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
POLICIES	05/18/2001
DIAGRAM/OUTDOOR	03/15/2001
DIAGRAM/INDOOR	03/15/2001
DAILY SCHEDULE	05/18/2001
ASSISTANT APPROVAL REQUEST	03/15/2013
CHILD CARE/DISCIPLINE POLICIES	05/18/2001
SAMPLE FORMS	05/18/2001
SAMPLE WEEKLY MENU	05/18/2001
ASSISTANT REFERENCES	04/05/2011
SANITATION INSPECTION	02/09/2023
FIRE/SAFETY INSPECTION	03/21/2023
EQUIPMENT LIST	06/08/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	06/08/2023
ANNUAL DECLARATION	06/08/2023

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 25-400.025 Organization and Administration Compliance
5 CSR 25-400.045 Licensing Process Not Observed
5 CSR 25-400.055 Annual Requirements Not Observed
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 Compliance
5 CSR 25-400.145 Nighttime Care Not Observed
5 CSR 25-400.155 Overlap Care of Children Not Observed
5 CSR 25-400.165 Emergency School Closings Not Observed
5 CSR 25-400.175 Child Care Program Compliance
5 CSR 25-400.185 Health Care Compliance
5 CSR 25-400.190 Nutrition and Food Service Not Observed
5 CSR 25-400.200 Transportation and Field Trips Not Observed
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