MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
BLAIR, DONNA K

Facility DVN
001563660

Phone
(417) 546-3990

Physical Address
614 ROCKHILL DR.
FORSYTH
MO 65653

Owner
BLAIR, DONNA K

Mailing Address
PO BOX 941
FORSYTH
MO 65653-0941

Provider/Director

E-mail Address
larryblair6564@yahoo.com

Incorporated

Child Care Specialist
BILLIE RUSSELL

Age Range
6 WEEKS - 12 YEARS

Capacity
20

Facility Type
GROUP HOME AND CENTER

Limitations
4 CHILDREN UNDER 24 MONTHS

Inspection Information

Date
12/09/2019

Arrival Time
12:40 PM

Departure Time
2:03 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2373197239

Document	Document-Date
DISASTER AND EMERGENCY PREPAREDNESS PLAN	12/09/2019
SAFE SLEEP POLICY	12/09/2019
OWNER/PROVIDER REFERENCES	02/20/2001
SAMPLE WEEKLY MENU	12/01/2011
POLICIES	07/23/2009
LOCAL BUILDING APPROVAL	12/20/2001
LOCAL ZONING APPROVAL	12/20/2001
LINES OF ADMINISTRATIVE AUTHORITY	12/20/2001
JOB RESPONSIBILITIES	12/20/2001
DISCIPLINE POLICIES	07/23/2009
DIRECTOR'S QUALIFICATIONS	01/02/2001
DIAGRAM/OUTDOOR	10/28/2004
DIAGRAM/INDOOR	08/05/2004
DAILY SCHEDULE	12/01/2001
CHILD CARE PRACTICES	07/23/2009
SANITATION INSPECTION	05/28/2019
APPLICATION	06/26/2019
STAFF SHEET	06/26/2019
EQUIPMENT LIST	06/26/2019
LOCAL FIRE DEPARTMENT NOTIFICATION	07/10/2017
FIRE/SAFETY INSPECTION	04/16/2019

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:15PM	5:15PM	6/11/2013

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.

Attendance at Time of Inspection

Total Staff 3

Total Children 16

Staff	Child	Class Age	Note
1	3	INFANTS AND TODDLERS
2	13	PRESCHOOL


19 CSR 30-62.032 Organization and Administration Compliance
19 CSR 30-62.042 Initial Licensing Information Compliance
19 CSR 30-62.052 License Renewal Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers Compliance
19 CSR 30-62.087 Fire Safety Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials Compliance
19 CSR 30-62.102 Personnel Compliance
19 CSR 30-62.112 Staff/Child Ratios Compliance
19 CSR 30-62.122 Medical Examination Reports Compliance
19 CSR 30-62.132 Admission Policies and Procedures Compliance
19 CSR 30-62.142 Nighttime Care Compliance
19 CSR 30-62.152 Hourly Care Facilities Compliance
19 CSR 30-62.162 Overlap Care of Children Not Observed
19 CSR 30-62.172 Emergency School Closings Not Observed
19 CSR 30-62.182 Child Care Program Compliance
19 CSR 30-62.192 Health Care Compliance
19 CSR 30-62.202 Nutrition and Food Service Compliance
19 CSR 30-62.212 Transportation and Field Trips Compliance
19 CSR 30-62.222 Records and Reports Compliance
19 CSR 30-63.040 Background Screening Findings 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. Compliance
RSMo 210.211. License required - exceptions - written notice of licensure status, when. Compliance