MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
JAMES, ANNETTE NOLENE

Facility DVN
002056653

Phone
(660) 216-2360

Physical Address
22145 COUNTY ROAD 164
KAHOKA
MO 63445-1488

Owner
JAMES, ANNETTE NOLENE

Mailing Address

Provider/Director

E-mail Address
dnjames@marktwain.net

Incorporated

Child Care Specialist
BETHANY C DUCKWORTH

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
05/03/2019

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2356048829

Document	Document-Date
OWNER/PROVIDER REFERENCES	08/22/2008
DIAGRAM/OUTDOOR	11/03/2008
DIAGRAM/INDOOR	11/03/2008
ASSISTANT APPROVAL REQUEST	07/20/2016
SAMPLE WEEKLY MENU	04/23/2008
POLICIES	11/03/2008
CHILD CARE/DISCIPLINE POLICIES	11/03/2008
DAILY SCHEDULE	11/03/2008
DISASTER AND EMERGENCY PREPAREDNESS PLAN	03/06/2012
SAFE SLEEP POLICY	01/27/2016
ASSISTANT REFERENCES	08/09/2016
APPLICATION	08/21/2018
EQUIPMENT LIST	08/21/2018
SANITATION INSPECTION	08/07/2018
FIRE/SAFETY INSPECTION	09/17/2018

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:00PM	9/13/2016
7:30AM	8:00AM	9/13/2016

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.