MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
DOUGLASS COMMUNITY SERVICES, INCORPORATED

Facility DVN
000672599

Phone
(573) 221-1540

Physical Address
661 CLINIC RD
HANNIBAL
MO 63401-3607

Owner
DOUGLASS COMMUNITY SERVICES, INCORPORATED

Mailing Address
909 BROADWAY
HANNIBAL
MO 63401-4249

Provider/Director
CAPP, ANNA LEE

E-mail Address
EHSCLINIC@DOUGLASSONLINE.ORG

Incorporated
Incorporated

Child Care Specialist
BETHANY CARREL DUCKWORTH

Age Range
6 WEEKS - 35 MONTHS

Capacity
16

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
03/06/2023

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2442394314

Document	Document-Date
ARTICLES OF INCORPORATION	06/02/2016
DIAGRAM/INDOOR	09/10/2002
DIAGRAM/OUTDOOR	09/10/2002
SAFE SLEEP POLICY	12/11/2015
LINES OF ADMINISTRATIVE AUTHORITY	04/27/2009
JOB RESPONSIBILITIES	06/15/2005
CHILD CARE PRACTICES	06/15/2005
POLICIES	06/15/2005
SAMPLE WEEKLY MENU	08/28/2001
SAMPLE FORMS	08/28/2001
DAILY SCHEDULE	08/28/2001
OWNER/PROVIDER REFERENCES	07/05/2001
DISCIPLINE POLICIES	03/03/2010
LLC ARTICLES OF ORGANIZATION	05/24/1993
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/06/2019
LOCAL ZONING APPROVAL	08/28/2008
DIRECTOR'S QUALIFICATIONS	01/30/2020
APPLICATION	08/25/2020
STAFF SHEET	08/27/2020
EQUIPMENT LIST	08/29/2022
ANNUAL DECLARATION	08/29/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	08/29/2022
FIRE/SAFETY INSPECTION	10/03/2022
CERTIFICATE OF GOOD STANDING	10/21/2021
SANITATION INSPECTION	06/01/2022

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.

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 Violation
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