MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
JACK N JILL DAYCARE

Facility DVN
002681209

Phone
(573) 406-1096

Physical Address
391 LAKE APOLLO DR
HANNIBAL
MO 63401-6202

Owner
HOBSON, LORI ANN

Mailing Address

Provider/Director
HOBSON, LORI ANN

E-mail Address
lahobsons@yahoo.com

Incorporated

Child Care Specialist
BETHANY C DUCKWORTH

Age Range
12 MONTHS - 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
01/14/2022

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2416089195

Document	Document-Date
ANNUAL DECLARATION	11/17/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	12/08/2021
LICENSING ORIENTATION	09/29/2017
REGISTERING FICTITIOUS NAMES	10/03/2017
DIAGRAM/INDOOR	01/30/2018
DIAGRAM/OUTDOOR	10/30/2017
SAMPLE WEEKLY MENU	12/28/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN	10/16/2017
DAILY SCHEDULE	10/16/2017
CHILD CARE/DISCIPLINE POLICIES	10/24/2017
POLICIES	10/24/2017
SAFE SLEEP POLICY	10/24/2017
OWNER/PROVIDER REFERENCES	11/14/2017
ASSISTANT REFERENCES	11/28/2017
ASSISTANT APPROVAL REQUEST	12/12/2017
APPLICATION	09/18/2019
EQUIPMENT LIST	11/17/2021
FIRE/SAFETY INSPECTION	11/17/2021
SANITATION INSPECTION	08/02/2021

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.

Compliance List
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 Violation
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel Violation
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