MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA- EMERSON BRANCH- JAMESTOWN ELEMENTARY

Facility DVN
001873398

Phone
(314) 452-3065

Physical Address
13750 OLD JAMESTOWN ROAD
ST LOUIS
MO 63033

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
3390 PERSHALL RD
ST LOUIS
MO 63135

Provider/Director
WILLIAMS, TIFFANY MICHELLE

E-mail Address
mark.pacatte@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
DENISE ELAYNE KOCH

Age Range
5 YEARS - 13 YEARS

Capacity
20

Facility Type
SCHOOL AGE

Limitations
20 SCHOOL-AGE CHILDREN DURING THE SCHOOL YEAR; 20 SCHOOL-AGE CHILDREN DURING THE SUMMER

Inspection Information

Date
10/18/2016

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2291366076

Document	Document-Date
DISCIPLINE POLICIES	03/26/2012
SAMPLE WEEKLY MENU	03/26/2012
DIRECTOR'S QUALIFICATIONS	12/23/2015
LINES OF ADMINISTRATIVE AUTHORITY	03/26/2012
CHILD CARE PRACTICES	03/26/2012
ARTICLES OF INCORPORATION	03/26/2012
JOB RESPONSIBILITIES	03/26/2012
DAILY SCHEDULE	03/26/2012
POLICIES	03/26/2012
CERTIFICATE OF GOOD STANDING	09/08/2012
STAFF SHEET	10/14/2016
EQUIPMENT LIST	10/14/2016
APPLICATION	09/26/2016

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

Compliance

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 3 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 10/17/2016

RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.

Compliance