DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

DOUGLASS COMMUNITY SERVICES, INCORPORATED

002558647

(660) 395-1455

406 BLEES INDUSTRIAL DR
MACON
MO  63552-4451

DOUGLASS COMMUNITY SERVICES, INCORPORATED

909 BROADWAY
HANNIBAL
MO  63401-4249

KEUNE, KIMBERLY DENISE

maconccpcm@douglassonline.org

Incorporated

BETHANY DUCKWORTH

6 WEEKS - 35 MONTHS

16

GROUP HOME AND CENTER

 
Inspection Information

01/30/2026

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2507384787


DocumentDocument-Date
DIAGRAM/INDOOR 01/18/2016
SAMPLE WEEKLY MENU 01/08/2016
SAMPLE FORMS 01/08/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN 01/08/2016
ARTICLES OF INCORPORATION 09/15/2017
DAILY SCHEDULE 01/08/2016
DIAGRAM/OUTDOOR 07/11/2018
DIRECTOR'S QUALIFICATIONS 12/21/2018
JOB RESPONSIBILITIES 06/18/2018
SAFE SLEEP POLICY 05/06/2019
LINES OF ADMINISTRATIVE AUTHORITY 05/06/2019
LOCAL ZONING APPROVAL 10/28/2019
APPLICATION 10/15/2019
DISCIPLINE POLICIES 11/12/2019
POLICIES 11/12/2019
STAFF SHEET 12/22/2025
CHILD CARE PRACTICES 11/12/2019
CERTIFICATE OF GOOD STANDING 11/22/2021
SANITATION INSPECTION 01/22/2026
EQUIPMENT LIST 11/13/2025
FIRE/SAFETY INSPECTION 10/07/2025
ANNUAL DECLARATION 11/13/2025
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 11/13/2025




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.

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
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Kierra Johnson
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

Correction Verification
Submit Documentation

Compliance Date
1/29/2026
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
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
Violation
 Provider Comments
Violation
There was no certification by a licensed physician for a medical exemption on file for one child(ren).
Licensing Rule Reference
5 CSR 25-500.192 Health Care (4) (B) 2. A. states: A medical exemption (see form at 19 CSR 40-61.185), by which the child shall be exempted from immunization requirements upon certification by a licensed physician that the immunization would seriously endanger the child's health or life;
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
1/29/2026
Violation
There was no parental written objection to immunizations on file for one child(ren).
Licensing Rule Reference
5 CSR 25-500.192 Health Care (4) (B) 2. B. states: A parent or guardian exemption, by which a child shall be exempted from immunization requirements if one (1) parent or guardian files a written objection to immunization with the day care administrator. Exemptions shall be accepted by the day care administrator when the necessary information as determined by the department is filed with the day care administrator by the parent or guardian. Exemption forms shall be provided by the department (see 19 CSR 40-61.185).
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
1/29/2026
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 older than five (5) years for Faith Whittle.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (5) states: Criminal background checks shall be completed for each child care staff member every five (5) years.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
1/29/2026
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