DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

WORTH COUNTY HEAD START - COMMUNITY SERVICES, INC.

000603574

(660) 564-3616

508 E 6TH
GRANT CITY
MO  64456

COMMUNITY SERVICES INCORPORATED OF NORTHWEST MISSOURI

PO BOX 328
MARYVILLE
MO  64468

PORTER, ABBEY NICOLE

lauffert.csi@gmail.com

Incorporated

PEGGY HASTINGS

36 MONTHS - 6 YEARS

20

GROUP HOME AND CENTER

 
Inspection Information

11/09/2016

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2293045900


DocumentDocument-Date
REGISTERING FICTITIOUS NAMES 06/17/2014
STAFF SHEET 03/30/2015
FIRE/SAFETY INSPECTION 03/12/2015
CERTIFICATE OF GOOD STANDING 04/02/2015
EQUIPMENT LIST 04/02/2015
APPLICATION 02/27/2015
DIRECTOR'S QUALIFICATIONS 12/09/2014
DAILY SCHEDULE 12/13/2002
ARTICLES OF INCORPORATION 12/20/2002
DIAGRAM/OUTDOOR 08/30/2001
DIAGRAM/INDOOR 08/30/2001
LOCAL ZONING APPROVAL 03/22/2007
LOCAL BUILDING APPROVAL 03/22/2007




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.

 
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
Compliance
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Rachel Jackson and Stormy Sherer as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (A) states: All persons working in a day care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
11/8/2016
Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Rachel Jackson and Stormy Sherer.
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
11/8/2016
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
Compliance
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
Compliance
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.
Compliance