MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
NEAL, THERESA ANN

Facility DVN
000740603

Phone
(417) 924-4903

Physical Address
104 N MADISON AVE
MANSFIELD
MO 65704-9540

Owner
NEAL, THERESA ANN

Mailing Address

Provider/Director
NEAL, THERESA ANN

E-mail Address
DNTNEALX4@YAHOO.COM

Incorporated

Child Care Specialist
ELAINE S COX

Age Range
6 WEEKS - 13 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 6 CHILDREN IN CARE NO MORE THAN 3 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

Inspection Information

Date
06/07/2021

Arrival Time
10:07 AM

Departure Time
11:11 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2401626931

Document	Document-Date
FIRE/SAFETY INSPECTION	04/13/2021
EQUIPMENT LIST	01/29/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	01/29/2021
ANNUAL DECLARATION	02/25/2021
SANITATION INSPECTION	12/03/2020
ASSISTANT APPROVAL REQUEST	01/07/2016
OWNER/PROVIDER REFERENCES	01/06/2000
CHILD CARE/DISCIPLINE POLICIES	01/18/2000
POLICIES	01/18/2000
DAILY SCHEDULE	01/18/2000
SAMPLE WEEKLY MENU	01/18/2000
ASSISTANT REFERENCES	01/12/2012
SAFE SLEEP POLICY	01/11/2016
DIAGRAM/INDOOR	01/18/2000
DIAGRAM/OUTDOOR	01/18/2000
LOCAL FIRE DEPARTMENT NOTIFICATION	01/17/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	01/17/2018

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	4:30PM	1/8/2020
7:00AM	8:00AM	1/8/2020

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 2

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 6

Staff	Child	Class Age	Note
1	6	MIXED	23 months to 4 years- (1 under two years and 1-2 year old) Theresa Neal