DHSS MO
MISSOURI DEPARTMENT OF HEALTH & SENIOR SERVICES

SECTION FOR CHILD CARE REGULATION

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

DOUGLASS COMMUNITY SERVICES, INC.

000708596

(573) 754-5471

130 MEMORIAL DR
LOUISIANA
MO  63353

DOUGLASS COMMUNITY SERVICES INC

711 GRAND AVE PO BOX 311
HANNIBAL
MO  63401

HENDERSON, SHANNON T

MARX, MICHAEL EDWARD

LOUSL@DOUGLASSONLINE.ORG

Incorporated


WENDI MATLICK

6 WEEKS - 5 YEARS

55

GROUP HOME AND CENTER

16 CHILDREN UNDER 24 MONTHS
 
Inspection Information

04/07/2016

12:00 PM

2:01 PM

UNANNOUNCED

COMPLIANCE MONITORING

2277674128


DocumentDocument-Date
POLICIES 03/03/2010
LOCAL ZONING APPROVAL 04/30/2009
LOCAL BUILDING APPROVAL 04/30/2009
SAMPLE FORMS 07/20/2005
LINES OF ADMINISTRATIVE AUTHORITY 06/25/2007
JOB RESPONSIBILITIES 07/20/2005
SAMPLE WEEKLY MENU 04/22/2009
DISCIPLINE POLICIES 03/03/2010
DIRECTOR'S QUALIFICATIONS 04/23/2009
DAILY SCHEDULE 03/15/2010
CHILD CARE PRACTICES 03/03/2010
APPLICATION 03/10/2015
CERTIFICATE OF GOOD STANDING 03/10/2015
EQUIPMENT LIST 03/10/2015
STAFF SHEET 03/10/2015
DIAGRAM/INDOOR 09/03/2015
DIAGRAM/OUTDOOR 09/08/2015
FIRE/SAFETY INSPECTION 09/07/2015
SANITATION INSPECTION 09/15/2015




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 2
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 7
Total Children 26
StaffChildClass AgeNote
2 7 INFANTS AND TODDLERS Amanda Ibbeson and Miranda Dixon
2 5 INFANTS AND TODDLERS Jessica Bazan and Robyn Adams
3 14 PRESCHOOL Willa Lewis, Carolyn Harrison and Tina Freels

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Initial Licensing Information
Compliance
19 CSR 30-62.052 License Renewal
Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
19 CSR 30-62.087 Fire Safety
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
Requirements for safe sleep training were not met as evidenced by Paige Cullon, Amanda Ibbeson, Jessica Bazan, and Kelsi Stribling did not complete safe sleep training in that staff did not have documentation of trainings.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (4) . states: Every three (3) years the center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 128, No. 5, November 1, 2011, and available from the University of Vermont College of Medicine, Given Building S261, 89 Beaumont Avenue, Burlington, Vermont 05405-0068, telephone number 802-656-2505, fax number 802-656-4844, or at www.pediatrics.aapublications.org/content/128/5/1030.full. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Center director, group child care home provider, and other caregivers, and those volunteers counted in staff/child ratios shall complete department approved safe sleep training as required.

Correction Verification
Corrected on Site

Compliance Date
4/7/2016
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (B) states: Medical examination reports shall include a “Risk Assessment for Tuberculosis” form, included herein, completed and signed by a health care professional, as provided by the Missouri Department of Health and Senior Services (MDHSS). If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
TB reports shall be on file as required

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.132 Admission Policies and Procedures
Compliance
19 CSR 30-62.142 Nighttime Care
Compliance
19 CSR 30-62.152 Hourly Care Facilities
Compliance
19 CSR 30-62.162 Overlap Care of Children
Compliance
19 CSR 30-62.172 Emergency School Closings
Not Observed
19 CSR 30-62.182 Child Care Program
Compliance
19 CSR 30-62.192 Health Care
Compliance
19 CSR 30-62.202 Nutrition and Food Service
Not Observed
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Violation
 Provider Comments
Violation
Parent and/or guardian was not notified upon request of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.
Licensing Rule Reference
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when. 7. states: All public, private, and parochial day care centers, preschools, and nursery schools shall notify the parent or guardian of each child at the time of initial enrollment in or attendance at the facility that the parent or guardian may request notice of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed. Beginning December 1, 2015, all public, private, and parochial day care centers, preschools, and nursery schools shall notify the parent or guardian of each child currently enrolled in or attending the facility that the parent or guardian may request notice of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed. Any public, private, or parochial day care center, preschool, or nursery school shall notify the parent or guardian of a child enrolled in or attending the facility, upon request, of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.
Correction Required
Parent and/or guardian shall be notified upon request of whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed.

Correction Verification
Submit Documentation

Compliance Date