MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
BLOOMFIELD, ANNETTE PAMELA

Facility DVN
000786734

Phone
(573) 303-6220

Physical Address
1808 CUNNINGHAM RD
COLUMBIA
MO 65203-4725

Owner
BLOOMFIELD, ANNETTE PAMELA

Mailing Address

Provider/Director
BLOOMFIELD, ANNETTE PAMELA

E-mail Address
apbisme@gmail.com

Incorporated

Child Care Specialist
CYNTHIA D MADDOX

Age Range
12 MONTHS - 12 YEARS

Capacity
10

Facility Type
FAMILY HOME

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

Inspection Information

Date
05/24/2021

Arrival Time
1:45 PM

Departure Time
2:43 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2400917277

Document	Document-Date
SANITATION INSPECTION	08/04/2020
SAMPLE WEEKLY MENU	10/21/2019
POLICIES	10/21/2019
OWNER/PROVIDER REFERENCES	10/21/2019
FIRE/SAFETY INSPECTION	06/24/2020
EQUIPMENT LIST	10/21/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	10/21/2019
DIAGRAM/OUTDOOR	08/27/2019
DIAGRAM/INDOOR	08/27/2019
DAILY SCHEDULE	10/21/2019
CHILD CARE/DISCIPLINE POLICIES	10/21/2019
ASSISTANT REFERENCES	10/21/2019
ASSISTANT APPROVAL REQUEST	10/21/2019
APPLICATION	07/22/2019

Overlap Start Time	Overlap End Time	Overlap Submit Date
11:30AM	12:45PM	10/24/2019
3:30PM	4:15PM	10/24/2019

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 2

Total Children 9

Staff	Child	Class Age	Note
2	9	MIXED	Annette Bloomfield and Matt Bloomfield were the caregivers with the children. Children range in age from 2 years to 6 years.


19 CSR 30-61.025 Organization and Administration Compliance
19 CSR 30-61.045 Licensing Process Compliance
19 CSR 30-61.055 Annual Requirements Compliance
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home Compliance
19 CSR 30-61.086 Fire Safety Compliance
19 CSR 30-61.090 Disaster and Emergency Preparedness Compliance
19 CSR 30-61.095 Furniture, Equipment and Materials Compliance
19 CSR 30-61.105 The Child Care Provider and Other Child Care Personnel Compliance
19 CSR 30-61.115 Day Care Family and Household Compliance
19 CSR 30-61.125 Medical Examination Reports Compliance
19 CSR 30-61.135 Admission Policies and Procedures Compliance
19 CSR 30-61.145 Nighttime Care Compliance
19 CSR 30-61.155 Overlap Care of Children Compliance
19 CSR 30-61.165 Emergency School Closings Compliance
19 CSR 30-61.175 Child Care Program Compliance
19 CSR 30-61.185 Health Care Compliance
19 CSR 30-61.190 Nutrition and Food Service Compliance
19 CSR 30-61.200 Transportation and Field Trips Compliance
19 CSR 30-61.210 Records and Reports Compliance
19 CSR 30-63.020 General Requirements Compliance
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. Compliance
RSMo 210.211. License required - exceptions - written notice of licensure status, when. Compliance
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance