DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

WILLIAMS, TERRI D

000911811

(660) 342-1133

672 W COMMERCIAL
KAHOKA
MO  63445

WILLIAMS, TERRI D



 

WILLIAMS, TERRI D

terriwilliams933@gmail.com


BETHANY C DUCKWORTH

BIRTH - 12 YEARS

10

FAMILY HOME

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

09/25/2020

9:30 AM

10:02 AM

ANNOUNCED

SUPPLEMENTAL

2386090676


DocumentDocument-Date
ASSISTANT APPROVAL REQUEST 03/03/2017
DAILY SCHEDULE 09/17/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN 02/01/2012
SAFE SLEEP POLICY 01/14/2016
ASSISTANT REFERENCES 04/14/2017
CHILD CARE/DISCIPLINE POLICIES 09/19/2007
OWNER/PROVIDER REFERENCES 06/02/1997
POLICIES 09/19/2007
DIAGRAM/INDOOR 09/20/2007
DIAGRAM/OUTDOOR 09/20/2007
SAMPLE WEEKLY MENU 02/20/1997
APPLICATION 07/31/2019
EQUIPMENT LIST 07/31/2019
FIRE/SAFETY INSPECTION 08/19/2020
SANITATION INSPECTION 09/17/2020

Overlap Start TimeOverlap End TimeOverlap Submit Date
  11:00AM   12:00PM   10/11/2018
  2:45PM   3:45PM   10/11/2018



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.
Attendance at Time of Inspection
Total Staff 1
Total Children 4
StaffChildClass AgeNote
1 4 MIXED Staff: Terri Williams Age range 11 months through 3 years. One child under 2 years.

 
19 CSR 30-61.025 Organization and Administration
Not Observed
19 CSR 30-61.045 Initial Licensing Information
Not Observed
19 CSR 30-61.055 Annual Requirements
Not Observed
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Not Observed
19 CSR 30-61.086 Fire Safety
Not Observed
19 CSR 30-61.090 Disaster and Emergency Preparedness
Not Observed
19 CSR 30-61.095 Furniture, Equipment and Materials
Not Observed
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel
Not Observed
19 CSR 30-61.115 Day Care Family and Household
Not Observed
19 CSR 30-61.125 Medical Examination Reports
Not Observed
19 CSR 30-61.135 Admission Policies and Procedures
Not Observed
19 CSR 30-61.145 Nighttime Care
Not Observed
19 CSR 30-61.155 Overlap Care of Children
Not Observed
19 CSR 30-61.165 Emergency School Closings
Not Observed
19 CSR 30-61.175 Child Care Program
Not Observed
19 CSR 30-61.185 Health Care
Not Observed
19 CSR 30-61.190 Nutrition and Food Service
Not Observed
19 CSR 30-61.200 Transportation and Field Trips
Not Observed
19 CSR 30-61.210 Records and Reports
Not Observed
19 CSR 30-63.020 General Requirements
Not Observed
19 CSR 30-63.040 Background Screening Findings
Compliance
RSMo 210.115. Reports of abuse, neglect, and under age eighteen deaths - persons required to report - supervisors and administrators not to impede reporting - deaths required to be reported to the division or child fatality review panel, when - report made to another state, when.
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Not Observed