MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
HINES, KRISTI KATHERINE

Facility DVN
001482284

Phone
(573) 259-4832

Physical Address
1151 LILAC DR
SULLIVAN
MO 63080-2352

Owner
HINES, KRISTI KATHERINE

Mailing Address

Provider/Director
HINES, KRISTI KATHERINE

E-mail Address
MKHINES@FIDNET.COM

Incorporated

Child Care Specialist
ALLA GERASIMOVA

Age Range
BIRTH - 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
11/09/2022

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2435334903

Document	Document-Date
OWNER/PROVIDER REFERENCES	06/08/2000
ASSISTANT APPROVAL REQUEST	04/20/2012
SAMPLE FORMS	07/26/2000
SAMPLE WEEKLY MENU	07/26/2000
DAILY SCHEDULE	07/26/2000
POLICIES	08/07/2000
CHILD CARE/DISCIPLINE POLICIES	08/07/2000
DIAGRAM/OUTDOOR	07/26/2000
DIAGRAM/INDOOR	07/26/2000
APPLICATION	07/08/2020
FIRE/SAFETY INSPECTION	05/17/2022
EQUIPMENT LIST	11/08/2022
SANITATION INSPECTION	05/16/2022
ANNUAL DECLARATION	11/08/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	11/08/2022

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:00PM	4:30PM	4/20/2012
6:30AM	7:00AM	4/20/2012

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.