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
APPLICATION	01/28/2022
CERTIFICATE OF GOOD STANDING	01/28/2022
CHILD CARE PRACTICES	06/05/2022
DAILY SCHEDULE	06/05/2022
DIAGRAM/INDOOR	06/15/2022
DIAGRAM/OUTDOOR	06/15/2022
DISASTER AND EMERGENCY PREPAREDNESS PLAN	06/05/2022
DISCIPLINE POLICIES	06/05/2022
JOB RESPONSIBILITIES	04/22/2022
LINES OF ADMINISTRATIVE AUTHORITY	05/03/2022
LLC ARTICLES OF ORGANIZATION	01/28/2022
LLC OPERATING AGREEMENT	05/04/2022
LOCAL BUILDING APPROVAL	04/28/2022
LOCAL FIRE DEPARTMENT NOTIFICATION	04/22/2022
LOCAL ZONING APPROVAL	04/28/2022
POLICIES	06/05/2022
REGISTERING FICTITIOUS NAMES	01/27/2022
SAFE SLEEP POLICY	06/05/2022
SAMPLE WEEKLY MENU	04/14/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	07/18/2023
EQUIPMENT LIST	07/18/2023
SAMPLE FORMS	06/16/2022
LICENSING ORIENTATION	01/27/2022
FIRE/SAFETY INSPECTION	07/31/2023
SANITATION INSPECTION	03/22/2023
DIRECTOR'S QUALIFICATIONS	05/19/2022

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	4:30PM	7/14/2022
6:30AM	7:30AM	7/14/2022

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 Compliance
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 Compliance
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 Compliance
5 CSR 25-500.172 Emergency School Closings Compliance
5 CSR 25-500.182 Child Care Program Compliance
5 CSR 25-500.192 Health Care Compliance
5 CSR 25-500.202 Nutrition and Food Service Compliance
5 CSR 25-500.212 Transportation and Field Trips Compliance
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 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