MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
BLOOMFIELD, ANNETTE PAMELA

Facility DVN
000786734

Phone
(573) 445-3369

Physical Address
1302 JAKE LN
COLUMBIA
MO 65203-0816

Owner
BLOOMFIELD, ANNETTE PAMELA

Mailing Address

Provider/Director

E-mail Address
APBISME@GMAIL.COM

Incorporated

Child Care Specialist
CYNTHIA D MADDOX

Age Range
12 MONTHS - 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
08/03/2018

Arrival Time
8:00 AM

Departure Time
8:57 AM

Notice
ANNOUNCED

Inspection Type
RENEWAL

Inspection ID
2336821067

Document	Document-Date
CHILD CARE/DISCIPLINE POLICIES	10/19/2006
OWNER/PROVIDER REFERENCES	06/14/2006
ASSISTANT REFERENCES	07/18/2013
SAMPLE FORMS	07/14/2006
DAILY SCHEDULE	07/14/2006
POLICIES	10/19/2006
DIAGRAM/OUTDOOR	07/14/2006
DIAGRAM/INDOOR	07/14/2006
ASSISTANT APPROVAL REQUEST	07/25/2014
SAMPLE WEEKLY MENU	10/19/2006
APPLICATION	06/22/2018
EQUIPMENT LIST	08/03/2018
FIRE/SAFETY INSPECTION	08/02/2018
SANITATION INSPECTION	07/26/2018

Overlap Start Time	Overlap End Time	Overlap Submit Date
10:00AM	12:00PM	2/18/2014

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 2

Total Children 5

Staff	Child	Class Age	Note
2	5	MIXED	Annette and Matt were the caregivers with the children. Children range in age from 2 years to 5 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