MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
JACKSON, JACQUELINE MARIE

Facility DVN
001425934

Phone
(314) 531-4959

Physical Address
3814 PENROSE ST
ST LOUIS
MO 63107-1636

Owner
JACKSON, JACQUELINE MARIE

Mailing Address

Provider/Director
JACKSON, JACQUELINE MARIE

E-mail Address
JTRJJ@AOL.COM

Incorporated

Child Care Specialist
SHALINDA WALLACE

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 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

Date
07/28/2021

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2405168159

Document	Document-Date
FIRE/SAFETY INSPECTION	01/28/2021
SANITATION INSPECTION	02/04/2021
EQUIPMENT LIST	01/26/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	01/26/2021
ANNUAL DECLARATION	02/09/2021
ASSISTANT REFERENCES	01/05/2011
ASSISTANT APPROVAL REQUEST	01/05/2011
SAMPLE WEEKLY MENU	10/31/2002
SAMPLE FORMS	10/31/2002
POLICIES	10/31/2002
DIAGRAM/OUTDOOR	10/31/2002
DIAGRAM/INDOOR	10/31/2002
CHILD CARE/DISCIPLINE POLICIES	10/31/2002
DAILY SCHEDULE	10/31/2002
LLC OPERATING AGREEMENT	12/28/2015
DISASTER AND EMERGENCY PREPAREDNESS PLAN	03/27/2018
SAFE SLEEP POLICY	09/26/2018
APPLICATION	02/05/2019

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	4:30PM	2/6/2015
7:30AM	8:30AM	2/6/2015

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 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 Violation
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 Violation
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