MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
SMITH, BETH ANN

Facility DVN
002244708

Phone
(573) 201-3277

Physical Address
11309 HIGHWAY 63 S
VIENNA
MO 65582-7133

Owner
SMITH, BETH ANN

Mailing Address
PO BOX 329
VIENNA
MO 65582

Provider/Director
SMITH, BETH ANN

E-mail Address
MBSMITH@SOCKET.NET

Incorporated

Child Care Specialist
LAUREN R RAYWARNKE

Age Range
6 WEEKS - 10 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
10/18/2022

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2433255410

Document	Document-Date
LOCAL FIRE DEPARTMENT NOTIFICATION	09/09/2010
POLICIES	09/30/2010
OWNER/PROVIDER REFERENCES	10/07/2010
ASSISTANT REFERENCES	10/12/2010
ASSISTANT APPROVAL REQUEST	10/12/2010
SAMPLE FORMS	09/09/2010
SAMPLE WEEKLY MENU	09/09/2010
DAILY SCHEDULE	09/09/2010
CHILD CARE/DISCIPLINE POLICIES	09/09/2010
DIAGRAM/OUTDOOR	09/09/2010
DIAGRAM/INDOOR	09/09/2010
APPLICATION	06/14/2020
FIRE/SAFETY INSPECTION	10/04/2022
SANITATION INSPECTION	08/05/2022
EQUIPMENT LIST	08/24/2022
ANNUAL DECLARATION	08/24/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	08/24/2022

Overlap Start Time	Overlap End Time	Overlap Submit Date
2:30PM	4:30PM	8/18/2016

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.