DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA FOUR RIVERS BRANCH BEAUFORT ELEMENTARY

002369360

(314) 443-4357

3200 HWY 50
BEAUFORT
MO  63013

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

400 GRAND AVE
WASHINGTON
MO  63090-1204

SOUDERS, NANCY

dallas.pennock@gwrymca.org

Incorporated

BROOKE POSKIN

5 YEARS - 13 YEARS

20

SCHOOL AGE

 
Inspection Information

04/27/2016

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2277498065


DocumentDocument-Date
CERTIFICATE OF INCORPORATION 08/20/2014
SAMPLE FORMS 08/19/2014
STAFF SHEET 08/19/2014
SAMPLE WEEKLY MENU 08/19/2014
POLICIES 08/19/2014
LOCAL FIRE DEPARTMENT NOTIFICATION 08/13/2014
JOB RESPONSIBILITIES 08/19/2014
DISCIPLINE POLICIES 08/19/2014
LINES OF ADMINISTRATIVE AUTHORITY 08/19/2014
CERTIFICATE OF GOOD STANDING 08/19/2014
ARTICLES OF INCORPORATION 08/19/2014
DAILY SCHEDULE 08/19/2014
CHILD CARE PRACTICES 08/19/2014
REGISTERING FICTITIOUS NAMES 08/06/2014
EQUIPMENT LIST 08/13/2014
APPLICATION 08/06/2014
DIRECTOR'S JOB RESPONSIBILITIES 10/27/2014
DIRECTOR'S QUALIFICATIONS 08/25/2015




Inspection determined facility to be in compliance with 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.

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Initial Licensing Information
Compliance
19 CSR 30-62.052 License Renewal
Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Compliance
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Nancy Souders as evidenced by the medical examination was not signed by the required medical source.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (A) states: All persons working in a day 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
4/6/2016
19 CSR 30-62.132 Admission Policies and Procedures
Compliance
19 CSR 30-62.172 Emergency School Closings
Compliance
19 CSR 30-62.182 Child Care Program
Compliance
19 CSR 30-62.192 Health Care
Compliance
19 CSR 30-62.202 Nutrition and Food Service
Compliance
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Violation
 Provider Comments
Violation
1 child(ren) records did not include work schedule of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
4/26/2016
Violation
1 child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
4/26/2016
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance