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

000670653

(660) 727-2622

157 E COMMERCIAL ST
KAHOKA
MO  63445-1701

NORTHEAST MISSOURI COMMUNITY ACTION AGENCY

PO BOX 966
KIRKSVILLE
MO  63501


rdunlap@capnemo.org

Incorporated

BETHANY DUCKWORTH

36 MONTHS - 5 YEARS

20

GROUP HOME AND CENTER

 
Inspection Information

03/07/2025

10:45 AM

1:09 PM

UNANNOUNCED

COMPLIANCE MONITORING

2488580512


DocumentDocument-Date
DAILY SCHEDULE 04/16/2018
CHILD CARE PRACTICES 08/29/2008
DISCIPLINE POLICIES 08/29/2008
LINES OF ADMINISTRATIVE AUTHORITY 08/29/2008
POLICIES 08/29/2008
ARTICLES OF INCORPORATION 09/30/1996
JOB RESPONSIBILITIES 09/30/1996
LOCAL ZONING APPROVAL 09/30/1996
DIRECTOR'S QUALIFICATIONS 06/19/2015
SAMPLE WEEKLY MENU 09/30/1996
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/29/2008
DIAGRAM/INDOOR 09/30/1996
DIAGRAM/OUTDOOR 09/30/1996
CERTIFICATE OF GOOD STANDING 04/17/2018
APPLICATION 01/14/2020
STAFF SHEET 01/14/2020
FIRE/SAFETY INSPECTION 11/04/2024
EQUIPMENT LIST 02/20/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/08/2024
ANNUAL DECLARATION 02/08/2024
SANITATION INSPECTION 12/20/2024




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 6
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 4
Total Children 9
StaffChildClass AgeNote
1 9 MIXED Staff: Marcia Stewart. Age range 3 years through 5 years.
3 0 NO CHILDREN IN ATTENDANCE Staff: Tonya Irvin, Chris Shoup (cook), and Haley Duncan (cook) Not counted in staff/child ratio at time of inspection.

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 equipment list was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (C) states: A current list of available equipment.
Correction Required
The facility shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The staff sheet was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (D) states: A current staff sheet.
Correction Required
The facility shall submit a current staff sheet as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.
Correction Required
The facility shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The Family Care Safety Registry check was not conducted for Tonya Irvin, Christina Shoup, Marcia Stewart, and Gloria Mohr 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

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
The director was not approved as evidenced by Christina Shoup retired in October, 2024 and the center does not have an approved director.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 1. . states: An approved certificated group child care home provider or center director shall be an adult who is responsible for planning, monitoring, and managing the facility’s daily program.
Correction Required
The director or group home provider shall be an approved, certificated adult who is responsible for the daily program.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.112 Staff/Child Ratios
Compliance
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: Tonya Irvin (Form needs signed by medical professional).
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

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
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