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
002558647

Phone
(660) 395-1455

Physical Address
406 BLEES INDUSTRIAL DR
MACON
MO 63552-4451

Owner
DOUGLASS COMMUNITY SERVICES, INCORPORATED

Mailing Address
711 GRAND AVE
HANNIBAL
MO 63401

Provider/Director
KEUNE, KIMBERLY DENISE

E-mail Address
maconccpcm@douglassonline.org

Incorporated
Incorporated

Child Care Specialist
CHRISTINA BRUCE

Age Range
6 WEEKS - 35 MONTHS

Capacity
16

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
01/19/2022

Arrival Time
8:52 AM

Departure Time
9:41 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2417289581

Document	Document-Date
DIAGRAM/INDOOR	01/18/2016
SAMPLE WEEKLY MENU	01/08/2016
SAMPLE FORMS	01/08/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN	01/08/2016
ARTICLES OF INCORPORATION	09/15/2017
DAILY SCHEDULE	01/08/2016
DIAGRAM/OUTDOOR	07/11/2018
DIRECTOR'S QUALIFICATIONS	12/21/2018
JOB RESPONSIBILITIES	06/18/2018
SAFE SLEEP POLICY	05/06/2019
LINES OF ADMINISTRATIVE AUTHORITY	05/06/2019
LOCAL ZONING APPROVAL	10/28/2019
APPLICATION	10/15/2019
DISCIPLINE POLICIES	11/12/2019
POLICIES	11/12/2019
STAFF SHEET	10/28/2019
CHILD CARE PRACTICES	11/12/2019
CERTIFICATE OF GOOD STANDING	11/22/2021
FIRE/SAFETY INSPECTION	12/02/2021
SANITATION INSPECTION	10/29/2021
EQUIPMENT LIST	11/22/2021
ANNUAL DECLARATION	11/22/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	11/22/2021

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 7

Total Children 9

Staff	Child	Class Age	Note
2	3	INFANTS AND TODDLERS	Staff: Alice Haddock and Kimberly Walker. Age range 4 months through 13 months.
2	6	MIXED	Staff: Linda Newland and Faith Whittle. Age range 12 months through 2 years. Three 2 year old children.
3	0	NO CHILDREN IN ATTENDANCE	Staff: Nicki Kuiper, Kitchen Manager, Kimberly Kuene, Director, and Rachel Butner, additional staff that arrived during inspection.


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