DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

NORTHEAST MISSOURI COMMUNITY ACTION AGENCY

000670680

(660) 397-3428

401 N 1ST ST
EDINA
MO  63537-1029

NORTHEAST MISSOURI COMMUNITY ACTION AGENCY



 

HUNT, TONYA MARIA

tonya_hunt@capnemo.org

Incorporated

BETHANY C DUCKWORTH

6 WEEKS - 5 YEARS

28

GROUP HOME AND CENTER

8 CHILDREN IN THE INFANT/TODDLER UNIT
 
Inspection Information

07/11/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2426775786


DocumentDocument-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 11/10/2021
ANNUAL DECLARATION 11/10/2021
DAILY SCHEDULE 10/04/2011
SAMPLE WEEKLY MENU 03/24/1997
SAFE SLEEP POLICY 02/14/2017
LINES OF ADMINISTRATIVE AUTHORITY 11/04/2019
LOCAL ZONING APPROVAL 01/10/1995
ARTICLES OF INCORPORATION 10/08/1965
DIAGRAM/INDOOR 01/03/2013
DIAGRAM/OUTDOOR 11/04/2009
CHILD CARE PRACTICES 10/04/2011
DISCIPLINE POLICIES 10/04/2011
POLICIES 10/04/2011
DISASTER AND EMERGENCY PREPAREDNESS PLAN 09/06/2019
APPLICATION 10/09/2019
EQUIPMENT LIST 11/10/2021
STAFF SHEET 10/09/2019
SANITATION INSPECTION 11/03/2021
JOB RESPONSIBILITIES 11/04/2019
DIRECTOR'S QUALIFICATIONS 09/05/2019
CERTIFICATE OF GOOD STANDING 01/26/2022
FIRE/SAFETY INSPECTION 01/13/2022




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
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
Violation
 Provider Comments
Violation
A medical examination report did not include either a completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: Santana Shultz.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberulin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date
7/8/2022
5 CSR 25-500.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
Written permission was not on file for other transportation.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 6. states: Permission for field trips, transportation to and from school and other transportation;
Correction Required
Written permission for field and transportation shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
7/8/2022
Violation
Written permission was not on file for field trips.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 6. states: Permission for field trips, transportation to and from school and other transportation;
Correction Required
Written permission for field and transportation shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
7/8/2022
Violation
The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider's policies.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. A. states: They have received a copy of the provider's policies pertaining to the admission, care and discharge of children;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
7/8/2022
Violation
The provider did not have parental acknowledgement on file indicating the parent has been informed that Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available for review.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. B. states: They have been informed that the Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available in the facility for their review;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
7/8/2022
Violation
The provider did not have parental acknowledgement on file indicating the parent and provider have agreed on a plan for continuing communication.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. C. states: They and the provider have agreed on a plan for continuing communication regarding the child's development, behavior and individual needs;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
7/8/2022
Violation
The provider did not have parental acknowledgement on file indicating the parent understands and agrees that the child may not be accepted for care when ill.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. D. states: They understand and agree that the child may not be accepted for care when ill.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
7/8/2022
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by One child(s) file(s) did not have the parental acknowledgement they have been notified that they may request whether there are children for whom an immunization exemption has been filed for currently enrolled in or attending the facility.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. F. states: They have been notified that they may request notice at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility
Correction Required
Child enrollment information shall be completed and on file as requested.

Correction Verification
Submit Documentation

Compliance Date
7/8/2022
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by One child(s) file did not have the parental acknowledgement they have received a copy of the provider's safe sleep policy.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. E. states: They have received a copy of the provider's safe sleep policy when enrolling children less than one (1) year of age.
Correction Required
Child enrollment information shall be completed and on file as requested.

Correction Verification
Submit Documentation

Compliance Date
7/8/2022
5 CSR 25-500.142 Nighttime Care
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