MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
POTTER, STEPHANIE

Facility DVN
000719137

Phone
(660) 838-6693

Physical Address
13888 OSAGE VALLEY RD
BOONVILLE
MO 65233

Owner
POTTER, STEPHANIE

Mailing Address

Provider/Director
POTTER, STEPHANIE

E-mail Address
SLPOTTER85@YMAIL.COM

Incorporated

Child Care Specialist
SUSAN MARIE DOUGLAS

Age Range
BIRTH - 14 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
03/10/2022

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2419630291

Document	Document-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	06/30/2021
ANNUAL DECLARATION	06/30/2021
DIAGRAM/INDOOR	08/14/2003
DIAGRAM/OUTDOOR	06/15/2005
POLICIES	06/19/1998
SAMPLE WEEKLY MENU	05/30/1996
DAILY SCHEDULE	05/30/1996
CHILD CARE/DISCIPLINE POLICIES	05/03/1996
OWNER/PROVIDER REFERENCES	06/26/1995
ASSISTANT REFERENCES	06/12/2009
DISASTER AND EMERGENCY PREPAREDNESS PLAN	06/14/2018
SAFE SLEEP POLICY	06/14/2018
ASSISTANT APPROVAL REQUEST	02/24/2012
APPLICATION	05/01/2019
FIRE/SAFETY INSPECTION	05/17/2021
EQUIPMENT LIST	06/30/2021
SANITATION INSPECTION	06/15/2021

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:45PM	5:15PM	6/19/2013
7:00AM	7:30AM	6/19/2013

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.