MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
JACK N JILL DAYCARE

Facility DVN
002681209

Phone
(573) 406-1096

Physical Address
391 LAKE APOLLO DR
HANNIBAL
MO 63401-6202

Owner
HOBSON, LORI ANN

Mailing Address

Provider/Director
HOBSON, LORI ANN

E-mail Address
lahobsons@yahoo.com

Incorporated

Child Care Specialist
BETHANY C DUCKWORTH

Age Range
12 MONTHS - 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
07/06/2022

Arrival Time
10:04 AM

Departure Time
10:43 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2426572304

Document	Document-Date
ANNUAL DECLARATION	11/17/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	12/08/2021
LICENSING ORIENTATION	09/29/2017
REGISTERING FICTITIOUS NAMES	10/03/2017
DIAGRAM/INDOOR	01/30/2018
DIAGRAM/OUTDOOR	10/30/2017
SAMPLE WEEKLY MENU	12/28/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN	10/16/2017
DAILY SCHEDULE	10/16/2017
CHILD CARE/DISCIPLINE POLICIES	10/24/2017
POLICIES	10/24/2017
SAFE SLEEP POLICY	10/24/2017
OWNER/PROVIDER REFERENCES	11/14/2017
ASSISTANT REFERENCES	11/28/2017
ASSISTANT APPROVAL REQUEST	12/12/2017
APPLICATION	09/18/2019
EQUIPMENT LIST	11/17/2021
FIRE/SAFETY INSPECTION	11/17/2021
SANITATION INSPECTION	08/02/2021

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 2

Total Children 7

Staff	Child	Class Age	Note
2	7	MIXED	Staff: Lori Hobson and Augusta Thomure. Age range 19 months through 3 years. Three children under 2 years old.

Compliance List
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 Compliance
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 Compliance
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