DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

HALE, TERESA ANN

000178525

(417) 732-6203

525 S VENTURA AVE
REPUBLIC
MO  65738-1705

HALE, TERESA ANN



 

HALE, TERESA ANN

Halehomedaycare@gmail.com


MELISSA HOLMAN

36 MONTHS - 14 YEARS

10

FAMILY HOME

 
Inspection Information

03/07/2022

1:15 PM

1:59 PM

UNANNOUNCED

COMPLIANCE MONITORING

2419768572


DocumentDocument-Date
EQUIPMENT LIST 03/07/2022
SAMPLE WEEKLY MENU 05/14/1981
POLICIES 02/01/1993
OWNER/PROVIDER REFERENCES 06/01/1981
ASSISTANT APPROVAL REQUEST 03/04/2013
DIAGRAM/OUTDOOR 05/15/1981
DIAGRAM/INDOOR 05/14/1981
DAILY SCHEDULE 04/14/1981
CHILD CARE/DISCIPLINE POLICIES 02/01/1993
ASSISTANT REFERENCES 03/04/2013
APPLICATION 01/07/2019
FIRE/SAFETY INSPECTION 10/28/2020
SANITATION INSPECTION 01/26/2021
ANNUAL DECLARATION 02/26/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/19/2021

Overlap Start TimeOverlap End TimeOverlap Submit Date
  11:00AM   1:00PM   12/28/2012



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 4
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 2
StaffChildClass AgeNote
1 2 PRESCHOOL Provider- Teresa Hale with two children age 5 years old.

 
5 CSR 25-400.025 Organization and Administration
Compliance
5 CSR 25-400.045 Licensing Process
Compliance
5 CSR 25-400.055 Annual Requirements
Violation
 Provider Comments
Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, promulgated as of 2020 and incorporated by reference in this rule. As published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102-0570 and available by the department at https://health.mo.gov/safety/childcare/forms.php indicating the licensee’s intent to continue operating a licensed family child care home and agreement to comply with all statutes and department licensing rules.
Correction Required
The child care provider shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The listing of household members and assistants was not submitted.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (1) (C) states: A listing of household members and assistant(s).
Correction Required
The child care provider shall submit a listing of all household members and assistants.

Correction Verification
Submit Documentation

Compliance Date

Violation
The annual sanitation inspection was not approved.
Licensing Rule Reference
5 CSR 25-400.055 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.
Correction Required
The facility shall submit evidence of compliance with annual sanitation requirements.

Correction Verification
Submit Documentation

Compliance Date

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
Compliance
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
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Theresa Hale.
Licensing Rule Reference
5 CSR 25-600.040 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a family child care home, group child care home, child care center, or license-exempt facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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