MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

Back

Facility Information

Facility Name
MICKENS, CYNTHIA LORRAYNE

Facility DVN
000402755

Phone
(816) 921-0526

Physical Address
3943 PASEO BLVD
KANSAS CITY
MO 64110-1311

Owner
MICKENS, CYNTHIA LORRAYNE

Mailing Address

Provider/Director
MICKENS, CYNTHIA LORRAYNE

E-mail Address
cmickenspoj@gmail.com

Incorporated

Child Care Specialist
PENNY SNODGRASS

Age Range
BIRTH - 12 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations
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; IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER

Inspection Information

Date
10/13/2023

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2456505449

Document	Document-Date
ANNUAL DECLARATION	01/31/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	01/31/2023
ASSISTANT APPROVAL REQUEST	01/22/2016
CHILD CARE/DISCIPLINE POLICIES	01/31/2008
DAILY SCHEDULE	01/30/2008
SAMPLE WEEKLY MENU	08/24/1990
DIAGRAM/INDOOR	10/30/2007
DIAGRAM/OUTDOOR	10/30/2007
POLICIES	01/31/2008
APPLICATION	12/09/2019
EQUIPMENT LIST	01/31/2023
SANITATION INSPECTION	11/02/2022
FIRE/SAFETY INSPECTION	02/07/2023

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.