DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

DOUGLASS COMMUNITY SERVICES, INCORPORATED

002558647

(660) 395-1455

406 BLEES INDUSTRIAL DR
MACON
MO  63552-4451

DOUGLASS COMMUNITY SERVICES, INCORPORATED

711 GRAND AVE
HANNIBAL
MO  63401

KEUNE, KIMBERLY DENISE

maconccpcm@douglassonline.org

Incorporated

BETHANY C DUCKWORTH

6 WEEKS - 35 MONTHS

16

GROUP HOME AND CENTER

 
Inspection Information

08/29/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2429985512


DocumentDocument-Date
ANNUAL DECLARATION 11/22/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 11/22/2021
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
EQUIPMENT LIST 11/22/2021
FIRE/SAFETY INSPECTION 12/02/2021
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
SANITATION INSPECTION 10/29/2021




Inspection determined facility to be in compliance with licensing rules.
Compliance 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.

Compliance List
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
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