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
ASSISTANT APPROVAL REQUEST	09/15/2015
CHILD CARE/DISCIPLINE POLICIES	09/15/2015
DAILY SCHEDULE	09/15/2015
DIAGRAM/INDOOR	09/15/2015
DIAGRAM/OUTDOOR	09/15/2015
LOCAL FIRE DEPARTMENT NOTIFICATION	09/15/2015
OWNER/PROVIDER REFERENCES	09/15/2015
POLICIES	09/15/2015
SAMPLE WEEKLY MENU	09/14/2015
ASSISTANT REFERENCES	09/15/2015
LLC ARTICLES OF ORGANIZATION	09/17/2015
LLC OPERATING AGREEMENT	09/17/2015
DISASTER AND EMERGENCY PREPAREDNESS PLAN	09/15/2015
APPLICATION	06/14/2019
SAFETY PLAN	09/09/2021
FIRE/SAFETY INSPECTION	07/25/2024
SANITATION INSPECTION	07/02/2024
ANNUAL DECLARATION	09/11/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	09/11/2024
EQUIPMENT LIST	09/11/2024

Overlap Start Time	Overlap End Time	Overlap Submit Date
2:30PM	4:30PM	9/21/2015

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 25-400.025 Organization and Administration

Not Observed

5 CSR 25-400.045 Licensing Process

Not Observed

5 CSR 25-400.055 Annual Requirements

Not Observed

5 CSR 25-400.085 Physical Requirements of the Family Day Care Home

Not Observed

5 CSR 25-400.086 Fire Safety

Not Observed

5 CSR 25-400.090 Disaster and Emergency Preparedness

Not Observed

5 CSR 25-400.095 Furniture, Equipment and Materials

Not Observed

5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel

Not Observed

5 CSR 25-400.115 Child Care Family and Household

Not Observed

5 CSR 25-400.125 Medical Examination Reports

Not Observed

5 CSR 25-400.135 Admission Policies and Procedures

Not Observed

5 CSR 25-400.145 Nighttime Care

Not Observed

5 CSR 25-400.155 Overlap Care of Children

Not Observed

5 CSR 25-400.165 Emergency School Closings

Not Observed

5 CSR 25-400.175 Child Care Program

Not Observed

5 CSR 25-400.185 Health Care

Not Observed

5 CSR 25-400.190 Nutrition and Food Service

Not Observed

5 CSR 25-400.200 Transportation and Field Trips

Not Observed

5 CSR 25-400.210 Records and Reports

Not Observed

5 CSR 25-600.020 General Requirements

Violation

	Provider Comments
Violation Criminal background check results were older than five (5) years for Suzanne Lambert, Becky Karnes and David Lambert. Licensing Rule Reference 5 CSR 25-600.020 General Requirements (5) states: Criminal background checks shall be completed for each child care staff member every five (5) years. Correction Required Required results of criminal background checks shall be on file. Correction Verification Submit Documentation Compliance Date

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

RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.

Compliance