MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
SOUTH CENTRAL MISSOURI COMMUNITY ACTION AGENCY

Facility DVN
000606982

Phone
(573) 996-5059

Physical Address
1 HOSPITAL DR
DONIPHAN
MO 63935-1274

Owner
SOUTH CENTRAL MISSOURI COMMUNITY ACTION AGENCY

Mailing Address
PO BOX 158
DONIPHAN
MO 63935-0158

Provider/Director
ROBERTS, AMANDA RENEE

E-mail Address
SCMCAA@HOTMAIL.COM

Incorporated
Incorporated

Child Care Specialist
LESLEY WARREN

Age Range
BIRTH - 5 YEARS

Capacity
83

Facility Type
GROUP HOME AND CENTER

Limitations
16 CHILDREN IN THE INFANT/TODDLER UNIT

Inspection Information

Date
10/15/2024

Arrival Time
8:55 AM

Departure Time
11:32 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2480010780

Document	Document-Date
ANNUAL DECLARATION	09/03/2024
APPLICATION	07/13/2022
ARTICLES OF INCORPORATION	08/16/2022
CHILD CARE PRACTICES	08/16/2022
DIAGRAM/INDOOR	07/11/2022
DIAGRAM/OUTDOOR	07/11/2022
CERTIFICATE OF GOOD STANDING	08/16/2022
DAILY SCHEDULE	08/16/2022
DIRECTOR'S QUALIFICATIONS	08/11/2022
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/16/2022
DISCIPLINE POLICIES	08/16/2022
EQUIPMENT LIST	09/03/2024
JOB RESPONSIBILITIES	08/16/2022
LINES OF ADMINISTRATIVE AUTHORITY	08/16/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	09/03/2024
SAMPLE FORMS	08/16/2022
SAFE SLEEP POLICY	08/16/2022
SAMPLE WEEKLY MENU	08/16/2022
POLICIES	08/16/2022
LOCAL BUILDING APPROVAL	08/16/2022
FIRE/SAFETY INSPECTION	07/30/2024
SANITATION INSPECTION	08/26/2024

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 7

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 22

Total Children 65

Staff	Child	Class Age	Note
3	6	INFANTS AND TODDLERS	Caregivers Sydnee Holland, Norma Arnold, Education Mentor Janie Evans 4 months - 2 years old
3	6	INFANTS AND TODDLERS	Caregivers Sarah Brown, Abigail Kallbreier and Rayanna Crook 11 months - 23 months
2	7	MIXED	Caregivers Shannon Griffith and Sherry Camden 5- 2 year olds 2- 3 year olds
2	7	MIXED	Caregivers Jenifer Parres and Jackee McKinney 6- 2 year olds 1- 3 year old
3	0	NO CHILDREN IN ATTENDANCE	Family Advocate and Designated Person on Charge Kristy Ward Family Advocste Kellie Barlow Cook Samantha Labryer
3	11	PRESCHOOL	Caregivers Benita Campbell, Jennifer Perran and Cearra Parish 11- 3 years old - 5 years old
3	13	PRESCHOOL	Caregivers Rose Reynolds, Caitlin Carlile and Harley Sappington 13- 3 years old - 4 years old
3	15	PRESCHOOL	Caregivers Felicia Rank, Skye Collins, and Shannon Martin 15- 3 years old - 5 years old

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 Compliance
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 Violation
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 Violation
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