MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
JACKSON, JACQUELINE

Facility DVN
001425934

Phone
(314) 531-4959

Physical Address
3814 PENROSE ST
ST LOUIS
MO 63107-1636

Owner
JACKSON, JACQUELINE MARIE

Mailing Address

Provider/Director
JACKSON, JACQUELINE MARIE

E-mail Address
JTRJJ@AOL.COM

Incorporated

Child Care Specialist
SHALINDA WALLACE

Age Range
6 WEEKS - 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
09/26/2018

Arrival Time
8:30 AM

Departure Time
10:01 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2340410180

Document	Document-Date
APPLICATION	01/17/2017
EQUIPMENT LIST	01/17/2017
LLC OPERATING AGREEMENT	12/28/2015
ASSISTANT REFERENCES	01/05/2011
ASSISTANT APPROVAL REQUEST	01/05/2011
SAMPLE WEEKLY MENU	10/31/2002
SAMPLE FORMS	10/31/2002
POLICIES	10/31/2002
DIAGRAM/OUTDOOR	10/31/2002
DIAGRAM/INDOOR	10/31/2002
CHILD CARE/DISCIPLINE POLICIES	10/31/2002
DAILY SCHEDULE	10/31/2002
FIRE/SAFETY INSPECTION	01/23/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	03/27/2018
SAFE SLEEP POLICY	09/26/2018

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	4:30PM	2/6/2015
7:30AM	8:30AM	2/6/2015

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 14

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	Ms. Jacqueline Jackson and Teina Evans is present with 5 children. One- 6 month old. Two- One year olds. Two- Two year olds.


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 Violation
19 CSR 30-61.135 Admission Policies and Procedures Violation
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 Violation
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. Violation