MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

LICENSE EXEMPT PROGRAM INSPECTION REPORT

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Facility Information

Facility Name
JACK IN THE BOX PLAY SCHOOL, INC.

Facility DVN
000424688

Phone
(573) 881-4195

Physical Address
715 S ORCHARD ST
CENTRALIA
MO 65240-1726

Owner
JACK IN THE BOX PLAY SCHOOL, INC.

Mailing Address
715 S ORCHARD ST
CENTRALIA
MO 65240-1726

Provider/Director
HENKE, KATHLEEN

E-mail Address
carlyhenke@gmail.com

Incorporated
Incorporated

Child Care Specialist
CYNTHIA D MADDOX

Age Range
36 MONTHS - 5 YEARS

Capacity
17

Facility Type
LICENSE EXEMPT PROGRAM

Limitations

Inspection Information

Date
04/08/2025

Arrival Time
11:00 AM

Departure Time
12:06 PM

Notice
ANNOUNCED

Inspection Type
ANNUAL

Inspection ID
2490820066

Document	Document-Date
FIRE/SAFETY INSPECTION	04/08/2025
SANITATION INSPECTION	02/21/2025

Inspection determined facility to be in compliance with rules.

Open Violations: NA

Attendance at Time of Inspection

Total Staff 2

Total Children 12

Staff	Child	Class Age	Note
2	12	PRESCHOOL	Carly Henke and Michael McDow were the staff with the children. The children ranged in age from 3 years to 4 years.