MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
HALL, JACKIE MYRTLE

Facility DVN
000496557

Phone
(417) 924-8338

Physical Address
2320 HIGHWAY 5
MANSFIELD
MO 65704-8303

Owner
HALL, JACKIE MYRTLE

Mailing Address

Provider/Director
HALL, JACKIE MYRTLE

E-mail Address
jackiehall@centurytel.net

Incorporated

Child Care Specialist
KATINA D KATTICH

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; 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
12/13/2024

Arrival Time
1:21 PM

Departure Time
1:40 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2484252747

Document	Document-Date
DAILY SCHEDULE	03/03/1997
ASSISTANT REFERENCES	08/27/2012
OWNER/PROVIDER REFERENCES	08/13/1996
SAMPLE WEEKLY MENU	08/27/1996
DIAGRAM/OUTDOOR	07/19/1996
DIAGRAM/INDOOR	07/19/1996
ASSISTANT APPROVAL REQUEST	08/27/1996
CHILD CARE/DISCIPLINE POLICIES	09/06/2002
POLICIES	09/06/2002
LOCAL FIRE DEPARTMENT NOTIFICATION	02/13/2018
SAFE SLEEP POLICY	02/13/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	02/07/2018
FIRE/SAFETY INSPECTION	09/26/2024
EQUIPMENT LIST	11/01/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	11/01/2024
ANNUAL DECLARATION	11/01/2024
SANITATION INSPECTION	09/24/2024
SAFETY PLAN	01/12/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
3:40PM	3:55PM	7/30/2012
7:00AM	7:45AM	7/30/2012

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 3

Total Children 8

Staff	Child	Class Age	Note
2	8	MIXED	Caregiver Jackie Hall and caregiver Donna Rippee present with eight children: two-under two, three-3 years, two-4year, one-5 year
1	0	NO CHILDREN IN ATTENDANCE	Household member Verlin Hall present with zero children present