DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

SHIVELY, LANA JO

002061852

(660) 815-2760

1108 SUNRISE DR
MARSHALL
MO  65340-2844

SHIVELY, LANA JO



 

SHIVELY, LANA JO

bill.shively@yahoo.com


ELLEN DONOHO

BIRTH - 5 YEARS

10

FAMILY HOME

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; IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER
 
Inspection Information

01/18/2022

12:15 PM

1:34 PM

UNANNOUNCED

COMPLIANCE MONITORING

2416278677


DocumentDocument-Date
ASSISTANT APPROVAL REQUEST 11/27/2017
ASSISTANT REFERENCES 12/01/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN 05/21/2012
SAMPLE WEEKLY MENU 12/17/2007
DAILY SCHEDULE 12/17/2007
CHILD CARE/DISCIPLINE POLICIES 12/17/2007
POLICIES 09/17/2007
DIAGRAM/INDOOR 09/17/2007
DIAGRAM/OUTDOOR 09/17/2007
LOCAL FIRE DEPARTMENT NOTIFICATION 12/07/2018
OWNER/PROVIDER REFERENCES 01/02/2019
APPLICATION 11/06/2019
SAFE SLEEP POLICY 09/17/2019
FIRE/SAFETY INSPECTION 11/22/2021
SANITATION INSPECTION 10/01/2021
EQUIPMENT LIST 01/18/2022
ANNUAL DECLARATION 01/18/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/18/2022

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:30PM   5:00PM   9/30/2013



Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 3
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 2
Total Children 6
StaffChildClass AgeNote
2 6 MIXED 2- two year old children 1- three year old children 1-four year old child 1- five year old child. 1-eight year old child Lana Shively and Bill Shively, staff

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
Compliance
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel
Violation
 Provider Comments
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2021, the staff listed need the following information: Lana Jo Shively.
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (4) (A) states: The provider shall obtain at least twelve (12) clock hours of child care-related training during each calendar year. Any assistant who works or volunteers more than five (5) hours per week shall meet the same training requirements. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

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
Two child(ren) records did not include child's full name, address, date of birth and date care begins and ends.
Licensing Rule Reference
5 CSR 25-400.210 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

Violation
Two children child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
5 CSR 25-400.210 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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