MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

Back

Facility Information

Facility Name
LEWIS, MARY ANN

Facility DVN
000917968

Phone
(417) 673-5576

Physical Address
24430 IVY RD
WEBB CITY
MO 64870-9112

Owner
LEWIS, MARY ANN

Mailing Address

Provider/Director
LEWIS, MARY ANN

E-mail Address
maryannlewis555@yahoo.com

Incorporated

Child Care Specialist
JENNIFER GOMEZ

Age Range
BIRTH - 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; 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; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER

Inspection Information

Date
12/28/2023

Arrival Time
10:28 AM

Departure Time
10:57 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2461600269

Document	Document-Date
POLICIES	04/08/2009
DIAGRAM/INDOOR	03/11/1997
ASSISTANT APPROVAL REQUEST	01/30/2013
SAMPLE WEEKLY MENU	05/15/1997
DAILY SCHEDULE	05/15/1997
CHILD CARE/DISCIPLINE POLICIES	04/05/2005
DIAGRAM/OUTDOOR	03/11/1997
SAFE SLEEP POLICY	11/15/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	11/15/2018
APPLICATION	02/25/2019
SANITATION INSPECTION	03/24/2023
ANNUAL DECLARATION	03/31/2023
EQUIPMENT LIST	03/31/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/31/2023
FIRE/SAFETY INSPECTION	03/13/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:00PM	5:00PM	3/25/2013

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 4

Staff	Child	Class Age	Note
1	4	MIXED	Provider Mary Lewis was present with 4 children, 3 to 7 years old.


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 Not Observed
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 Compliance
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. Not Observed
RSMo 210.211. License required - exceptions - written notice of licensure status, when. Not Observed
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance