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
001584898

Phone
(573) 406-5574

Physical Address
2161 JOHNSON ST
HANNIBAL
MO 63401-5843

Owner
DOUGLASS COMMUNITY SERVICES, INCORPORATED

Mailing Address
711 GRAND AVE
HANNIBAL
MO 63401-3179

Provider/Director
BROKES-MARTIN, TAMMY

E-mail Address
EHSCM@DOUGLASSONLINE.ORG

Incorporated
Incorporated

Child Care Specialist
BETHANY C DUCKWORTH

Age Range
6 WEEKS - 35 MONTHS

Capacity
24

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
10/19/2021

Arrival Time
12:40 PM

Departure Time
1:23 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2410192482

Document	Document-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	02/26/2021
DIRECTOR'S QUALIFICATIONS	09/18/2020
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	02/26/2021
SANITATION INSPECTION	05/20/2021
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: 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.

Attendance at Time of Inspection

Total Staff 3

Staff	Child	Class Age	Note
3	0	NO CHILDREN IN ATTENDANCE	Staff: Sarah Blake, Laura O'Brien, and Jenise Pape. No children in attendance as facility is working virtually with children.


19 CSR 30-62.032 Organization and Administration Compliance
19 CSR 30-62.042 Licensing Process Compliance
19 CSR 30-62.052 Annual Requirements 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 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