MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

INSPECTION REPORT

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Facility Information

Facility Name

Facility DVN

Phone

Physical Address

Owner

Mailing Address

Provider/Director

E-mail Address

Incorporated

Child Care Specialist

Age Range

Capacity

Facility Type

Limitations

Inspection Information

Date

Arrival Time

Departure Time

Notice

Inspection Type

Inspection ID

Document	Document-Date
LOCAL ZONING APPROVAL	03/10/2014
CHILD CARE PRACTICES	01/30/1995
DAILY SCHEDULE	01/30/1995
SAMPLE WEEKLY MENU	01/30/1995
DISCIPLINE POLICIES	01/30/1995
JOB RESPONSIBILITIES	01/30/1995
LINES OF ADMINISTRATIVE AUTHORITY	01/30/1995
POLICIES	01/30/1995
ARTICLES OF INCORPORATION	04/07/1965
DIAGRAM/INDOOR	12/19/1995
DIAGRAM/OUTDOOR	01/17/1996
DIRECTOR'S QUALIFICATIONS	02/03/1997
LOCAL FIRE DEPARTMENT NOTIFICATION	04/06/2016
CERTIFICATE OF GOOD STANDING	04/15/2018
APPLICATION	02/15/2018
STAFF SHEET	04/05/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	03/26/2012
SANITATION INSPECTION	11/17/2021
FIRE/SAFETY INSPECTION	01/03/2022
ANNUAL DECLARATION	02/01/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	02/01/2022
EQUIPMENT LIST	02/01/2022

Open Violations:

NOTE

The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

Compliance List
5 CSR 25-500.032 Organization and Administration Compliance
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Compliance
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers Compliance
5 CSR 25-500.087 Fire Safety Compliance
5 CSR 25-500.090 Disaster and Emergency Preparedness Compliance
5 CSR 25-500.092 Furniture, Equipment and Materials Compliance
5 CSR 25-500.102 Personnel Compliance
5 CSR 25-500.112 Staff/Child Ratios Compliance
5 CSR 25-500.122 Medical Examination Reports Compliance
5 CSR 25-500.132 Admission Policies and Procedures Compliance
5 CSR 25-500.142 Nighttime Care Compliance
5 CSR 25-500.162 Overlap Care of Children Compliance
5 CSR 25-500.172 Emergency School Closings Compliance
5 CSR 25-500.182 Child Care Program Compliance
5 CSR 25-500.192 Health Care Compliance
5 CSR 25-500.202 Nutrition and Food Service Compliance
5 CSR 25-500.212 Transportation and Field Trips Compliance
5 CSR 25-500.222 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