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

002817170

(660) 349-4046

200 PFEIFFER AVE
KIRKSVILLE
MO  63501-5044

NORTHEAST MISSOURI COMMUNITY ACTION AGENCY



 

BASS, CRYSTAL KAY

cbass@capnemo.org

Incorporated

BETHANY DUCKWORTH

BIRTH - 2 YEARS

12

GROUP HOME AND CENTER

4 CHILDREN UNDER 12 MONTHS
 
Inspection Information

06/16/2026

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2515089968


DocumentDocument-Date
APPLICATION 02/04/2021
ARTICLES OF INCORPORATION 10/29/1965
CERTIFICATE OF GOOD STANDING 01/31/2020
LOCAL ZONING APPROVAL 04/30/2021
LOCAL BUILDING APPROVAL 04/30/2021
DIRECTOR'S QUALIFICATIONS 10/30/2020
SAFE SLEEP POLICY 04/07/2021
SAMPLE WEEKLY MENU 04/07/2021
DAILY SCHEDULE 04/07/2021
JOB RESPONSIBILITIES 04/07/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN 04/07/2021
CHILD CARE PRACTICES 04/07/2021
DISCIPLINE POLICIES 04/07/2021
LINES OF ADMINISTRATIVE AUTHORITY 04/07/2021
DIAGRAM/INDOOR 04/07/2021
DIAGRAM/OUTDOOR 04/07/2021
POLICIES 04/07/2021
SAMPLE FORMS 04/07/2021
LICENSING ORIENTATION 02/10/2021
FIRE/SAFETY INSPECTION 01/29/2026
EQUIPMENT LIST 04/07/2026
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/07/2026
ANNUAL DECLARATION 04/07/2026
SANITATION INSPECTION 01/27/2026




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
Violation
 Provider Comments
Violation
The walls located in the north side of the I/T unit where the older I/T children are was/were not in good condition as evidenced by there was peeling paint and drywall underneath the window on the west wall, and north and south wall about table/chair height in various places.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 6. states: Walls, ceilings and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.
Correction Required
Walls, ceilings, and floors shall be made of approved materials, easily cleaned and in good condition.

Correction Verification
Submit Documentation

Compliance Date
6/10/2026
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 caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Kallie Wiltbank. Kallie was not listed on the MOPD report for NMCAA - 200 Pfeiffer Ave.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number from the department.
Correction Required
All caregivers shall obtain a MOPD ID.

Correction Verification
Submit Documentation

Compliance Date
6/10/2026
Violation
Kallie Wiltbank (no documentation available in MOPD system) did not complete safe sleep training within 30 days of employment or volunteering at the facility.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (4) (A) 3. states: The child care provider, group child care home provider, child care staff members, and volunteers shall complete safe sleep training described in subsection (4)(A) of this rule within thirty (30) days of employment or volunteering at the facility.
Correction Required
The department-approved safe sleep training must be completed within 30 days of employment or volunteering.

Correction Verification
Submit Documentation

Compliance Date
6/10/2026
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 Kallie Wiltbank 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
Submit Documentation

Compliance Date
6/10/2026
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: Kallie Wiltbank.
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
6/10/2026
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