MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
DAVID, MICHAELENE A

Facility DVN
000745895

Phone
(573) 581-7410

Physical Address
1350 MARGRETTA
MEXICO
MO 65265

Owner
DAVID, MICHAELENE ANN

Mailing Address

Provider/Director
DAVID, MICHAELENE ANN

E-mail Address
nanadavid7@gmail.com

Incorporated

Child Care Specialist
CYNTHIA D MADDOX

Age Range
BIRTH - 13 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 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER

Inspection Information

Date
03/26/2019

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2353162584

Document	Document-Date
ASSISTANT REFERENCES	02/22/2010
CHILD CARE/DISCIPLINE POLICIES	05/11/2000
DAILY SCHEDULE	05/11/2000
DIAGRAM/OUTDOOR	05/11/2000
DIAGRAM/INDOOR	05/11/2000
OWNER/PROVIDER REFERENCES	05/11/2000
POLICIES	05/11/2000
SAMPLE WEEKLY MENU	05/11/2000
SANITATION INSPECTION	02/04/2019
ASSISTANT APPROVAL REQUEST	02/26/2018
APPLICATION	02/26/2018
EQUIPMENT LIST	02/26/2018
FIRE/SAFETY INSPECTION	03/21/2019

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.