MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
POTTER, STEPHANIE

Facility DVN
000719137

Phone
(660) 838-6693

Physical Address
13888 OSAGE VALLEY RD
BOONVILLE
MO 65233

Owner
POTTER, STEPHANIE

Mailing Address

Provider/Director
POTTER, STEPHANIE

E-mail Address
SLPOTTER85@YMAIL.COM

Incorporated

Child Care Specialist
LU A GAINES

Age Range
BIRTH - 14 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
01/27/2023

Arrival Time
1:14 PM

Departure Time
1:36 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2439905152

Document	Document-Date
DIAGRAM/INDOOR	08/14/2003
DIAGRAM/OUTDOOR	06/15/2005
POLICIES	06/19/1998
SAMPLE WEEKLY MENU	05/30/1996
DAILY SCHEDULE	05/30/1996
CHILD CARE/DISCIPLINE POLICIES	05/03/1996
OWNER/PROVIDER REFERENCES	06/26/1995
ASSISTANT REFERENCES	06/12/2009
DISASTER AND EMERGENCY PREPAREDNESS PLAN	06/14/2018
SAFE SLEEP POLICY	06/14/2018
ASSISTANT APPROVAL REQUEST	02/24/2012
APPLICATION	05/01/2019
EQUIPMENT LIST	07/01/2022
SANITATION INSPECTION	06/27/2022
ANNUAL DECLARATION	07/01/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	07/01/2022
FIRE/SAFETY INSPECTION	07/05/2022

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:45PM	5:15PM	6/19/2013
7:00AM	7:30AM	6/19/2013

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.

Attendance at Time of Inspection

Total Staff 1

Total Children 9

Staff	Child	Class Age	Note
1	9	MIXED	Staff Stephanie Potter present with children ages 8 months - 5 years old. 2 children were under 2 years old.


5 CSR 25-400.025 Organization and Administration Not Observed
5 CSR 25-400.045 Licensing Process Not Observed
5 CSR 25-400.055 Annual Requirements Not Observed
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 Not Observed
5 CSR 25-400.095 Furniture, Equipment and Materials Compliance
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel Compliance
5 CSR 25-400.115 Child Care Family and Household Compliance
5 CSR 25-400.125 Medical Examination Reports Not Observed
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 Not Observed
5 CSR 25-400.165 Emergency School Closings Not Observed
5 CSR 25-400.175 Child Care Program Compliance
5 CSR 25-400.185 Health Care Not Observed
5 CSR 25-400.190 Nutrition and Food Service Not Observed
5 CSR 25-400.200 Transportation and Field Trips Compliance
5 CSR 25-400.210 Records and Reports Not Observed
5 CSR 25-600.020 General Requirements Not Observed
5 CSR 25-600.040 Background Screening Findings Not Observed
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