MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
FORWARD, PATRICIA

Facility DVN
000479932

Phone
(573) 442-4487

Physical Address
310 E OLD PLANK RD
COLUMBIA
MO 65203

Owner
FORWARD, PATRICIA

Mailing Address

Provider/Director
FORWARD, PATRICIA

E-mail Address
pdforward@msn.com

Incorporated

Child Care Specialist
JIM PARSLEY

Age Range
6 WEEKS - 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
03/08/2022

Arrival Time
8:45 AM

Departure Time
9:47 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2419475751

Document	Document-Date
OWNER/PROVIDER REFERENCES	07/24/1992
POLICIES	06/23/2010
DAILY SCHEDULE	07/28/1996
ASSISTANT REFERENCES	07/30/2010
ASSISTANT APPROVAL REQUEST	07/30/2010
CHILD CARE/DISCIPLINE POLICIES	06/23/2010
SAMPLE WEEKLY MENU	07/24/1992
DIAGRAM/OUTDOOR	07/24/1992
DIAGRAM/INDOOR	04/16/1998
APPLICATION	06/06/2018
EQUIPMENT LIST	06/06/2018
FIRE/SAFETY INSPECTION	06/14/2021
SANITATION INSPECTION	06/17/2021
ANNUAL DECLARATION	07/28/2021

Overlap Start Time	Overlap End Time	Overlap Submit Date
2:45PM	4:45PM	1/11/2016

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 8

Staff	Child	Class Age	Note
1	8	MIXED	There were 8 children 10 months through 5 years of age in care including 2 children under 2 years of age.


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 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 Not Observed
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