MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
PUXICO R-VIII SCHOOL DISTRICT

Facility DVN
001506338

Phone
(573) 222-6221

Physical Address
481 N BEDFORD ST
PUXICO
MO 63960-9144

Owner
PUXICO R-VIII SCHOOL DISTRICT

Mailing Address

Provider/Director
CULBERTSON, LISA ANN

E-mail Address
ecaldwell@puxico.k12.mo.us

Incorporated

Child Care Specialist
MELISSA JILL SMITH

Age Range
36 MONTHS - 5 YEARS

Capacity
20

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
07/25/2022

Arrival Time
11:51 AM

Departure Time
11:51 AM

Notice
UNANNOUNCED

Inspection Type
SUPPLEMENTAL

Inspection ID
2432767778

Document	Document-Date
JOB RESPONSIBILITIES	05/25/2016
DAILY SCHEDULE	05/25/2016
DIAGRAM/INDOOR	05/25/2016
DIAGRAM/OUTDOOR	05/25/2016
CHILD CARE PRACTICES	05/25/2016
DISCIPLINE POLICIES	05/25/2016
POLICIES	05/25/2016
SAMPLE WEEKLY MENU	06/01/2016
DIRECTOR'S QUALIFICATIONS	07/12/2016
LINES OF ADMINISTRATIVE AUTHORITY	06/18/2016
LOCAL FIRE DEPARTMENT NOTIFICATION	06/01/2016
LOCAL ZONING APPROVAL	06/01/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN	06/18/2016
APPLICATION	05/13/2020
STAFF SHEET	04/14/2020
SANITATION INSPECTION	03/16/2022
FIRE/SAFETY INSPECTION	01/11/2022
ANNUAL DECLARATION	04/21/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	04/21/2022
EQUIPMENT LIST	04/21/2022

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.