MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

Back

Facility Information

Facility Name
GOFF, STACY LYNN

Facility DVN
002887461

Phone
(573) 544-6234

Physical Address
608 N 2ND ST
WELLSVILLE
MO 63384-1102

Owner
GOFF, STACY LYNN

Mailing Address
608 N 2ND ST
WELLSVILLE
MO 63384-1102

Provider/Director
GOFF, STACY LYNN

E-mail Address
stacygoff49@yahoo.com

Incorporated

Child Care Specialist
CYNTHIA D MADDOX

Age Range
6 WEEKS - 12 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations
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 2 CHILDREN 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; UP TO 8 CHILDREN IN CARE, ALL CHILDREN MAY BE UNDER AGE 2 WITH 2 ADULT CAREGIVERS

Inspection Information

Date
01/09/2024

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2462039328

Document	Document-Date
APPLICATION	01/25/2022
SAMPLE FORMS	07/08/2022
DIAGRAM/INDOOR	07/08/2022
DIAGRAM/OUTDOOR	07/08/2022
SAFETY PLAN	02/25/2022
SAFE SLEEP POLICY	03/21/2022
SAMPLE WEEKLY MENU	02/25/2022
DAILY SCHEDULE	02/09/2022
CHILD CARE/DISCIPLINE POLICIES	07/25/2022
DISASTER AND EMERGENCY PREPAREDNESS PLAN	07/25/2022
POLICIES	07/25/2022
FIRE/SAFETY INSPECTION	04/13/2023
SANITATION INSPECTION	05/10/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	06/12/2023
EQUIPMENT LIST	06/12/2023
ANNUAL DECLARATION	06/12/2023

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.

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 Violation
5 CSR 25-400.115 Child Care Family and Household Compliance
5 CSR 25-400.125 Medical Examination Reports Compliance
5 CSR 25-400.135 Admission Policies and Procedures Compliance
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 Compliance
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 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
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized. Compliance