MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
SHUCK, MONA LISA

Facility DVN
001322607

Phone
(573) 489-7275

Physical Address
8180 N PLAIN VIEW DR
COLUMBIA
MO 65202-6718

Owner
SHUCK, MONA LISA

Mailing Address

Provider/Director
SHUCK, MONA LISA

E-mail Address
MLSHUCK@HOTMAIL.COM

Incorporated

Child Care Specialist
CYNTHIA D MADDOX

Age Range
BIRTH - 12 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations
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; 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 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS

Inspection Information

Date
08/16/2022

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2429035303

Document	Document-Date
ASSISTANT REFERENCES	05/04/2009
ASSISTANT APPROVAL REQUEST	05/04/2009
CHILD CARE/DISCIPLINE POLICIES	04/28/2011
SAMPLE FORMS	07/16/1999
SAMPLE WEEKLY MENU	04/16/1999
DAILY SCHEDULE	06/15/1999
DIAGRAM/OUTDOOR	06/15/1999
DIAGRAM/INDOOR	06/15/1999
APPLICATION	04/20/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	11/06/2019
EQUIPMENT LIST	07/12/2022
FIRE/SAFETY INSPECTION	06/22/2022
ANNUAL DECLARATION	05/31/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	07/12/2022
SANITATION INSPECTION	03/09/2022

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:30PM	5/4/2009

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.


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
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