MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

Back

Facility Information

Facility Name
CULBERTSON, SHERRY A

Facility DVN
000429549

Phone
(573) 222-6268

Physical Address
4063 COUNTY 290 RD
PUXICO
MO 63960

Owner
CULBERTSON, SHERRY A

Mailing Address

Provider/Director

E-mail Address
sculbertson56@yahoo.com

Incorporated

Child Care Specialist
JESSICA GRAHAM

Age Range
12 MONTHS - 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; 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
03/18/2019

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2352491100

Document	Document-Date
EQUIPMENT LIST	02/04/2019
DIAGRAM/INDOOR	04/03/1991
DIAGRAM/OUTDOOR	04/03/1991
POLICIES	10/14/2004
SAMPLE WEEKLY MENU	01/31/1992
CHILD CARE/DISCIPLINE POLICIES	10/14/2004
OWNER/PROVIDER REFERENCES	04/15/1991
ASSISTANT APPROVAL REQUEST	03/31/2017
ASSISTANT REFERENCES	03/31/2017
DAILY SCHEDULE	01/31/1992
SANITATION INSPECTION	02/14/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	03/22/2012
FIRE/SAFETY INSPECTION	02/14/2019
APPLICATION	02/04/2019

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.


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 Violation
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home Violation
19 CSR 30-61.086 Fire Safety Violation
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 Violation
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 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules. Violation
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance