DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

BLAUVELT, WHITNEY ANN

002793615

(573) 808-5709

93 VOSHOLL LN
BONNOTS MILL
MO  65016-2262

BLAUVELT, WHITNEY ANN



 

BLAUVELT, WHITNEY ANN

whitney-23@live.com


LAUREN R RAYWARNKE

BIRTH - 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

11/05/2021

9:45 AM

10:52 AM

UNANNOUNCED

COMPLIANCE MONITORING

2411972418


DocumentDocument-Date
ANNUAL DECLARATION 10/06/2021
APPLICATION 08/15/2019
CHILD CARE/DISCIPLINE POLICIES 09/30/2019
DAILY SCHEDULE 09/30/2019
DIAGRAM/INDOOR 10/09/2019
DIAGRAM/OUTDOOR 10/09/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 10/08/2019
EQUIPMENT LIST 10/06/2021
POLICIES 09/30/2019
SAFE SLEEP POLICY 10/08/2019
SAMPLE WEEKLY MENU 10/28/2019
ASSISTANT APPROVAL REQUEST 09/10/2019
FIRE/SAFETY INSPECTION 07/08/2020
SANITATION INSPECTION 08/04/2021
LICENSING ORIENTATION 08/30/2019
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 10/06/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:45PM   5:00PM   12/5/2019
  6:30AM   7:00AM   12/5/2019



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
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
StaffChildClass AgeNote
1 6 MIXED Whitney Blauvelt with 6 children, one child age 1, two children age 2, two children age 3 and one child age 4.

 
5 CSR 25-400.025 Organization and Administration
Compliance
5 CSR 25-400.045 Licensing Process
Compliance
5 CSR 25-400.055 Annual Requirements
Violation
 Provider Comments
Violation
The annual fire safety inspection was not conducted.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.
Correction Required
The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
Hazardous items as follows were accessible to children: Suave Shower Gel. The item(s) was/were located on the bathtub ledge accessible to children in the children's bathroom.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (1) (J) states: All flammable liquids, matches, cleaning supplies, poisonous materials, medicines, alcoholic beverages, hazardous personal care items or other hazardous items shall be inaccessible to children.
Correction Required
Hazardous items shall be inaccessible to children.

Correction Verification
Corrected on Site

Compliance Date
11/5/2021
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
Violation
 Provider Comments
Violation
1 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-400.210 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
Corrected on Site

Compliance Date
11/5/2021
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