DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA - OFALLON BRANCH- HAWTHORN ELEMENTARY

000176465

(314) 443-6240

166 BOONE HILLS DR
ST PETERS
MO  63376

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3451 PHEASANT MEADOW DR
O FALLON
MO  63368-7324

SCRIVENS, SUSAN

susan.scrivens@gwrymca.org

Incorporated

ALYSSA MARIE RILEY

5 YEARS - 12 YEARS

48

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

09/28/2016

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2289983804


DocumentDocument-Date
SAMPLE FORMS 05/15/1992
DAILY SCHEDULE 01/13/1983
DIRECTOR'S JOB RESPONSIBILITIES 01/10/1983
EQUIPMENT LIST 09/04/2013
APPLICATION 09/04/2013
CERTIFICATE OF GOOD STANDING 10/30/2013
STAFF SHEET 09/04/2013
POLICIES 08/05/1982




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
Violation
 Provider Comments
Violation
The requirements for first aid and CPR training were not met as evidenced by at least one caregiver for every 20 children in capacity was not certified in first aid/CPR in that only two staff members, Ms. Gloria and Ms. Latasia, have documentation of first aid/CPR certification. One additional staff member is needed.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (O) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification and approved by the department. First aid/CPR training may count toward the annual clock hour training requirement.
Correction Required
Required certification in first aid/CPR shall be on file. At least one caregiver with the certification shall be on site as required.

Correction Verification
Submit Documentation

Compliance Date
9/27/2016
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Compliance
19 CSR 30-62.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information as evidenced by 1 child did not have authorization for emergency medical care.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (8) (E) 4. states: Instructions for action to be taken if the parent(s) or physician designated by the parent(s) cannot be reached in an emergency and permission for emergency medical care;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/27/2016
Violation
The facility did not meet requirements for child enrollment and health information on file as evidenced by child(s) file(s) did not have the parental acknowledgement they have been notified that they may request whether there are children for whom an immunization exemption has been filed for currently enrolled in or attending the facility.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (8) (E) 8. F. states: They have been notified that they may request notice at initial enrollment in or attendance at the facility or upon request of whether there are children for whom an immunization exemption has been filed currently enrolled in or attending the facility.
Correction Required
Child enrollment information shall be completed and on file as requested.

Correction Verification
Submit Documentation

Compliance Date
9/27/2016
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 2 immunization record(s) was/were not on file .
Licensing Rule Reference
19 CSR 30-62.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/27/2016
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 home address 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
9/27/2016
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance