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
001584914

Phone
(573) 324-0167

Physical Address
1903 W LOCUST ST
BOWLING GREEN
MO 63334-1027

Owner
DOUGLASS COMMUNITY SERVICES, INCORPORATED

Mailing Address
711 GRAND AVE
HANNIBAL
MO 63401-3179

Provider/Director
ANDERSON, CHRISTINA MARIE

E-mail Address
bgcm@douglassonline.org

Incorporated
Incorporated

Child Care Specialist
JOY LYNN NICHOLS

Age Range
BIRTH - 5 YEARS

Capacity
56

Facility Type
GROUP HOME AND CENTER

Limitations
16 CHILDREN IN THE INFANT/TODDLER UNIT

Inspection Information

Date
11/18/2021

Arrival Time
12:30 PM

Departure Time
12:57 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2413144867

Document	Document-Date
LOCAL ZONING APPROVAL	01/14/2001
LOCAL BUILDING APPROVAL	01/14/2001
SAMPLE FORMS	03/22/2005
LINES OF ADMINISTRATIVE AUTHORITY	04/18/2007
ARTICLES OF INCORPORATION	04/02/2008
SAMPLE WEEKLY MENU	04/24/2001
JOB RESPONSIBILITIES	03/26/2007
DISCIPLINE POLICIES	03/17/2009
DIRECTOR'S QUALIFICATIONS	10/28/2008
DIAGRAM/OUTDOOR	09/22/2005
DIAGRAM/INDOOR	08/21/2008
DAILY SCHEDULE	03/21/2007
CHILD CARE PRACTICES	03/17/2009
CERTIFICATE OF GOOD STANDING	01/12/2015
STAFF SHEET	03/13/2019
APPLICATION	02/11/2019
ANNUAL DECLARATION	03/30/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/30/2021
EQUIPMENT LIST	03/30/2021
FIRE/SAFETY INSPECTION	01/07/2021
SANITATION INSPECTION	04/08/2021

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 4

Total Children 13

Staff	Child	Class Age	Note
2	6	MIXED	children ages two and three; Susan Blair and Emily Goodin
2	7	MIXED	children ages 8 months to 2 years; Raina Gaedike and Maria Hurd


5 CSR 25-500.032 Organization and Administration Compliance
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Compliance
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