MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
DAHLMAN, LISA MARIE

Facility DVN
001407016

Phone
(660) 349-5220

Physical Address
416 N FLORENCE
KIRKSVILLE
MO 63501-0

Owner
DAHLMAN, LISA MARIE

Mailing Address

Provider/Director
DAHLMAN, LISA MARIE

E-mail Address
jldahlman5@gmail.com

Incorporated

Child Care Specialist
ELLEN DONOHO

Age Range
BIRTH - 10 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
04/06/2023

Arrival Time
10:25 AM

Departure Time
11:24 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2444610343

Document	Document-Date
SAMPLE WEEKLY MENU	10/13/1999
POLICIES	10/13/1999
OWNER/PROVIDER REFERENCES	11/10/1999
DIAGRAM/OUTDOOR	10/13/1999
DIAGRAM/INDOOR	10/13/1999
DAILY SCHEDULE	10/13/1999
CHILD CARE/DISCIPLINE POLICIES	10/13/1999
ASSISTANT REFERENCES	08/05/2010
ASSISTANT APPROVAL REQUEST	02/05/2016
APPLICATION	01/15/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN	09/01/2011
SAFE SLEEP POLICY	01/01/2016
SANITATION INSPECTION	12/07/2022
EQUIPMENT LIST	03/09/2023
ANNUAL DECLARATION	03/09/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/09/2023
FIRE/SAFETY INSPECTION	01/05/2023

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 1

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 6

Staff	Child	Class Age	Note
1	6	MIXED	18 months-3 years 1 under the age of 2 years Lisa Dahlman, staff


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 25-400.145 Nighttime Care Compliance
5 CSR 25-400.155 Overlap Care of Children 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 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance