MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
BLACKBURN, AMANDA

Facility DVN
002553937

Phone
(816) 284-1388

Physical Address
601 E SAMUEL ST
HAMILTON
MO 64644-1250

Owner
BLACKBURN, AMANDA LYNN

Mailing Address

Provider/Director

E-mail Address

Incorporated

Child Care Specialist
JILL EILEEN 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

Inspection Information

Date
07/09/2018

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2329477417

Document	Document-Date
OWNER/PROVIDER REFERENCES	10/27/2015
SAMPLE WEEKLY MENU	11/03/2015
EQUIPMENT LIST	11/03/2015
LOCAL FIRE DEPARTMENT NOTIFICATION	11/03/2015
DIAGRAM/OUTDOOR	09/21/2015
DIAGRAM/INDOOR	11/09/2015
DAILY SCHEDULE	11/09/2015
FIRE/SAFETY INSPECTION	09/13/2017
POLICIES	11/03/2015
APPLICATION	08/29/2017
SANITATION INSPECTION	09/18/2017

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.