MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
HOME AWAY FROM HOME CHILD CARE LLC

Facility DVN
002426940

Phone
(540) 850-9550

Physical Address
5264 AUTUMNWINDS DR
ST LOUIS
MO 63129-2463

Owner
HOME AWAY FROM HOME CHILD CARE LLC

Mailing Address

Provider/Director
KLEISLY, HOLLY MARIE

E-mail Address
tohollyshomes@aol.com

Incorporated

Child Care Specialist
DENISE ELAYNE KOCH

Age Range
BIRTH - 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
10/03/2018

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2340474897

Document	Document-Date
SAFE SLEEP POLICY	04/19/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN	04/19/2017
LLC ARTICLES OF ORGANIZATION	09/20/2018
APPLICATION	01/09/2017
CHILD CARE/DISCIPLINE POLICIES	01/09/2017
DAILY SCHEDULE	01/09/2017
LLC OPERATING AGREEMENT	01/09/2017
DIAGRAM/INDOOR	01/09/2017
DIAGRAM/OUTDOOR	01/09/2017
EQUIPMENT LIST	01/09/2017
POLICIES	01/09/2017
SAMPLE WEEKLY MENU	01/09/2017
SANITATION INSPECTION	02/16/2018
SAMPLE FORMS	01/09/2017
ASSISTANT APPROVAL REQUEST	09/29/2017
ASSISTANT REFERENCES	09/29/2017
FIRE/SAFETY INSPECTION	03/05/2018
LOCAL FIRE DEPARTMENT NOTIFICATION	01/12/2017
OWNER/PROVIDER REFERENCES	05/01/2017

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:30PM	5/3/2017

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.