DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

WORTH COUNTY HEAD START

000603574

(660) 564-3616

508 E 6TH
GRANT CITY
MO  64456

COMMUNITY SERVICES, INCORPORATED, OF NORTHWEST MISSOURI

PO BOX 328
MARYVILLE
MO  64468

COVEY, ASHLEY RENEE

LAUFFERT@CSINWMO.ORG

Incorporated

MICHELLE RENEE TRUSSELL

36 MONTHS - 6 YEARS

20

GROUP HOME AND CENTER

 
Inspection Information

12/02/2021

10:15 AM

11:06 AM

UNANNOUNCED

COMPLIANCE MONITORING

2413503405


DocumentDocument-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 05/03/2021
DAILY SCHEDULE 12/13/2002
ARTICLES OF INCORPORATION 12/20/2002
DIAGRAM/OUTDOOR 08/30/2001
DIAGRAM/INDOOR 08/30/2001
LOCAL ZONING APPROVAL 03/22/2007
LOCAL BUILDING APPROVAL 03/22/2007
CERTIFICATE OF GOOD STANDING 05/04/2021
REGISTERING FICTITIOUS NAMES 06/17/2014
CHILD CARE PRACTICES 10/03/1994
JOB RESPONSIBILITIES 10/03/1994
LINES OF ADMINISTRATIVE AUTHORITY 10/03/1994
POLICIES 10/03/1994
SAMPLE WEEKLY MENU 10/03/1994
DIRECTOR'S QUALIFICATIONS 10/12/2018
APPLICATION 03/15/2019
SANITATION INSPECTION 02/23/2021
ANNUAL DECLARATION 05/03/2021
FIRE/SAFETY INSPECTION 07/23/2020
EQUIPMENT LIST 05/03/2021
STAFF SHEET 11/09/2020




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 5
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 2
Total Children 11
StaffChildClass AgeNote
2 11 MIXED Caregivers, Ashley Covey & Laticxia Velez, was present with three 3-year olds; five 4-year olds & three 5-year olds.

 
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
Violation
 Provider Comments
Violation
The facility did not conduct a Family Care Safety Registry screening for Joyce Jackson, who was hired on 8.9.21.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (P) states: The child care provider shall conduct a Family Care Safety Registry screening prior to employment for any newly hired child care staff member who has a qualifying criminal background check result.
Correction Required
Required results of the Family Care Safety Registry screening shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
Background screening information was not available for review for Joyce Jackson.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (Q) states: Background screening information received by the provider shall be retained in the individual’s file in a confidential manner and available for review.
Correction Required
Background screening information shall be available and kept confidential.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Shylea Moellenberndt as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a day care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Shylea Moellenberndt.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include a “Risk Assessment for Tuberculosis” form, included herein, completed and signed by a health care professional, as provided by the Missouri Department of Health and Senior Services (MDHSS). If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
TB reports shall be on file as required

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Joyce Jackson.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a family child care home, group child care home, child care center, or license-exempt facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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