DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

DOUGLASS COMMUNITY SERVICES, INCORPORATED

000659630

(660) 263-7421

707 SINNOCK
MOBERLY
MO  65270

DOUGLASS COMMUNITY SERVICES, INCORPORATED

909 BROADWAY
HANNIBAL
MO  63401-4249

BOSS, SUSAN MARIE

moberlycm@douglassonline.org

Incorporated

SUSAN MARIE DOUGLAS

36 MONTHS - 5 YEARS

60

GROUP HOME AND CENTER

 
Inspection Information

04/04/2023

12:00 PM

1:51 PM

UNANNOUNCED

COMPLIANCE MONITORING

2444355147


DocumentDocument-Date
SAMPLE FORMS 04/13/2022
POLICIES 04/02/2008
LINES OF ADMINISTRATIVE AUTHORITY 10/06/2004
DISCIPLINE POLICIES 04/18/2008
JOB RESPONSIBILITIES 10/06/2004
DIRECTOR'S QUALIFICATIONS 10/06/2004
ARTICLES OF INCORPORATION 10/06/2004
CHILD CARE PRACTICES 04/18/2008
DAILY SCHEDULE 10/06/2004
DIAGRAM/OUTDOOR 10/06/2004
DIAGRAM/INDOOR 10/06/2004
LOCAL ZONING APPROVAL 10/06/2004
LOCAL BUILDING APPROVAL 10/06/2004
APPLICATION 04/24/2020
STAFF SHEET 07/01/2020
CERTIFICATE OF GOOD STANDING 02/14/2023
EQUIPMENT LIST 04/04/2023
SANITATION INSPECTION 11/15/2021
ANNUAL DECLARATION 02/13/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/14/2023
SAMPLE WEEKLY MENU 10/06/1994
FIRE/SAFETY INSPECTION 12/14/2022
DISASTER AND EMERGENCY PREPAREDNESS PLAN 04/13/2022




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 2
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 21
StaffChildClass AgeNote
1 9 MIXED Esther Daves, staff was present with 9 children ages 3 to 5.
2 12 MIXED Katie Ferguson, staff and Sativa Cotten , staff were present with 12 children ages 3 to 5. Volunteer not counted in ratio Wanda Cason.
5 0 NO CHILDREN IN ATTENDANCE Susan Boss, director, Nicole Kuiper cook, Becky Kendrick staff, Kristen Rutherford, staff and Shameacke Bryant, staff were present at the inspection.

 
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 annual sanitation inspection was not approved.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (B) states: Evidence of compliance with local, state, or both, sanitation requirements.
Correction Required
The facility shall submit evidence of compliance with annual sanitation requirements.

Correction Verification
Submit Documentation

Compliance Date

Violation
The Family Care Safety Registry check was not conducted for Nicole Kuiper 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

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
The observed surface area under little tyke climber slide unit , from which a child might fall consists of grass.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (6) (A) 8. states: Concrete, asphalt, carpet, grass or bare soil is not an acceptable surface under outdoor equipment from which children might fall and be injured.
Correction Required
The facility shall not use concrete, asphalt, carpet, grass or bare soil under equipment from which a child might fall.

Correction Verification
Corrected on Site

Compliance Date
4/4/2023
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