MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
DAVIS, TINA DIANE

Facility DVN
000437914

Phone
(660) 882-7030

Physical Address
23373 BOONVILLE RD
BOONVILLE
MO 65233

Owner
DAVIS, TINA DIANE

Mailing Address

Provider/Director
DAVIS, TINA DIANE

E-mail Address

Incorporated

Child Care Specialist
LU A GAINES

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
03/02/2023

Arrival Time
11:11 AM

Departure Time
11:55 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2442239523

Document	Document-Date
ASSISTANT APPROVAL REQUEST	07/10/2013
SAFE SLEEP POLICY	01/15/2016
ASSISTANT REFERENCES	08/26/2015
DISASTER AND EMERGENCY PREPAREDNESS PLAN	02/02/2012
SAMPLE WEEKLY MENU	08/07/1991
OWNER/PROVIDER REFERENCES	06/20/1991
CHILD CARE/DISCIPLINE POLICIES	07/23/1997
DIAGRAM/INDOOR	07/13/2010
DIAGRAM/OUTDOOR	04/02/2002
POLICIES	08/20/2018
DAILY SCHEDULE	08/20/2018
LOCAL FIRE DEPARTMENT NOTIFICATION	03/07/2019
APPLICATION	07/30/2019
FIRE/SAFETY INSPECTION	11/07/2022
SANITATION INSPECTION	08/15/2022
EQUIPMENT LIST	09/23/2022
ANNUAL DECLARATION	09/23/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	09/23/2022

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:00PM	5:00PM	7/19/2011

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 10

Staff	Child	Class Age	Note
1	10	MIXED	Staff Tina Davis present with children ranging in age from 5 months - 5 years old. 1 child was under 2 years of age.

Compliance List
5 CSR 25-400.025 Organization and Administration Not Observed
5 CSR 25-400.045 Licensing Process Compliance
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 Compliance
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 Compliance
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. Not Observed
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