DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

DOUGLASS COMMUNITY SERVICES, INCORPORATED

000708596

(573) 754-5471

130 MEMORIAL DR
LOUISIANA
MO  63353-2418

DOUGLASS COMMUNITY SERVICES, INCORPORATED

711 GRAND AVE
HANNIBAL
MO  63401-3179

WEIS, JONI LYNN

louhs1@douglassonline.org

Incorporated

SUSAN MARIE DOUGLAS

6 WEEKS - 5 YEARS

55

GROUP HOME AND CENTER

8 CHILDREN UNDER 12 MONTHS; 20 CHILDREN UNDER 24 MONTHS
 
Inspection Information

09/15/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2430893267


DocumentDocument-Date
POLICIES 03/03/2010
LOCAL ZONING APPROVAL 04/30/2009
LOCAL BUILDING APPROVAL 04/30/2009
SAMPLE FORMS 07/20/2005
LINES OF ADMINISTRATIVE AUTHORITY 06/25/2007
JOB RESPONSIBILITIES 07/20/2005
SAMPLE WEEKLY MENU 04/22/2009
DISCIPLINE POLICIES 03/03/2010
DIRECTOR'S QUALIFICATIONS 09/15/2022
DAILY SCHEDULE 03/15/2010
CHILD CARE PRACTICES 03/03/2010
CERTIFICATE OF GOOD STANDING 03/10/2015
DIAGRAM/INDOOR 09/03/2015
DIAGRAM/OUTDOOR 09/08/2015
APPLICATION 02/11/2019
STAFF SHEET 04/05/2019
ARTICLES OF INCORPORATION 09/02/2008
FIRE/SAFETY INSPECTION 04/07/2022
SANITATION INSPECTION 04/07/2022
ANNUAL DECLARATION 05/02/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 05/02/2022
EQUIPMENT LIST 05/02/2022
SAFE SLEEP POLICY 06/14/2022
DISASTER AND EMERGENCY PREPAREDNESS PLAN 06/14/2022




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 Robyn Adams, Miranda Blair, Jessica Branstetter, Malinda Chinn, Amanda Elliot, Carolyn Harrison, Linda Holtsman, Willa Lewis, Jenasica Mayfield, Emily Price, Jennifer Rue, Lakin Shealor, Jamie, Turco, Kayla Young 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
8/19/2022
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
The facility does not have an approved director on staff.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 3. states: The licensee is required to maintain an approved certificated group child care home provider or center director on staff.
Correction Required
The facility shall have an approved director/group home provider.

Correction Verification
Submit Documentation

Compliance Date
9/15/2022
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 Jessica Branstetter 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 child 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
8/25/2022
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: Jessica Branstetter.
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
8/15/2022
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