MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
DAHLMAN, LISA MARIE

Facility DVN
001407016

Phone
(660) 627-1038

Physical Address
416 N FLORENCE
KIRKSVILLE
MO 63501-0

Owner
DAHLMAN, LISA MARIE

Mailing Address

Provider/Director
DAHLMAN, LISA MARIE

E-mail Address
jldahlman5@gmail.com

Incorporated

Child Care Specialist
BETHANY C DUCKWORTH

Age Range
BIRTH - 10 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
10/22/2021

Arrival Time
10:07 AM

Departure Time
10:26 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2411022899

Document	Document-Date
SAMPLE WEEKLY MENU	10/13/1999
POLICIES	10/13/1999
OWNER/PROVIDER REFERENCES	11/10/1999
DIAGRAM/OUTDOOR	10/13/1999
DIAGRAM/INDOOR	10/13/1999
DAILY SCHEDULE	10/13/1999
CHILD CARE/DISCIPLINE POLICIES	10/13/1999
ASSISTANT REFERENCES	08/05/2010
ASSISTANT APPROVAL REQUEST	02/05/2016
FIRE/SAFETY INSPECTION	04/08/2021
SANITATION INSPECTION	12/10/2020
APPLICATION	01/15/2020
EQUIPMENT LIST	03/10/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN	09/01/2011
SAFE SLEEP POLICY	01/01/2016
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/10/2021
ANNUAL DECLARATION	03/10/2021

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 6

Staff	Child	Class Age	Note
1	6	MIXED	Staff: Lisa Dahlman. Age range 5 months through 3 years. Two children under 2 years.


5 CSR 25-400.025 Organization and Administration Compliance
5 CSR 25-400.045 Licensing Process Compliance
5 CSR 25-400.055 Annual Requirements Compliance
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home Compliance
5 CSR 25-400.086 Fire Safety Compliance
5 CSR 25-400.090 Disaster and Emergency Preparedness Compliance
5 CSR 25-400.095 Furniture, Equipment and Materials Compliance
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel Compliance
5 CSR 25-400.115 Day Care Family and Household Compliance
5 CSR 25-400.125 Medical Examination Reports Compliance
5 CSR 25-400.135 Admission Policies and Procedures Compliance
5 CSR 25-400.145 Nighttime Care Compliance
5 CSR 25-400.155 Overlap Care of Children Compliance
5 CSR 25-400.165 Emergency School Closings Compliance
5 CSR 25-400.175 Child Care Program Compliance
5 CSR 25-400.185 Health Care Compliance
5 CSR 25-400.190 Nutrition and Food Service Compliance
5 CSR 25-400.200 Transportation and Field Trips Compliance
5 CSR 25-400.210 Records and Reports Compliance
5 CSR 25-600.020 Background Screening Findings Compliance
5 CSR 25-600.040 General Requirements 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