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
09/12/2019

Arrival Time
11:50 AM

Departure Time
1:03 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2363967004

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	07/31/2019
FIRE/SAFETY INSPECTION	08/20/2019

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: 2

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 1

Total Children 7

Staff	Child	Class Age	Note
1	7	MIXED	Staff: Annette "Nolene" James 2 children under age 2. Age range 16 months to 4 years