MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
BELBEN, ALLISON

Facility DVN
002212126

Phone
(417) 315-1621

Physical Address
3934 W YOUNG ST
SPRINGFIELD
MO 65803-5404

Owner
BELBEN, ALLISON

Mailing Address

Provider/Director

E-mail Address
mrsbelben@gmail.com

Incorporated

Child Care Specialist
ANGEL DONSON

Age Range
6 WEEKS - 5 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations
2 CHILDREN UNDER 12 MONTHS; 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
12/26/2019

Arrival Time
12:50 PM

Departure Time
1:25 PM

Notice
UNANNOUNCED

Inspection Type
REINSPECTION

Inspection ID
2372313444

Document	Document-Date
ASSISTANT REFERENCES	06/27/2012
OWNER/PROVIDER REFERENCES	04/05/2012
ASSISTANT APPROVAL REQUEST	06/27/2012
SAMPLE FORMS	11/18/2011
SAMPLE WEEKLY MENU	11/18/2011
DAILY SCHEDULE	11/18/2011
CHILD CARE/DISCIPLINE POLICIES	11/18/2011
DIAGRAM/OUTDOOR	11/18/2011
DIAGRAM/INDOOR	11/18/2011
APPLICATION	04/25/2018
FIRE/SAFETY INSPECTION	02/22/2018
EQUIPMENT LIST	07/25/2018

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 4

NOTE

The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.