MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
HUMMEL, REBECCA PATTUGALAN

Facility DVN
001911131

Phone
(417) 823-7868

Physical Address
3870 S HOMEWOOD ST
SPRINGFIELD
MO 65807-3963

Owner
HUMMEL, REBECCA PATTUGALAN

Mailing Address

Provider/Director
HUMMEL, REBECCA PATTUGALAN

E-mail Address
RPATHUMMEL@GMAIL.COM

Incorporated

Child Care Specialist
ELAINE S COX

Age Range
BIRTH - 13 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 6 CHILDREN IN CARE NO MORE THAN 3 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

Inspection Information

Date
03/25/2022

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2419650121

Document	Document-Date
DIAGRAM/INDOOR	01/24/2005
DIAGRAM/OUTDOOR	01/24/2005
DAILY SCHEDULE	01/24/2005
SAMPLE WEEKLY MENU	01/24/2005
SAMPLE FORMS	01/24/2005
POLICIES	01/24/2005
OWNER/PROVIDER REFERENCES	03/14/2005
ASSISTANT REFERENCES	01/15/2013
CHILD CARE/DISCIPLINE POLICIES	01/24/2005
LOCAL FIRE DEPARTMENT NOTIFICATION	01/31/2018
ASSISTANT APPROVAL REQUEST	01/23/2018
SAFE SLEEP POLICY	08/03/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/03/2018
SAFETY PLAN	03/10/2021
SANITATION INSPECTION	12/03/2021
FIRE/SAFETY INSPECTION	11/18/2021
EQUIPMENT LIST	03/01/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/01/2022
ANNUAL DECLARATION	03/01/2022

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:15PM	5:15PM	1/9/2015

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.