MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
CLOUGH, KIMBERLY MARIE

Facility DVN
003058257

Phone
(573) 619-9327

Physical Address
125 COUNTY ROAD 604
LINN
MO 65051-2736

Owner
CLOUGH, KIMBERLY MARIE

Mailing Address

Provider/Director
CLOUGH, KIMBERLY MARIE

E-mail Address
cloughk6@yahoo.com

Incorporated

Child Care Specialist
LAUREN R RAYWARNKE

Age Range
6 WEEKS - 4 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations

Inspection Information

Date
01/23/2025

Arrival Time
1:15 PM

Departure Time
1:48 PM

Notice
UNANNOUNCED

Inspection Type
REINSPECTION

Inspection ID
2486174906

Document	Document-Date
SAMPLE WEEKLY MENU	07/01/2024
CHILD CARE/DISCIPLINE POLICIES	06/26/2024
POLICIES	06/26/2024
SAFE SLEEP POLICY	04/30/2024
EQUIPMENT LIST	07/19/2024
SANITATION INSPECTION	06/25/2024
LICENSING ORIENTATION	06/15/2024
APPLICATION	03/19/2024
DAILY SCHEDULE	08/09/2024
LOCAL FIRE DEPARTMENT NOTIFICATION	08/01/2024
DISASTER AND EMERGENCY PREPAREDNESS PLAN	07/24/2024
DIAGRAM/OUTDOOR	04/17/2024
DIAGRAM/INDOOR	04/17/2024
FIRE/SAFETY INSPECTION	08/13/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	08/13/2024
SAMPLE FORMS	08/13/2024

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 1

Total Children 9

Staff	Child	Class Age	Note
1	9	MIXED	Provider Kimberly Clough with 9 children, one child 4 months old, one child age 1, four children age 2 and three children ages 3 through 5 year's old.