MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
CENTRAL MISSOURI COMMUNITY ACTION

Facility DVN
000280137

Phone
(573) 449-1575

Physical Address
403 PARK AVE STE B
COLUMBIA
MO 65201-4374

Owner
CENTRAL MISSOURI COMMUNITY ACTION

Mailing Address
807B N PROVIDENCE RD
COLUMBIA
MO 65203-4359

Provider/Director
POULSEN, ASHLEY LYNN

E-mail Address
ashleyp@cmca.us

Incorporated
Incorporated

Child Care Specialist
CYNTHIA D MADDOX

Age Range
6 WEEKS - 5 YEARS

Capacity
53

Facility Type
GROUP HOME AND CENTER

Limitations
8 CHILDREN UNDER 24 MONTHS

Inspection Information

Date
08/18/2022

Arrival Time
10:15 AM

Departure Time
11:56 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2429280148

Document	Document-Date
DIRECTOR'S QUALIFICATIONS	03/27/2012
JOB RESPONSIBILITIES	10/12/1994
ARTICLES OF INCORPORATION	03/13/2006
CHILD CARE PRACTICES	09/25/2012
SAMPLE WEEKLY MENU	10/12/1994
DAILY SCHEDULE	09/10/2001
POLICIES	09/25/2012
DIAGRAM/OUTDOOR	09/10/2001
DIAGRAM/INDOOR	05/07/2001
LOCAL ZONING APPROVAL	02/01/1995
LOCAL BUILDING APPROVAL	02/01/1995
CERTIFICATE OF GOOD STANDING	11/22/2016
APPLICATION	12/05/2018
STAFF SHEET	12/05/2018
DISCIPLINE POLICIES	09/25/2012
DISASTER AND EMERGENCY PREPAREDNESS PLAN	01/22/2008
SAMPLE FORMS	09/25/2012
ANNUAL DECLARATION	12/09/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	12/09/2021
EQUIPMENT LIST	12/09/2021
FIRE/SAFETY INSPECTION	11/23/2021
SANITATION INSPECTION	05/12/2022

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.

Attendance at Time of Inspection

Total Staff 8

Total Children 6

Staff	Child	Class Age	Note
3	6	INFANTS AND TODDLERS	Elisha (Abike) Akinmoladum, Mahasin (Meemee) Awadelkarim and Shaequayl (Shae) Mitchell were the teachers with the children. Children range in age from 7 months to 2 years.
5	0	NO CHILDREN IN ATTENDANCE	Ashley Poulsen (director), Kalia White, Kimberly Miller, Michelle Merk and Stephanie Reuschling were all staff present in the facility. Several of the classrooms are currently closed until children return next week.


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 25-500.162 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