DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

NEAL, THERESA ANN

000740603

(417) 924-4903

104 N MADISON AVE
MANSFIELD
MO  65704-9540

NEAL, THERESA ANN



 

NEAL, THERESA ANN

DNTNEALX4@YAHOO.COM


LAUREN R RAYWARNKE

6 WEEKS - 13 YEARS

10

FAMILY HOME

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

06/22/2022

10:45 AM

12:12 PM

UNANNOUNCED

COMPLIANCE MONITORING

2425912319


DocumentDocument-Date
ASSISTANT APPROVAL REQUEST 01/07/2016
OWNER/PROVIDER REFERENCES 01/06/2000
CHILD CARE/DISCIPLINE POLICIES 01/18/2000
POLICIES 01/18/2000
DAILY SCHEDULE 01/18/2000
SAMPLE WEEKLY MENU 01/18/2000
ASSISTANT REFERENCES 01/12/2012
SAFE SLEEP POLICY 01/11/2016
DIAGRAM/INDOOR 01/18/2000
DIAGRAM/OUTDOOR 01/18/2000
LOCAL FIRE DEPARTMENT NOTIFICATION 01/17/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 01/17/2018
SANITATION INSPECTION 03/09/2022
ANNUAL DECLARATION 04/26/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/26/2022
EQUIPMENT LIST 04/26/2022
FIRE/SAFETY INSPECTION 04/28/2022

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:30PM   4:30PM   1/8/2020
  7:00AM   8:00AM   1/8/2020



Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
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 6
StaffChildClass AgeNote
1 6 MIXED Theresa Neal with 6 children, one child 6 months old, two children age 2, two children age 4 and one child age 7.

 
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
Violation
 Provider Comments
Violation
Safe sleep training was not completed within the past 3 years for the assistant(s), Derrick Neal.
Licensing Rule Reference
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel (5) . states: Safe Sleep Training. Every three (3) years the provider and assistant(s) in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 138, No. 5, November 1, 2016 and available at http://pediatrics.aappublications.org/content/pediatrics/early/2016/10/20/peds.2016-2938.full.pdf. This rule does not incorporate any subsequent amendments or additions.
Correction Required
The child care provider and assistant(s) shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-400.115 Child 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
Violation
 Provider Comments
Violation
1 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-400.210 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers’ name and address, work schedule and home and work telephone numbers.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
6/22/2022
5 CSR 25-600.020 General Requirements
Compliance
5 CSR 25-600.040 Background Screening Findings
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