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
REGISTERING FICTITIOUS NAMES	09/19/2011
LOCAL ZONING APPROVAL	12/12/2011
LOCAL BUILDING APPROVAL	12/12/2011
DIAGRAM/OUTDOOR	12/12/2011
SAMPLE WEEKLY MENU	12/12/2011
SAMPLE FORMS	11/23/2011
LOCAL FIRE DEPARTMENT NOTIFICATION	12/12/2011
LLC ARTICLES OF ORGANIZATION	09/19/2011
LINES OF ADMINISTRATIVE AUTHORITY	11/23/2011
JOB RESPONSIBILITIES	11/23/2011
DIRECTOR'S QUALIFICATIONS	05/30/2012
DIRECTOR'S JOB RESPONSIBILITIES	11/23/2011
CHILD CARE PRACTICES	11/23/2011
DAILY SCHEDULE	11/23/2011
POLICIES	10/10/2013
LLC OPERATING AGREEMENT	09/30/2013
DISCIPLINE POLICIES	10/10/2013
DIAGRAM/INDOOR	10/10/2013
DISASTER AND EMERGENCY PREPAREDNESS PLAN	09/19/2018
SAFE SLEEP POLICY	09/19/2018
APPLICATION	09/04/2019
FIRE/SAFETY INSPECTION	09/08/2022
SANITATION INSPECTION	10/12/2022
STAFF SHEET	10/03/2022
EQUIPMENT LIST	10/03/2022
ANNUAL DECLARATION	10/03/2022

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:30PM	12/12/2011

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 Compliance
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 Compliance
5 CSR 25-500.142 Nighttime Care Not Observed
5 CSR 25-500.162 Overlap Care of Children Not Observed
5 CSR 25-500.172 Emergency School Closings Not Observed
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 Compliance
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 Compliance
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