MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
SUNDERLAND, GAYLA DAWN

Facility DVN
002021038

Phone
(660) 373-0291

Physical Address
1001 S 12TH ST
BETHANY
MO 64424-1819

Owner
SUNDERLAND, GAYLA DAWN

Mailing Address

Provider/Director
SUNDERLAND, GAYLA DAWN

E-mail Address
gayladsunderland@gmail.com

Incorporated

Child Care Specialist
ELLEN DONOHO

Age Range
6 WEEKS - 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 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; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS

Inspection Information

Date
11/15/2023

Arrival Time
9:15 AM

Departure Time
9:58 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2458862001

Document	Document-Date
POLICIES	12/05/2006
DIAGRAM/OUTDOOR	12/05/2006
DIAGRAM/INDOOR	12/05/2006
CHILD CARE/DISCIPLINE POLICIES	12/05/2006
SAMPLE WEEKLY MENU	12/05/2006
DAILY SCHEDULE	11/05/2006
ASSISTANT REFERENCES	01/25/2017
OWNER/PROVIDER REFERENCES	12/05/2006
ASSISTANT APPROVAL REQUEST	04/03/2017
APPLICATION	03/09/2019
SANITATION INSPECTION	05/17/2023
EQUIPMENT LIST	05/09/2023
FIRE/SAFETY INSPECTION	03/23/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	05/09/2023
ANNUAL DECLARATION	05/09/2023
SAFETY PLAN	03/18/2021

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:10PM	5:10PM	10/7/2017

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 1

Total Children 6

Staff	Child	Class Age	Note
1	6	MIXED	2-3 years old. 1- two year old child. Gayla Sunderland, staff

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 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 Not Observed
5 CSR 25-400.135 Admission Policies and Procedures Not Observed
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 Not Observed
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 Not Observed
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
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance