MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
MARTIN, KIMBERLY

Facility DVN
000601165

Phone
(573) 779-3502

Physical Address
10350 WEBSTER ROAD
CALEDONIA
MO 63631

Owner
MARTIN, KIMBERLY

Mailing Address

Provider/Director
MARTIN, KIMBERLY

E-mail Address
billykim1216@hotmail.com

Incorporated

Child Care Specialist
BRITTANY HECHT

Age Range
6 WEEKS - 12 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
10/23/2023

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2457281568

Document	Document-Date
OWNER/PROVIDER REFERENCES	03/04/1994
DAILY SCHEDULE	04/14/1994
SAMPLE WEEKLY MENU	04/14/1994
POLICIES	05/11/1994
CHILD CARE/DISCIPLINE POLICIES	05/11/1994
DIAGRAM/INDOOR	05/11/1994
DIAGRAM/OUTDOOR	05/11/1994
ASSISTANT REFERENCES	01/19/2010
ASSISTANT APPROVAL REQUEST	03/04/2016
APPLICATION	03/01/2018
SAFE SLEEP POLICY	10/11/2017
FIRE/SAFETY INSPECTION	03/07/2023
SANITATION INSPECTION	02/22/2023
EQUIPMENT LIST	02/23/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	02/23/2023
ANNUAL DECLARATION	02/23/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:15PM	5:15PM	2/11/2014

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.

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 Violation
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home Compliance
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 Violation
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 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
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance