DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

DOUGLASS COMMUNITY SERVICES, INCORPORATED

001584898

(573) 406-5574

2161 JOHNSON ST
HANNIBAL
MO  63401-5843

DOUGLASS COMMUNITY SERVICES, INCORPORATED

909 BROADWAY
HANNIBAL
MO  63401-4249

CAPP, ANNA LEE

EHSCM@DOUGLASSONLINE.ORG

Incorporated

BETHANY DUCKWORTH

6 WEEKS - 35 MONTHS

24

GROUP HOME AND CENTER

 
Inspection Information

04/09/2025

11:35 AM

12:56 PM

UNANNOUNCED

COMPLIANCE MONITORING

2490793725


DocumentDocument-Date
APPLICATION 02/22/2019
STAFF SHEET 04/04/2019
DIAGRAM/INDOOR 05/06/2010
DIAGRAM/OUTDOOR 05/06/2010
SAFE SLEEP POLICY 01/07/2016
DISCIPLINE POLICIES 02/26/2010
CHILD CARE PRACTICES 02/26/2010
POLICIES 02/26/2010
ARTICLES OF INCORPORATION 05/24/1993
JOB RESPONSIBILITIES 08/10/2006
LINES OF ADMINISTRATIVE AUTHORITY 08/17/2004
DAILY SCHEDULE 09/05/2002
SAMPLE WEEKLY MENU 09/10/2002
LOCAL BUILDING APPROVAL 09/05/2008
DISASTER AND EMERGENCY PREPAREDNESS PLAN 03/02/2021
DIRECTOR'S QUALIFICATIONS 09/18/2020
CERTIFICATE OF GOOD STANDING 02/26/2021
LOCAL ZONING APPROVAL 02/26/2021
FIRE/SAFETY INSPECTION 02/24/2025
EQUIPMENT LIST 02/25/2025
SANITATION INSPECTION 12/18/2024
ANNUAL DECLARATION 02/25/2025
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/25/2025




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 7
Total Children 10
StaffChildClass AgeNote
2 6 INFANTS AND TODDLERS Staff: Caroline Wolfemeyer and Alexis Keesey. Age range 4 months through 22 months.
2 4 MIXED Staff: Laura Keesey and Sharea Salmon. Age range 22 months through 2 years. Three 2 year old children.
3 0 NO CHILDREN IN ATTENDANCE Staff: Anna Capp, Gloria Smith, and Sarah Blake. 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
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
Background screening information was not kept confidential for Alexis Keesey and Caroline Wolfemeyer as their staff file was not available for review.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (Q) states: Background screening information received by the provider shall be retained in the individual’s file in a confidential manner and available for review.
Correction Required
Background screening information shall be kept confidential.

Correction Verification
Corrected on Site

Compliance Date
4/9/2025
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Alexis Keesey and Caroline Wolfemeyer as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Corrected on Site

Compliance Date
4/9/2025
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: Alexis Keesey and Caroline Wolfemeyer. The staff files were not available of premise for review.
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
Corrected on Site

Compliance Date
4/9/2025
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
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Alexis Keesey and Caroline Wolfemeyer Alexis' and Caroline's file were not avialable for review.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Corrected on Site

Compliance Date
4/9/2025
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