00PM	5:00PM	11/4/2015

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.