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
SANITATION INSPECTION	04/20/2022
FIRE/SAFETY INSPECTION	07/07/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	06/06/2022
DAILY SCHEDULE	06/08/2016
SAMPLE FORMS	08/30/2013
DISCIPLINE POLICIES	08/30/2013
POLICIES	08/30/2013
LOCAL BUILDING APPROVAL	06/01/2016
LOCAL ZONING APPROVAL	06/01/2016
OWNER/PROVIDER REFERENCES	08/30/2013
LOCAL FIRE DEPARTMENT NOTIFICATION	08/30/2013
LLC OPERATING AGREEMENT	04/20/2016
LINES OF ADMINISTRATIVE AUTHORITY	08/30/2013
CERTIFICATE OF GOOD STANDING	04/20/2016
CHILD CARE PRACTICES	08/30/2013
LLC ARTICLES OF ORGANIZATION	04/20/2016
DIRECTOR'S QUALIFICATIONS	08/30/2013
REGISTERING FICTITIOUS NAMES	04/20/2016
DIAGRAM/INDOOR	08/30/2013
DIAGRAM/OUTDOOR	08/30/2013
JOB RESPONSIBILITIES	08/30/2013
DISASTER AND EMERGENCY PREPAREDNESS PLAN	03/30/2013
SAFE SLEEP POLICY	08/30/2013
SAMPLE WEEKLY MENU	08/30/2013
STAFF SHEET	03/29/2020
APPLICATION	03/29/2020
LICENSING ORIENTATION	08/30/2013
EQUIPMENT LIST	06/06/2022
ANNUAL DECLARATION	06/06/2022

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.


5 CSR 25-500.032 Organization and Administration Not Observed
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Not Observed
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 Not Observed
5 CSR 25-500.132 Admission Policies and Procedures Not Observed
5 CSR 25-500.142 Nighttime Care Not Observed
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 Not Observed
5 CSR 25-500.212 Transportation and Field Trips Not Observed
5 CSR 25-500.222 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. — Not Observed
RSMo 210.211. License required - exceptions - written notice of licensure status, when. Not Observed