MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
MARTIN, KIMBERLY

Facility DVN
000601165

Phone
(573) 779-3502

Physical Address
10350 WEBSTER ROAD
CALEDONIA
MO 63631

Owner
MARTIN, KIMBERLY

Mailing Address

Provider/Director
MARTIN, KIMBERLY

E-mail Address
billykim1216@hotmail.com

Incorporated

Child Care Specialist
BRITTANY HECHT

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
05/11/2022

Arrival Time
9:15 AM

Departure Time
10:18 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2423521888

Document	Document-Date
OWNER/PROVIDER REFERENCES	03/04/1994
DAILY SCHEDULE	04/14/1994
SAMPLE WEEKLY MENU	04/14/1994
POLICIES	05/11/1994
CHILD CARE/DISCIPLINE POLICIES	05/11/1994
DIAGRAM/INDOOR	05/11/1994
DIAGRAM/OUTDOOR	05/11/1994
ASSISTANT REFERENCES	01/19/2010
ASSISTANT APPROVAL REQUEST	03/04/2016
APPLICATION	03/01/2018
SAFE SLEEP POLICY	10/11/2017
FIRE/SAFETY INSPECTION	02/07/2022
SANITATION INSPECTION	03/14/2022
EQUIPMENT LIST	05/11/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	05/11/2022
ANNUAL DECLARATION	05/11/2022

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:15PM	5:15PM	2/11/2014

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 7

Staff	Child	Class Age	Note
1	7	MIXED	Kim Martin, Provider 1 - 10 Month Olds 1 - 2 Year Old 5 - 3 & 4 Year Olds