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

06/30/2023

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2449992705


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 05/26/2023
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: 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
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
5/26/2023
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
6/16/2023
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