MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
THOLEN, LISA

Facility DVN
002550798

Phone
(417) 291-1200

Physical Address
606 E BRIARBROOK LN
CARL JUNCTION
MO 64834-9695

Owner
THOLEN, LISA

Mailing Address

Provider/Director
THOLEN, LISA

E-mail Address
ltholen@hotmail.com

Incorporated

Child Care Specialist
LEAH WHITE

Age Range
BIRTH - 12 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
10/26/2021

Arrival Time
12:16 PM

Departure Time
1:00 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2411410716

Document	Document-Date
FIRE/SAFETY INSPECTION	08/02/2021
CHILD CARE/DISCIPLINE POLICIES	10/26/2015
SAMPLE WEEKLY MENU	10/06/2015
DIAGRAM/INDOOR	10/06/2015
DIAGRAM/OUTDOOR	10/06/2015
DAILY SCHEDULE	10/06/2015
OWNER/PROVIDER REFERENCES	10/19/2015
LOCAL FIRE DEPARTMENT NOTIFICATION	10/26/2015
ASSISTANT REFERENCES	10/19/2015
POLICIES	10/26/2015
APPLICATION	07/12/2019
EQUIPMENT LIST	10/26/2021
ASSISTANT APPROVAL REQUEST	08/09/2017
SANITATION INSPECTION	08/06/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	10/26/2021
ANNUAL DECLARATION	10/26/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN	10/26/2021
SAFE SLEEP POLICY	10/26/2021

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:35PM	5:30PM	9/24/2021

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 5

Staff	Child	Class Age	Note
1	5	MIXED	Lisa Tholen was present with five children, 11 months to to three years of age.