MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
JACKSON, TAMMY

Facility DVN
001044140

Phone
(573) 338-9630

Physical Address
3035 OAK VALLEY DR
JEFFERSON CITY
MO 65109-1046

Owner
JACKSON, TAMMY

Mailing Address

Provider/Director

E-mail Address
tammyd_1@yahoo.com

Incorporated

Child Care Specialist
ALISON MICHELE EVANS

Age Range
BIRTH - 13 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
10/17/2017

Arrival Time
12:00 PM

Departure Time
12:33 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2315837332

Document	Document-Date
APPLICATION	04/11/2016
EQUIPMENT LIST	04/11/2016
FIRE/SAFETY INSPECTION	03/13/2017
SANITATION INSPECTION	02/22/2016
ASSISTANT REFERENCES	03/19/2014
SAMPLE FORMS	02/12/2014
SAMPLE WEEKLY MENU	02/12/2014
POLICIES	02/12/2014
DIAGRAM/OUTDOOR	02/12/2014
DIAGRAM/INDOOR	02/12/2014
DAILY SCHEDULE	02/12/2014
CHILD CARE/DISCIPLINE POLICIES	02/12/2014
OWNER/PROVIDER REFERENCES	03/19/2014
ASSISTANT APPROVAL REQUEST	06/18/2014

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:30PM	6/18/2014

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 5

Staff	Child	Class Age	Note
1	5	MIXED	Tammy with 5 children which one of them is under age 2.


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