DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

SOUTH CENTRAL MISSOURI COMMUNITY ACTION AGENCY

000750352

(573) 322-0099

63 N HERREN AVE
ELLSINORE
MO  63937

SOUTH CENTRAL MISSOURI COMMUNITY ACTION AGENCY

PO BOX 414
ELLSINORE
MO  63937

CARTER WOLFE, TIERNEY ALYSSA

SCMCAA@HOTMAIL.COM

Incorporated

SARAH L THACKER

36 MONTHS - 5 YEARS

40

GROUP HOME AND CENTER

 
Inspection Information

04/13/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2421715796


DocumentDocument-Date
ARTICLES OF INCORPORATION 01/19/2011
CHILD CARE PRACTICES 10/19/2011
SAMPLE WEEKLY MENU 07/13/2011
DAILY SCHEDULE 07/13/2011
JOB RESPONSIBILITIES 03/05/1999
POLICIES 10/19/2011
DIAGRAM/INDOOR 08/31/2012
DIAGRAM/OUTDOOR 10/19/2011
DISCIPLINE POLICIES 10/19/2011
LOCAL ZONING APPROVAL 07/07/2011
LINES OF ADMINISTRATIVE AUTHORITY 07/12/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 10/12/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN 01/10/2018
APPLICATION 04/03/2018
EQUIPMENT LIST 02/14/2022
STAFF SHEET 04/03/2018
FIRE/SAFETY INSPECTION 02/15/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/14/2022
ANNUAL DECLARATION 02/14/2022
SANITATION INSPECTION 01/04/2022




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.

 
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 Janie Hudson, Kim Lewis and Debbie Brooks 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
4/5/2022
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
A caregiver did not obtain one clock hour of training for each month of employment. The staff listed need the following information: Clarissa Courtway needs 1 hour of training for 2021.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (C) states: Caregivers who were employed after the first of the year shall obtain one (1) clock of hour training for each one (1) month of employment, regardless of the date employment began.
Correction Required
Required training hours shall be documented for each employee.

Correction Verification
Submit Documentation

Compliance Date
3/28/2022
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 Debbie Brooks and Kim Lewis 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
3/28/2022
Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Kim Lewis and Debbie Brooks.
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
3/28/2022
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 Kim Lewis and Debbie Brooks.
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
3/28/2022
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