MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA-MID COUNTY BRANCH-IVELAND ELEMENTARY

Facility DVN
000168830

Phone
(314) 493-6345

Physical Address
1836 DYER AVE
ST LOUIS
MO 63114

Owner
THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER ST LOUIS

Mailing Address
1900 URBAN DR
ST LOUIS
MO 63144

Provider/Director
HOLLINGSWORTH, BRENNAN G

E-mail Address
BHOLLINGSWORTH@YMCASTLOUIS.ORG

Incorporated
Incorporated

Child Care Specialist
DEBBIE ASHLOCK

Age Range
5 YEARS - 12 YEARS

Capacity
40

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
11/20/2015

Arrival Time
7:00 AM

Departure Time
8:31 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2267809351

Document	Document-Date
APPLICATION	11/10/2014
EQUIPMENT LIST	11/10/2014
STAFF SHEET	11/10/2014
ARTICLES OF INCORPORATION	01/02/2004
CERTIFICATE OF INCORPORATION	01/02/2004
CERTIFICATE OF GOOD STANDING	11/10/2014
CHILD CARE PRACTICES	01/06/1984
DAILY SCHEDULE	12/05/1983
DIRECTOR'S JOB RESPONSIBILITIES	12/05/1983
DIRECTOR'S QUALIFICATIONS	03/25/2013
DISCIPLINE POLICIES	01/06/1984
JOB RESPONSIBILITIES	01/06/1984
LINES OF ADMINISTRATIVE AUTHORITY	01/02/2004
POLICIES	05/01/1992
SAMPLE WEEKLY MENU	12/05/1983
SAMPLE FORMS	12/05/1983

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 1

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 3

Total Children 13

Staff	Child	Class Age	Note
3	13	SCHOOL AGE	with Alex, Tanisha and Alex