MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

Back

Facility Information

Facility Name
DOUGLASS COMMUNITY SERVICES INCORPORATED

Facility DVN
000708596

Phone
(573) 754-5471

Physical Address
130 MEMORIAL DR
LOUISIANA
MO 63353

Owner
DOUGLASS COMMUNITY SERVICES INCORPORATED

Mailing Address
711 GRAND AVE PO BOX 311
HANNIBAL
MO 63401

Provider/Director
HENDERSON, SHANNON T

E-mail Address
LOUSL@DOUGLASSONLINE.ORG

Incorporated
Incorporated

Child Care Specialist
WENDI MATLICK

Age Range
6 WEEKS - 5 YEARS

Capacity
55

Facility Type
GROUP HOME AND CENTER

Limitations
16 CHILDREN UNDER 24 MONTHS

Inspection Information

Date
06/22/2016

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2283325411

Document	Document-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: 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.