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
ARTICLES OF INCORPORATION	12/01/2017
DIRECTOR'S QUALIFICATIONS	05/16/2019
CERTIFICATE OF GOOD STANDING	01/14/2023
ANNUAL DECLARATION	01/05/2023
EQUIPMENT LIST	01/13/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	01/13/2023
FIRE/SAFETY INSPECTION	10/05/2022
SANITATION INSPECTION	11/21/2022
DIAGRAM/INDOOR	12/13/2019
DIAGRAM/OUTDOOR	12/15/2017
LLC ARTICLES OF ORGANIZATION	12/07/2017
SAMPLE FORMS	12/15/2017
DISCIPLINE POLICIES	12/27/2017
LOCAL FIRE DEPARTMENT NOTIFICATION	12/27/2017
CHILD CARE PRACTICES	12/27/2017
LLC OPERATING AGREEMENT	12/07/2017
APPLICATION	12/13/2019
LINES OF ADMINISTRATIVE AUTHORITY	01/26/2018
JOB RESPONSIBILITIES	12/21/2017
DAILY SCHEDULE	09/10/2019
LOCAL BUILDING APPROVAL	12/19/2017
LOCAL ZONING APPROVAL	12/29/2017
STAFF SHEET	12/18/2019
SAFE SLEEP POLICY	12/18/2017
SAMPLE WEEKLY MENU	02/09/2018
DIRECTOR'S QUALIFICATIONS	05/16/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/30/2018

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 Compliance
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 Compliance
5 CSR 25-500.132 Admission Policies and Procedures Compliance
5 CSR 25-500.142 Nighttime Care Compliance
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 Compliance
5 CSR 25-500.212 Transportation and Field Trips Compliance
5 CSR 25-500.222 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