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

09/27/2023

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2455774027


DocumentDocument-Date
SANITATION INSPECTION 08/08/2023
FIRE/SAFETY INSPECTION 05/03/2023
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 07/13/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 07/13/2023
ANNUAL DECLARATION 07/13/2023

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:30PM   5:30PM   8/3/2023



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.

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
Violation
 Provider Comments
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by exposed internet wire frayed on the backside of the house.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 5. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
9/21/2023
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by two large holes more than 3.5 inch size are found under the fence left facing corner and in the center.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 5. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
9/21/2023
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by a water hose was hanging over the porch rail.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 5. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
9/21/2023
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by large tree branches/sticks and a pile of rocks in a wagon were on the playground, creating possible hazardous situations.
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (3) (A) 5. states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
9/21/2023
Violation
The bathroom was not clean and odor free as evidenced by there was a urine residue on the toilet bowl edge and on the lid .
Licensing Rule Reference
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home (2) (C) 1. E. states: Bathrooms shall be clean and odor free.
Correction Required
Bathrooms shall be clean and odor free.

Correction Verification
Submit Documentation

Compliance Date
9/21/2023
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
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
Violation
 Provider Comments
Violation
A copy of qualifying background screening results was/were not kept on file for: Angela Arthur , Trinity Arthur and Dillon Arthur.
Licensing Rule Reference
5 CSR 25-400.210 Records and Reports (8) states: A copy of qualifying background screening results shall be kept on file for child care staff members, as required by 5 CSR 25-600.020 General Requirements.
Correction Required
The child care provider shall keep on file a copy of qualifying background screening results for child care staff member(s).

Correction Verification
Submit Documentation

Compliance Date
9/21/2023
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