DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

CENTRAL MISSOURI COMMUNITY ACTION

000280137

(573) 449-1575

403 PARK AVE STE B
COLUMBIA
MO  65201-4374

CENTRAL MISSOURI COMMUNITY ACTION

807B N PROVIDENCE RD
COLUMBIA
MO  65203-4359

POULSEN, ASHLEY LYNN

ashleyp@cmca.us

Incorporated

LU A GAINES

6 WEEKS - 5 YEARS

53

GROUP HOME AND CENTER

8 CHILDREN UNDER 24 MONTHS
 
Inspection Information

05/16/2023

9:59 AM

9:59 AM

UNANNOUNCED

SUPPLEMENTAL

2447377731


DocumentDocument-Date
DIRECTOR'S QUALIFICATIONS 03/27/2012
JOB RESPONSIBILITIES 10/12/1994
ARTICLES OF INCORPORATION 03/13/2006
CHILD CARE PRACTICES 09/25/2012
SAMPLE WEEKLY MENU 10/12/1994
DAILY SCHEDULE 09/10/2001
POLICIES 09/25/2012
DIAGRAM/OUTDOOR 09/10/2001
DIAGRAM/INDOOR 05/07/2001
LOCAL ZONING APPROVAL 02/01/1995
LOCAL BUILDING APPROVAL 02/01/1995
CERTIFICATE OF GOOD STANDING 11/22/2016
APPLICATION 12/05/2018
STAFF SHEET 12/05/2018
DISCIPLINE POLICIES 09/25/2012
DISASTER AND EMERGENCY PREPAREDNESS PLAN 01/22/2008
SAMPLE FORMS 09/25/2012
ANNUAL DECLARATION 01/04/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/04/2023
EQUIPMENT LIST 01/04/2023
FIRE/SAFETY INSPECTION 12/08/2022
SANITATION INSPECTION 11/18/2022




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
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
Not Observed
5 CSR 25-500.042 Licensing Process
Not Observed
5 CSR 25-500.052 Annual Requirements
Not Observed
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Not Observed
5 CSR 25-500.087 Fire Safety
Not Observed
5 CSR 25-500.090 Disaster and Emergency Preparedness
Not Observed
5 CSR 25-500.092 Furniture, Equipment and Materials
Violation
 Provider Comments
Violation
The seats of swings in the outdoor play area did not have lightweight seats of rubber, plastic, canvas or nylon as evidenced by tire swing seats are not lightweight material.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (3) (G) states: Swings shall have lightweight seats of rubber, plastic, canvas or nylon.
Correction Required
Swing seats shall be constructed of an approved material.

Correction Verification
Submit Documentation

Compliance Date
2/24/2023
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: Mahasin Awadelkarim need .50 hours, Michelle Merk needs 7.50 hours, and Stephanie Reuschling needs 1.50 hours.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.112 Staff/Child Ratios
Not Observed
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Michelle Merk, Sephanie Reuschling and Kimberly Yagel Garza 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
2/24/2023
Violation
A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: Michelle Merk, Stephanie Reuschling, and Kimberly Yagel Garza.
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 tuberculin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date
2/24/2023
5 CSR 25-500.132 Admission Policies and Procedures
Not Observed
5 CSR 25-500.142 Nighttime Care
Not Observed
5 CSR 25-500.162 Overlap Care of Children
Not Observed
5 CSR 25-500.172 Emergency School Closings
Not Observed
5 CSR 25-500.182 Child Care Program
Not Observed
5 CSR 25-500.192 Health Care
Not Observed
5 CSR 25-500.202 Nutrition and Food Service
Not Observed
5 CSR 25-500.212 Transportation and Field Trips
Not Observed
5 CSR 25-500.222 Records and Reports
Not Observed
5 CSR 25-600.020 General Requirements
Not Observed
5 CSR 25-600.040 Background Screening Findings
Not Observed
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. —
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed