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
11/07/2023

Arrival Time
11:32 AM

Departure Time
12:16 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2458552671

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.

Attendance at Time of Inspection

Total Staff 2

Total Children 8

Staff	Child	Class Age	Note
1	8	MIXED	Kim Adams, Provider 2 - 6-23 Month Olds 1 - 2 Year Old 5 - 3-5 Year Olds
1	0	NO CHILDREN IN ATTENDANCE	Billy Adams, Household Member/Caregiver (Asleep upstairs in the Family Home)