DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

NORTHEAST MISSOURI COMMUNITY ACTION AGENCY

001380876

(660) 754-6288

505 WELSH DR
WAYLAND
MO  63472

NORTHEAST MISSOURI COMMUNITY ACTION AGENCY



 

WOLFE, JILL MARIE

kcampbell@capnemo.org

Incorporated

BETHANY CARREL DUCKWORTH

6 WEEKS - 5 YEARS

20

GROUP HOME AND CENTER

4 CHILDREN UNDER 24 MONTHS
 
Inspection Information

05/01/2023

9:48 AM

11:51 AM

UNANNOUNCED

COMPLIANCE MONITORING

2446319419


DocumentDocument-Date
SAMPLE FORMS 01/16/2014
SAMPLE WEEKLY MENU 01/16/2014
DAILY SCHEDULE 01/16/2014
CHILD CARE PRACTICES 01/16/2014
DIAGRAM/OUTDOOR 01/16/2014
DIAGRAM/INDOOR 01/16/2014
APPLICATION 01/20/2019
STAFF SHEET 03/12/2019
SAFE SLEEP POLICY 10/31/2018
LINES OF ADMINISTRATIVE AUTHORITY 01/16/2014
DISCIPLINE POLICIES 01/16/2014
POLICIES 01/16/2014
ARTICLES OF INCORPORATION 10/30/1967
JOB RESPONSIBILITIES 07/15/1999
CERTIFICATE OF GOOD STANDING 09/20/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 09/15/2020
DIRECTOR'S QUALIFICATIONS 02/24/2021
FIRE/SAFETY INSPECTION 02/06/2023
SANITATION INSPECTION 03/15/2022
EQUIPMENT LIST 02/27/2023
ANNUAL DECLARATION 02/27/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/27/2023




Inspection determined facility to be in compliance with licensing rules.
Compliance 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 1
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Staff: Kim Himenes No children in attendance. Head Start is closed on Mondays and CI Duckworth was not aware of this.

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
Violation
 Provider Comments
Violation
The annual sanitation inspection was not conducted.
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

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
Violation
 Provider Comments
Violation
One (Child B) child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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