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
06/10/2021

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2401957202

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: 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.


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 Violation
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