MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
SHUCK, MONA LISA

Facility DVN
001322607

Phone
(573) 489-7275

Physical Address
8180 N PLAIN VIEW DR
COLUMBIA
MO 65202-6718

Owner
SHUCK, MONA LISA

Mailing Address

Provider/Director
SHUCK, MONA LISA

E-mail Address
MLSHUCK@HOTMAIL.COM

Incorporated

Child Care Specialist
LEKEL LYONS

Age Range
BIRTH - 12 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations
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; 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 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS

Inspection Information

Date
07/22/2021

Arrival Time
9:03 AM

Departure Time
11:05 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2404754041

Document	Document-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	05/27/2021
ANNUAL DECLARATION	05/27/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN	11/06/2019
ASSISTANT REFERENCES	05/04/2009
ASSISTANT APPROVAL REQUEST	05/04/2009
CHILD CARE/DISCIPLINE POLICIES	04/28/2011
SAMPLE FORMS	07/16/1999
SAMPLE WEEKLY MENU	04/16/1999
DAILY SCHEDULE	06/15/1999
DIAGRAM/OUTDOOR	06/15/1999
DIAGRAM/INDOOR	06/15/1999
APPLICATION	04/20/2019
FIRE/SAFETY INSPECTION	03/30/2021
EQUIPMENT LIST	06/01/2021
SANITATION INSPECTION	04/21/2021

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:30PM	5/4/2009

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

Staff	Child	Class Age	Note
1	4	MIXED	Mona Shuck was the caregiver of children age range 4 months-3 years old. There was 2 children under 2.


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