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

000670635

(660) 457-3603

302 STATE HWY M
GLENWOOD
MO  63541

NORTHEAST MISSOURI COMMUNITY ACTION AGENCY



 

GOTTMAN, KRISTIE JUNE

kgottman@capnemo.org

Incorporated

BETHANY CARREL DUCKWORTH

6 WEEKS - 5 YEARS

28

GROUP HOME AND CENTER

8 CHILDREN UNDER 24 MONTHS; LIMITED TO 4 CHILDREN UNDER 12 MONTHS
 
Inspection Information

02/22/2024

12:00 PM

12:13 PM

UNANNOUNCED

REINSPECTION

2464605214


DocumentDocument-Date
SAMPLE WEEKLY MENU 03/24/1997
JOB RESPONSIBILITIES 03/24/1997
LINES OF ADMINISTRATIVE AUTHORITY 01/06/2010
ARTICLES OF INCORPORATION 03/24/1997
DISCIPLINE POLICIES 12/09/2013
POLICIES 12/09/2013
CERTIFICATE OF GOOD STANDING 12/18/2013
CHILD CARE PRACTICES 01/06/2016
DIRECTOR'S QUALIFICATIONS 10/24/2018
APPLICATION 09/16/2019
DIAGRAM/INDOOR 09/02/2020
DAILY SCHEDULE 09/02/2020
STAFF SHEET 09/02/2020
DIAGRAM/OUTDOOR 09/02/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 09/14/2020
SAFE SLEEP POLICY 09/14/2020
SANITATION INSPECTION 11/01/2023
EQUIPMENT LIST 10/13/2023
ANNUAL DECLARATION 10/13/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 10/13/2023
FIRE/SAFETY INSPECTION 02/13/2024




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.
Attendance at Time of Inspection
Total Staff 6
Total Children 18
StaffChildClass AgeNote
2 8 MIXED Staff: Stephanie Graves and Latreasa White. Age range 5 months to 2 years. Four 2 year old children.
2 10 MIXED Staff: Kristie Gottman and Roberta Beeler. Age range 3 years through 5 years.
2 0 NO CHILDREN IN ATTENDANCE Staff: Debbie Kelso and Rob Lewis. Not counted in child/staff ratio at time of inspection.

Compliance List
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
Violation
 Provider Comments
Violation
The annual fire safety inspection was not approved.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee.
Correction Required
The facility shall submit evidence of compliance with annual fire safety requirements.

Correction Verification
Submit Documentation

Compliance Date
2/14/2024
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
2/14/2024
Violation
The Family Care Safety Registry check was not conducted for James Robertson 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
2/14/2024
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
Infant sleeping requirements were not met as evidenced by soft materials or objects were placed under a sleeping infant in that the crib had a rolled up blanket under the mattress to keep the mattress elevated.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (1) (B) 2. F. states: Soft materials or objects such as pillows, quilts, comforters, or sheepskins, even if covered by a sheet, shall not be placed under a sleeping infant. If a mattress cover to protect against wetness is used, it shall be tightly fitting and thin.
Correction Required
Infant sleeping requirements shall be met.

Correction Verification
Submit Documentation

Compliance Date
2/22/2024
5 CSR 25-500.102 Personnel
Not Observed
5 CSR 25-500.112 Staff/Child Ratios
Not Observed
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
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: Stephanie Graves (needs 2nd page).
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
2/14/2024
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