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
DISCIPLINE POLICIES	10/01/2003
CHILD CARE PRACTICES	10/01/2003
DAILY SCHEDULE	04/28/2005
POLICIES	10/01/2003
DIAGRAM/OUTDOOR	12/27/2007
DIAGRAM/INDOOR	09/16/2009
JOB RESPONSIBILITIES	07/17/2013
LINES OF ADMINISTRATIVE AUTHORITY	07/17/2013
SAMPLE WEEKLY MENU	07/17/2013
DIRECTOR'S QUALIFICATIONS	08/09/2017
CERTIFICATE OF GOOD STANDING	07/28/2015
ARTICLES OF INCORPORATION	07/17/2013
LOCAL BUILDING APPROVAL	07/17/2013
LOCAL FIRE DEPARTMENT NOTIFICATION	07/17/2013
LOCAL ZONING APPROVAL	07/17/2013
SAMPLE FORMS	07/17/2013
OWNER/PROVIDER REFERENCES	07/17/2013
APPLICATION	08/20/2019
STAFF SHEET	10/03/2022
FIRE/SAFETY INSPECTION	10/12/2023
SAFE SLEEP POLICY	07/28/2015
LICENSING ORIENTATION	10/01/2003
DISASTER AND EMERGENCY PREPAREDNESS PLAN	07/28/2015
EQUIPMENT LIST	10/05/2023
SANITATION INSPECTION	09/01/2023
ANNUAL DECLARATION	10/05/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	10/05/2023

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.

Compliance List
5 CSR 25-500.032 Organization and Administration Compliance
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Not Observed
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 Not Observed
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 Not Observed
5 CSR 25-500.172 Emergency School Closings Not Observed
5 CSR 25-500.182 Child Care Program Compliance
5 CSR 25-500.192 Health Care Not Observed
5 CSR 25-500.202 Nutrition and Food Service Not Observed
5 CSR 25-500.212 Transportation and Field Trips Not Observed
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 Not Observed
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