MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

INSPECTION REPORT

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Facility Information

Facility Name

Facility DVN

Phone

Physical Address

Owner

Mailing Address

Provider/Director

E-mail Address

Incorporated

Child Care Specialist

Age Range

Capacity

Facility Type

Limitations

Inspection Information

Date

Arrival Time

Departure Time

Notice

Inspection Type

Inspection ID

Document	Document-Date
ANNUAL DECLARATION	10/18/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	10/18/2021
LICENSING ORIENTATION	08/03/2015
LOCAL ZONING APPROVAL	09/22/2015
LOCAL BUILDING APPROVAL	09/22/2015
LOCAL FIRE DEPARTMENT NOTIFICATION	09/10/2015
DAILY SCHEDULE	09/08/2015
SAMPLE WEEKLY MENU	08/07/2015
JOB RESPONSIBILITIES	08/05/2015
DISCIPLINE POLICIES	08/03/2015
CHILD CARE PRACTICES	08/03/2015
POLICIES	08/03/2015
LINES OF ADMINISTRATIVE AUTHORITY	06/15/2015
LLC ARTICLES OF ORGANIZATION	06/15/2015
LLC OPERATING AGREEMENT	06/15/2015
DIRECTOR'S QUALIFICATIONS	09/28/2017
EQUIPMENT LIST	03/21/2018
DIAGRAM/OUTDOOR	08/03/2015
DIAGRAM/INDOOR	03/21/2018
APPLICATION	08/13/2019
STAFF SHEET	08/13/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/03/2015
SAFE SLEEP POLICY	08/03/2015
FIRE/SAFETY INSPECTION	09/25/2019
SANITATION INSPECTION	05/27/2020

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:30PM	11/5/2015

Open Violations:

NOTE

The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.