DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

ADVENTURE TIME PLAYCARE LLC

002932072

(573) 715-1674

1111 S HICKORY ST
SALEM
MO  65560-2468

ADVENTURE TIME PLAYCARE LLC



 

ARTHUR, ANGELA DAWN

adventuretimeplaycare@gmail.com


ALLA GERASIMOVA

1 MONTH - 12 YEARS

10

FAMILY HOME

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

02/06/2023

11:45 AM

12:47 PM

UNANNOUNCED

COMPLIANCE MONITORING

2440628489


DocumentDocument-Date
SANITATION INSPECTION 05/12/2022
FIRE/SAFETY INSPECTION 06/01/2022
DIAGRAM/OUTDOOR 08/01/2022
DIAGRAM/INDOOR 08/01/2022
DISASTER AND EMERGENCY PREPAREDNESS PLAN 01/10/2022
SAFE SLEEP POLICY 01/25/2022
DAILY SCHEDULE 01/25/2022
SAMPLE WEEKLY MENU 01/25/2022
CERTIFICATE OF INCORPORATION 09/21/2021
ARTICLES OF INCORPORATION 09/21/2021
APPLICATION 06/16/2022
EQUIPMENT LIST 07/28/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 07/28/2022




Inspection determined facility to be in compliance with licensing rules.
Compliance 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 4
StaffChildClass AgeNote
1 4 MIXED Angela Arthur with a 9 month old , 2 years old and two 3 years old children.

Compliance List
5 CSR 25-400.025 Organization and Administration
Compliance
5 CSR 25-400.045 Licensing Process
Compliance
5 CSR 25-400.055 Annual Requirements
Compliance
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
Violation
 Provider Comments
Violation
The facility's disaster and emergency plan was not available in each room used for child care as evidenced by the plan was not available in a main day care room and in a bedroom that is used for nap time.
Licensing Rule Reference
5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (A) states: At all times, a copy of the facility's disaster emergency plan is readily available in the office area and in each room used for care of children.
Correction Required
The facilities disaster and emergency plan must be available in required locations.

Correction Verification
Corrected on Site

Compliance Date
2/6/2023
Violation
The facility's name, address and telephone number was not posted in each room used for child care.
Licensing Rule Reference
5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (B) 1. A. states: The name, address, and telephone number of the facility.
Correction Required
Facility must post information as required.

Correction Verification
Corrected on Site

Compliance Date
2/6/2023
Violation
The facility's list of emergency numbers are not posted in each room used for child care, specifically in a main day care room and the bedroom that is used for naping.
Licensing Rule Reference
5 CSR 25-400.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station.
Correction Required
Facility must post information as required.

Correction Verification
Corrected on Site

Compliance Date
2/6/2023
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
Compliance
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
Compliance
5 CSR 25-400.165 Emergency School Closings
Compliance
5 CSR 25-400.175 Child Care Program
Compliance
5 CSR 25-400.185 Health Care
Compliance
5 CSR 25-400.190 Nutrition and Food Service
Compliance
5 CSR 25-400.200 Transportation and Field Trips
Compliance
5 CSR 25-400.210 Records and Reports
Compliance
5 CSR 25-600.020 General Requirements
Compliance
5 CSR 25-600.040 Background Screening Findings
Compliance
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