DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

SMITH, BETH ANN

002244708

(573) 422-3493

11309 HIGHWAY 63 S
VIENNA
MO  65582-7133

SMITH, BETH ANN

PO BOX 329
VIENNA
MO  65582

SMITH, BETH ANN

MBSMITH@SOCKET.NET


LAUREN R RAYWARNKE

6 WEEKS - 10 YEARS

10

FAMILY HOME

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

10/13/2021

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2410247504


DocumentDocument-Date
LOCAL FIRE DEPARTMENT NOTIFICATION 09/09/2010
POLICIES 09/30/2010
OWNER/PROVIDER REFERENCES 10/07/2010
ASSISTANT REFERENCES 10/12/2010
ASSISTANT APPROVAL REQUEST 10/12/2010
SAMPLE FORMS 09/09/2010
SAMPLE WEEKLY MENU 09/09/2010
DAILY SCHEDULE 09/09/2010
CHILD CARE/DISCIPLINE POLICIES 09/09/2010
DIAGRAM/OUTDOOR 09/09/2010
DIAGRAM/INDOOR 09/09/2010
APPLICATION 06/14/2020
EQUIPMENT LIST 08/24/2021
FIRE/SAFETY INSPECTION 07/07/2021
SANITATION INSPECTION 07/26/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 08/24/2021
ANNUAL DECLARATION 08/24/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  2:30PM   4:30PM   8/18/2016



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
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
Violation
 Provider Comments
Violation
1 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
10/13/2021
Violation
1 child(ren) records did not include date care begins and ends.
Licensing Rule Reference
19 CSR 30-61.210 Records and Reports (2) (A) states: The child’s full name, address, birth date and the date care begins and ends.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
10/13/2021
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