MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
NORTHEAST MISSOURI COMMUNITY ACTION AGENCY

Facility DVN
002817170

Phone
(660) 665-9855

Physical Address
200 PFEIFFER AVE
KIRKSVILLE
MO 63501-5044

Owner
NORTHEAST MISSOURI COMMUNITY ACTION AGENCY

Mailing Address

Provider/Director
BASS, CRYSTAL KAY

E-mail Address
cbass@capnemo.org

Incorporated
Incorporated

Child Care Specialist
BETHANY C DUCKWORTH

Age Range
BIRTH - 2 YEARS

Capacity
12

Facility Type
GROUP HOME AND CENTER

Limitations
4 CHILDREN UNDER 12 MONTHS

Inspection Information

Date
10/14/2022

Arrival Time
11:08 AM

Departure Time
12:19 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2432880845

Document	Document-Date
APPLICATION	02/04/2021
ARTICLES OF INCORPORATION	10/29/1965
CERTIFICATE OF GOOD STANDING	01/31/2020
LOCAL ZONING APPROVAL	04/30/2021
LOCAL BUILDING APPROVAL	04/30/2021
DIRECTOR'S QUALIFICATIONS	10/30/2020
SAFE SLEEP POLICY	04/07/2021
SAMPLE WEEKLY MENU	04/07/2021
DAILY SCHEDULE	04/07/2021
JOB RESPONSIBILITIES	04/07/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN	04/07/2021
CHILD CARE PRACTICES	04/07/2021
DISCIPLINE POLICIES	04/07/2021
LINES OF ADMINISTRATIVE AUTHORITY	04/07/2021
DIAGRAM/INDOOR	04/07/2021
DIAGRAM/OUTDOOR	04/07/2021
POLICIES	04/07/2021
SAMPLE FORMS	04/07/2021
LICENSING ORIENTATION	02/10/2021
FIRE/SAFETY INSPECTION	03/01/2022
EQUIPMENT LIST	04/12/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	04/12/2022
ANNUAL DECLARATION	04/12/2022

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 7

Total Children 10

Staff	Child	Class Age	Note
1	4	INFANTS AND TODDLERS	Staff: K.B. Age range 7 months through 13 months.
3	6	MIXED	Staff: C.V., J.C. and C.B. Age range 17 months through 2 years. Three 2 year old children.
3	0	NO CHILDREN IN ATTENDANCE	Staff: C.B, J.C. and K.R. Not counted in child/staff ratio.

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 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