DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
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Facility Information

SOUTH CENTRAL MISSOURI COMMUNITY ACTION AGENCY

000606982

(573) 996-5059

ROUTE 2, BOX 16
DONIPHAN
MO  63935

SOUTH CENTRAL MISSOURI COMMUNITY ACTION AGENCY

PO BOX 246
DONIPHAN
MO  63935-0246

ROBERTS, AMANDA RENEE

aroberts@scmcaa.org

Incorporated

MELISSA JILL SMITH

36 MONTHS - 5 YEARS

74

GROUP HOME AND CENTER

 
Inspection Information

10/19/2021

9:19 AM

10:51 AM

UNANNOUNCED

COMPLIANCE MONITORING

2410675440


DocumentDocument-Date
FIRE/SAFETY INSPECTION 10/18/2021
EQUIPMENT LIST 09/02/2021
ANNUAL DECLARATION 09/02/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 09/02/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN 05/19/2020
SANITATION INSPECTION 09/25/2020
LOCAL ZONING APPROVAL 04/23/2013
CERTIFICATE OF GOOD STANDING 03/27/2019
ARTICLES OF INCORPORATION 03/27/2019
CHILD CARE PRACTICES 08/18/2005
DAILY SCHEDULE 08/18/2005
DIAGRAM/INDOOR 09/20/2010
DIAGRAM/OUTDOOR 09/20/2010
DISCIPLINE POLICIES 08/18/2005
LINES OF ADMINISTRATIVE AUTHORITY 08/18/2005
POLICIES 08/18/2005
SAMPLE WEEKLY MENU 08/18/2005
JOB RESPONSIBILITIES 08/18/2005
DIRECTOR'S QUALIFICATIONS 03/17/2015
APPLICATION 03/27/2019
STAFF SHEET 05/16/2019




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
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 11
Total Children 39
StaffChildClass AgeNote
3 0 NO CHILDREN IN ATTENDANCE Kristy Ward, Designated person in charge, and Bonnie Sappington and Marsha Boyles, cooks, present
3 15 PRESCHOOL Skye Collins, Shannon Martin and Felicia Rank, caregivers present with 15 children 3-5 years
2 10 PRESCHOOL Evelyn Stull and Benita Campbell, caregivers with 10 children 3-4 years
3 14 PRESCHOOL Rose Reynolds, Jennifer Perren and Kristy Bailey, caregivers with 14 children 3-4 years

 
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Violation
 Provider Comments
Violation
The annual sanitation inspection was not conducted.
Licensing Rule Reference
5 CSR 25-500.052 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
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
5 CSR 25-500.087 Fire Safety
Compliance
5 CSR 25-500.090 Disaster and Emergency Preparedness
Compliance
5 CSR 25-500.092 Furniture, Equipment and Materials
Compliance
5 CSR 25-500.102 Personnel
Compliance
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Compliance
5 CSR 25-500.132 Admission Policies and Procedures
Compliance
5 CSR 25-500.142 Nighttime Care
Compliance
5 CSR 25-500.152 Hourly Care Facilities
Compliance
5 CSR 25-500.162 Overlap Care of Children
Compliance
5 CSR 25-500.172 Emergency School Closings
Compliance
5 CSR 25-500.182 Child Care Program
Compliance
5 CSR 25-500.192 Health Care
Compliance
5 CSR 25-500.202 Nutrition and Food Service
Compliance
5 CSR 25-500.212 Transportation and Field Trips
Compliance
5 CSR 25-500.222 Records and Reports
Compliance
5 CSR 25-600.020 General Requirements
Compliance
5 CSR 25-600.040 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