DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

DOUGLASS COMMUNITY SERVICES, INCORPORATED

001584898

(573) 406-5574

2161 JOHNSON ST
HANNIBAL
MO  63401-5843

DOUGLASS COMMUNITY SERVICES, INCORPORATED

711 GRAND AVE
HANNIBAL
MO  63401-3179

BROKES-MARTIN, TAMMY

EHSCM@DOUGLASSONLINE.ORG

Incorporated

BETHANY C DUCKWORTH

6 WEEKS - 35 MONTHS

24

GROUP HOME AND CENTER

 
Inspection Information

04/11/2022

9:38 AM

10:45 AM

UNANNOUNCED

COMPLIANCE MONITORING

2421420871


DocumentDocument-Date
APPLICATION 02/22/2019
EQUIPMENT LIST 03/01/2022
STAFF SHEET 04/04/2019
FIRE/SAFETY INSPECTION 01/04/2022
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 04/08/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/01/2022
ANNUAL DECLARATION 03/01/2022




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 3
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
StaffChildClass AgeNote
3 0 NO CHILDREN IN ATTENDANCE Staff: Tammy Martin, Jeremy Shuck, and Sarah Blake. No children in attendance at site. Site is only offering virtual services at this time.

 
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 Family Care Safety Registry check was not conducted for Lori Grimes, Laura O'Brien, and Agnes Kidd. within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

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
Violation
 Provider Comments
Violation
A copy of qualifying background screening results was/were not kept on file for: Toni Serio and Jeremy Shuck.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (9) states: A copy of qualifying background screening results shall be kept on file for child care staff members, as required by 19 CSR 30-63.020 General Requirements.
Correction Required
The facility shall keep on file a copy of qualifying background screening results for child care staff member(s).

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Toni Serio and Jeremy Shuck.
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