DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

DOUGLASS COMMUNITY SERVICES, INCORPORATED

001584898

(573) 406-5574

2161 JOHNSON ST
HANNIBAL
MO  63401-5843

DOUGLASS COMMUNITY SERVICES, INCORPORATED

711 GRAND AVE
HANNIBAL
MO  63401-3179

BROKES-MARTIN, TAMMY

EHSCM@DOUGLASSONLINE.ORG

Incorporated

BETHANY C DUCKWORTH

6 WEEKS - 35 MONTHS

24

GROUP HOME AND CENTER

 
Inspection Information

04/09/2021

10:00 AM

11:56 AM

UNANNOUNCED

COMPLIANCE MONITORING

2397275178


DocumentDocument-Date
APPLICATION 02/22/2019
EQUIPMENT LIST 02/26/2021
STAFF SHEET 04/04/2019
FIRE/SAFETY INSPECTION 01/11/2021
CERTIFICATE OF GOOD STANDING 02/22/2019
DIRECTOR'S QUALIFICATIONS 10/09/2018
DIAGRAM/INDOOR 05/06/2010
DIAGRAM/OUTDOOR 05/06/2010
SAFE SLEEP POLICY 01/07/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN 03/02/2021
DISCIPLINE POLICIES 02/26/2010
CHILD CARE PRACTICES 02/26/2010
POLICIES 02/26/2010
ARTICLES OF INCORPORATION 05/24/1993
JOB RESPONSIBILITIES 08/10/2006
LINES OF ADMINISTRATIVE AUTHORITY 08/17/2004
DAILY SCHEDULE 09/05/2002
SAMPLE WEEKLY MENU 09/10/2002
LOCAL BUILDING APPROVAL 09/05/2008
LOCAL ZONING APPROVAL 09/05/2008
SANITATION INSPECTION 02/07/2020
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/26/2021
ANNUAL DECLARATION 02/26/2021




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 6
Total Children 12
StaffChildClass AgeNote
1 1 INFANTS AND TODDLERS Staff: Alyssa Wilkerson. Child was 20 months old.
1 4 INFANTS AND TODDLERS Staff: Agnes Jane Kidd. Age range 15 weeks through 9 months.
2 7 INFANTS AND TODDLERS Staff: Carla Lamberson and Alexis Lee. Age range 11 months through 2 years. Two 2 year old children.
1 0 NO CHILDREN IN ATTENDANCE Staff: Alexis Horton. Preparing for new classroom. No children in attendance.
1 0 NO CHILDREN IN ATTENDANCE Staff: Tammy Brokes-Martin, Director

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Licensing Process
Violation
 Provider Comments
Violation
Posting requirements were not met as evidenced by the posted license was outdated.
Licensing Rule Reference
19 CSR 30-62.042 Licensing Process (12) states: Once granted, the license shall be posted near the entrance of the facility where it may be seen easily by parents or others who visit.
Correction Required
The official license shall be posted.

Correction Verification
Corrected on Site

Compliance Date
4/9/2021
19 CSR 30-62.052 Annual Requirements
Violation
 Provider Comments
Violation
The annual sanitation inspection was not conducted.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.
Correction Required
The facility shall submit evidence of compliance with annual sanitation requirements.

Correction Verification
Submit Documentation

Compliance Date

Violation
The Family Care Safety Registry check was not conducted for Seth McBride, Faith Carr, Sarah Blake, Kristin Fasnacht, Lorri Grimes, Alissa Horton, Agnes Kidd, Carla Lamberson, Alexis Lee, Tammy Brokes-Martin, Laura O'Brien, Jenise Pape, Heidi Swank, and Alyssa Wilkerson within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Submit Documentation

Compliance Date

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
Compliance
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
19 CSR 30-63.020 General Requirements
Compliance
19 CSR 30-63.040 Background Screening Findings
Compliance
RSMo 210.115. Reports of abuse, neglect, and under age eighteen deaths — persons required to report — supervisors and administrators not to impede reporting — deaths required to be reported to the division or child fatality review panel, when — report made to another state, when. —
Compliance
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance