MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
PAPER MOON NURSERY LLC

Facility DVN
002692706

Phone
(573) 289-2151

Physical Address
551 SOUTHAMPTON DR
COLUMBIA
MO 65203-3057

Owner
PAPER MOON NURSERY LLC

Mailing Address

Provider/Director

E-mail Address
jackiebnichols@gmail.com

Incorporated

Child Care Specialist
LEKEL LYONS

Age Range
BIRTH - 24 MONTHS

Capacity
8

Facility Type
FAMILY HOME

Limitations
8 CHILDREN UNDER 24 MONTHS; UP TO 8 CHILDREN IN CARE, ALL CHILDREN MAY BE UNDER AGE 2 WITH 2 ADULT CAREGIVERS

Inspection Information

Date
02/14/2020

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2374640917

Document	Document-Date
APPLICATION	11/20/2019
ASSISTANT APPROVAL REQUEST	03/06/2018
ARTICLES OF INCORPORATION	01/19/2018
CHILD CARE/DISCIPLINE POLICIES	03/06/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	03/06/2018
DIAGRAM/INDOOR	03/06/2018
EQUIPMENT LIST	02/08/2018
POLICIES	02/08/2018
DAILY SCHEDULE	02/08/2018
LLC OPERATING AGREEMENT	03/06/2018
SAFE SLEEP POLICY	02/08/2018
SAMPLE FORMS	02/08/2018
OWNER/PROVIDER REFERENCES	03/06/2018
SAMPLE WEEKLY MENU	02/08/2018
SANITATION INSPECTION	02/05/2018
LLC ARTICLES OF ORGANIZATION	01/19/2018
FIRE/SAFETY INSPECTION	11/28/2018

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.