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
LICENSING ORIENTATION	09/15/2014
REGISTERING FICTITIOUS NAMES	09/15/2014
FIRE/SAFETY INSPECTION	05/24/2023
SANITATION INSPECTION	06/20/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	07/27/2023
EQUIPMENT LIST	07/27/2023
ANNUAL DECLARATION	07/27/2023
CHILD CARE PRACTICES	09/15/2014
DAILY SCHEDULE	09/15/2014
DIAGRAM/INDOOR	09/15/2014
DIAGRAM/OUTDOOR	09/15/2014
DISCIPLINE POLICIES	09/15/2014
LOCAL ZONING APPROVAL	09/15/2014
SAFE SLEEP POLICY	09/15/2014
SAMPLE FORMS	09/15/2014
POLICIES	09/15/2014
OWNER/PROVIDER REFERENCES	09/15/2014
SAMPLE WEEKLY MENU	09/15/2014
JOB RESPONSIBILITIES	09/15/2014
LOCAL BUILDING APPROVAL	09/15/2014
DIRECTOR'S QUALIFICATIONS	09/15/2014
LINES OF ADMINISTRATIVE AUTHORITY	09/15/2014
LOCAL FIRE DEPARTMENT NOTIFICATION	09/15/2014
DISASTER AND EMERGENCY PREPAREDNESS PLAN	09/15/2014
APPLICATION	05/20/2020
STAFF SHEET	05/20/2020

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:00PM	5:00PM	3/20/2023

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.


5 CSR 25-500.032 Organization and Administration Not Observed
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Not Observed
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 Not Observed
5 CSR 25-500.132 Admission Policies and Procedures Not Observed
5 CSR 25-500.142 Nighttime Care Compliance
5 CSR 25-500.162 Overlap Care of Children Not Observed
5 CSR 25-500.172 Emergency School Closings Not Observed
5 CSR 25-500.182 Child Care Program Compliance
5 CSR 25-500.192 Health Care Not Observed
5 CSR 25-500.202 Nutrition and Food Service Not Observed
5 CSR 25-500.212 Transportation and Field Trips Not Observed
5 CSR 25-500.222 Records and Reports Not Observed
5 CSR 25-600.020 General Requirements Not Observed
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