MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
ELLIOTT, KAREN ANN

Facility DVN
000614562

Phone
(417) 588-1499

Physical Address
15186 GLENDALE RD
LEBANON
MO 65536-6637

Owner
ELLIOTT, KAREN ANN

Mailing Address

Provider/Director
ELLIOTT, KAREN ANN

E-mail Address
karenelliott1957@icloud.com

Incorporated

Child Care Specialist
ALLA GERASIMOVA

Age Range
BIRTH - 13 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 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; IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER

Inspection Information

Date
02/08/2024

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2464216073

Document	Document-Date
SAMPLE WEEKLY MENU	12/01/1999
DAILY SCHEDULE	12/01/1999
CHILD CARE/DISCIPLINE POLICIES	12/01/1999
DIAGRAM/OUTDOOR	12/01/1999
DIAGRAM/INDOOR	12/01/1999
ASSISTANT APPROVAL REQUEST	09/26/2013
APPLICATION	10/28/2019
SANITATION INSPECTION	09/19/2023
FIRE/SAFETY INSPECTION	08/29/2023
EQUIPMENT LIST	12/04/2023
ANNUAL DECLARATION	12/04/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	12/04/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:30PM	5:30PM	9/9/2019

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.