MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
PAYNE HOME DAYCARE LLC

Facility DVN
002546187

Phone
(417) 883-9665

Physical Address
1225 S ESTATE AVE
SPRINGFIELD
MO 65804-0642

Owner
PAYNE HOME DAYCARE LLC

Mailing Address

Provider/Director
PAYNE, CAROLINE DENISE

E-mail Address
wsrtmed@outlook.com

Incorporated

Child Care Specialist
HEATHER E RADNEY

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
02/01/2022

Arrival Time
9:40 AM

Departure Time
10:50 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2417092135

Document	Document-Date
ANNUAL DECLARATION	07/23/2021
FIRE/SAFETY INSPECTION	05/03/2021
ASSISTANT APPROVAL REQUEST	03/23/2015
OWNER/PROVIDER REFERENCES	05/14/2001
SAMPLE WEEKLY MENU	05/14/2001
DAILY SCHEDULE	05/14/2001
DIAGRAM/INDOOR	05/21/2001
DIAGRAM/OUTDOOR	05/21/2001
CHILD CARE/DISCIPLINE POLICIES	06/14/2005
LLC ARTICLES OF ORGANIZATION	08/01/2015
APPLICATION	04/08/2019
SAFE SLEEP POLICY	06/10/2019
POLICIES	06/10/2019
LLC OPERATING AGREEMENT	06/03/2020
SANITATION INSPECTION	04/27/2021
EQUIPMENT LIST	04/23/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	04/23/2021

Overlap Start Time	Overlap End Time	Overlap Submit Date
2:00PM	4:00PM	6/10/2019

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 10

Staff	Child	Class Age	Note
1	10	MIXED	Caroline Payne with children ages 7 months- 5 years old (2 under 24 months)