DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

MICKELSON, KRISTINA LYNN

001838177

(573) 202-9925

11075 WOODALE DR
ROLLA
MO  65401

MICKELSON, KRISTINA LYNN



 


krissmickelson75@gmail.com


SHELBY N KOETTING

BIRTH - 13 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

09/29/2020

12:00 PM

12:25 PM

ANNOUNCED

SUPPLEMENTAL

2386402059


DocumentDocument-Date
OWNER/PROVIDER REFERENCES 02/23/2004
SAMPLE WEEKLY MENU 05/05/2004
SAMPLE FORMS 02/02/2004
DAILY SCHEDULE 02/02/2004
CHILD CARE/DISCIPLINE POLICIES 02/02/2004
POLICIES 02/02/2004
DIAGRAM/OUTDOOR 07/30/2004
DIAGRAM/INDOOR 07/30/2004
ASSISTANT APPROVAL REQUEST 05/25/2010
APPLICATION 08/18/2020
EQUIPMENT LIST 09/28/2020
FIRE/SAFETY INSPECTION 06/17/2020
SANITATION INSPECTION 06/22/2020




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 8
StaffChildClass AgeNote
1 8 MIXED Kristina Mickelson with 8 children (2 under age 2, 2 children age 2, and 4 preschool children).

 
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