MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
DOUGLASS COMMUNITY SERVICES, INCORPORATED

Facility DVN
002558647

Phone
(660) 395-1455

Physical Address
406 BLEES INDUSTRIAL DR
MACON
MO 63552-4451

Owner
DOUGLASS COMMUNITY SERVICES INCORPORATED

Mailing Address
711 GRAND AVE
HANNIBAL
MO 63401

Provider/Director
KEUNE, KIMBERLY DENISE

E-mail Address
maconccpcm@douglassonline.org

Incorporated
Incorporated

Child Care Specialist
SUSAN MARIE DOUGLAS

Age Range
6 WEEKS - 36 MONTHS

Capacity
16

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
11/27/2019

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2369675177

Document	Document-Date
APPLICATION	10/15/2019
EQUIPMENT LIST	10/15/2019
DIAGRAM/INDOOR	01/18/2016
DISCIPLINE POLICIES	11/12/2019
POLICIES	11/12/2019
STAFF SHEET	10/28/2019
SAMPLE WEEKLY MENU	01/08/2016
SAMPLE FORMS	01/08/2016
CHILD CARE PRACTICES	11/12/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	01/08/2016
CERTIFICATE OF GOOD STANDING	10/15/2019
ARTICLES OF INCORPORATION	09/15/2017
DAILY SCHEDULE	01/08/2016
SANITATION INSPECTION	11/12/2019
FIRE/SAFETY INSPECTION	11/05/2019
DIAGRAM/OUTDOOR	07/11/2018
DIRECTOR'S QUALIFICATIONS	12/21/2018
JOB RESPONSIBILITIES	06/18/2018
SAFE SLEEP POLICY	05/06/2019
LINES OF ADMINISTRATIVE AUTHORITY	05/06/2019
LOCAL ZONING APPROVAL	10/28/2019

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.