DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

SOUTH CENTRAL MISSOURI COMMUNITY ACTION AGENCY

000606982

(573) 996-5059

1 HOSPITAL DR
DONIPHAN
MO  63935-1274

SOUTH CENTRAL MISSOURI COMMUNITY ACTION AGENCY

PO BOX 158
DONIPHAN
MO  63935-0158

ROBERTS, AMANDA RENEE

SCMCAA@HOTMAIL.COM

Incorporated

LESLEY WARREN

BIRTH - 5 YEARS

83

GROUP HOME AND CENTER

16 CHILDREN IN THE INFANT/TODDLER UNIT
 
Inspection Information

10/15/2024

8:55 AM

11:32 AM

UNANNOUNCED

COMPLIANCE MONITORING

2480010780


DocumentDocument-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.
Compliance 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
StaffChildClass AgeNote
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
 Provider Comments
Violation
Safe sleep training was not completed within the past 3 years for the following staff Amanda Roberts, Sherry Camden.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) (A) . states: Every three (3) years, the child care provider, group child care home provider, child care staff members, and volunteers in a group child care home or child care center licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Policy Statement on sleep-related infant deaths. The Sleep-Related Infant Deaths: Updated 2022 Recommendations for Reducing Infant Deaths in the Sleep Environment, July 2022, is incorporated by reference in this rule, as published by the American Academy of Pediatrics and available at https://publications.aap.org/pediatrics/article/150/1/e2022057990/188304/Sleep-Related-Infant-Deaths-Updated-2022 or as published in PEDIATRICS Volume 150, Issue 1, July 2022. A copy can also be obtained from the Department of Elementary and Secondary Education, Office of Childhood, 205 Jefferson Street, PO Box 480, Jefferson City, MO 65102-0480 and at https://dese.mo.gov/governmental-affairs/deseadministrativerules/incorporated-reference-materials. This rule does not incorporate any subsequent amendments or additions.
Correction Required
The director, group home provider, other caregivers, and those volunteers counted in staff/child ratio, shall complete department-approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date

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
 Provider Comments
Violation
The provider did not have parental acknowledgement on file indicating the parent received a copy of the provider's policies.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. A. states: They have received a copy of the provider's policies pertaining to the admission, care and discharge of children;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not have parental acknowledgement on file indicating the parent has been informed that Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available for review.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. B. states: They have been informed that the Licensing Rules for Group Day Care Homes and Child Day Care Centers in Missouri are available in the facility for their review;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not have parental acknowledgement on file indicating the parent and provider have agreed on a plan for continuing communication.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. C. states: They and the provider have agreed on a plan for continuing communication regarding the child's development, behavior and individual needs;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not have parental acknowledgement on file indicating the parent understands and agrees that the child may not be accepted for care when ill.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. D. states: They understand and agree that the child may not be accepted for care when ill.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child(s) file did not have the parental acknowledgement they have received a copy of the provider's safe sleep policy.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. E. states: They have received a copy of the provider's safe sleep policy when enrolling children less than one (1) year of age.
Correction Required
Child enrollment information shall be completed and on file as requested.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by 1 child(s) file(s) did not have the parental acknowledgement they have been notified that they may request whether there are children for whom an immunization exemption has been filed for currently enrolled in or attending the facility.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (8) (E) 8. F. states: They have been notified that they may request notice at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility
Correction Required
Child enrollment information shall be completed and on file as requested.

Correction Verification
Submit Documentation

Compliance Date

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