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
CHILD CARE PRACTICES	11/15/2013
DISCIPLINE POLICIES	11/15/2013
DIAGRAM/INDOOR	11/15/2013
DIAGRAM/OUTDOOR	11/01/2013
LLC OPERATING AGREEMENT	10/10/2014
DIRECTOR'S QUALIFICATIONS	10/10/2014
SAMPLE WEEKLY MENU	11/15/2013
DAILY SCHEDULE	11/15/2013
LINES OF ADMINISTRATIVE AUTHORITY	11/15/2013
OWNER/PROVIDER REFERENCES	09/17/2014
LOCAL BUILDING APPROVAL	09/17/2014
LOCAL ZONING APPROVAL	09/17/2014
POLICIES	11/15/2013
JOB RESPONSIBILITIES	10/10/2014
LLC ARTICLES OF ORGANIZATION	11/12/2013
APPLICATION	06/17/2020
STAFF SHEET	06/17/2020
FIRE/SAFETY INSPECTION	06/08/2023
SANITATION INSPECTION	07/12/2023
EQUIPMENT LIST	10/04/2023
ANNUAL DECLARATION	10/04/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	10/04/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
4:00PM	5:00PM	12/14/2018
6:30AM	7:30AM	12/14/2018

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 25-500.032 Organization and Administration Compliance
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Compliance
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 Compliance
5 CSR 25-500.132 Admission Policies and Procedures Compliance
5 CSR 25-500.142 Nighttime Care Compliance
5 CSR 25-500.162 Overlap Care of Children Compliance
5 CSR 25-500.172 Emergency School Closings Compliance
5 CSR 25-500.182 Child Care Program Compliance
5 CSR 25-500.192 Health Care Compliance
5 CSR 25-500.202 Nutrition and Food Service Compliance
5 CSR 25-500.212 Transportation and Field Trips Compliance
5 CSR 25-500.222 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