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

10/18/2024

12:07 PM

12:07 PM

UNANNOUNCED

SUPPLEMENTAL

2480283513


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: 2
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
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
Not Observed
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
The facility does not have an approved director on staff.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 3. states: The licensee is required to maintain an approved certificated group child care home provider or center director on staff.
Correction Required
The facility shall have an approved director/group home provider.

Correction Verification
Submit Documentation

Compliance Date

Violation
Safe sleep training was not completed within the past 3 years for the following staff Amanda Roberts, Sherry Camden. As of 10/18/2024 Amanda Roberts is no longer employed.
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
Not Observed
5 CSR 25-500.122 Medical Examination Reports
Not Observed
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
10/15/2024
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
10/15/2024
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
10/15/2024
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
10/15/2024
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
10/15/2024
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
10/15/2024
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