DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-EMERSON BRANCH- COLD WATER ELEMENTARY

000180030

(314) 409-8702

1105 WIETHAUPT
FLORISSANT
MO  63031

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3390 PERSHALL RD
ST LOUIS
MO  63135-1407

BLAKELY, KRISTY

mark.pacatte@gwrymca.org

Incorporated

BARBARA R GREENLAND

5 YEARS - 13 YEARS

32

SCHOOL AGE

 
Inspection Information

10/31/2016

4:00 PM

5:03 PM

UNANNOUNCED

COMPLIANCE MONITORING

2292607752


DocumentDocument-Date
DIRECTOR'S QUALIFICATIONS 08/23/2012
SAMPLE WEEKLY MENU 08/31/1983
SAMPLE FORMS 08/31/1983
POLICIES 08/31/1983
LINES OF ADMINISTRATIVE AUTHORITY 08/31/1983
JOB RESPONSIBILITIES 08/31/1983
DISCIPLINE POLICIES 08/31/1983
DIRECTOR'S JOB RESPONSIBILITIES 08/31/1983
DAILY SCHEDULE 08/31/1983
ARTICLES OF INCORPORATION 08/31/1983
APPLICATION 04/13/2015
CERTIFICATE OF GOOD STANDING 04/22/2015
STAFF SHEET 04/13/2015
EQUIPMENT LIST 04/22/2015




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 11
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 1
Total Children 17
StaffChildClass AgeNote
1 17 SCHOOL AGE Ms. Angie Brewer, group leader, was present with seventeen children ages five to ten years of age.

 
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
Violation
 Provider Comments
Violation
The facility did not review with staff use of fire extinguishers.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (3) (B) 4. states: The use of fire extinguishers.
Correction Required
Facility must review emergency plan with staff as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not review with staff use of and response to fire alarms.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (3) (B) 3. states: The use of and response to fire alarms;
Correction Required
Facility must review emergency plan with staff as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not review with staff disaster procedures in the various possible emergency situations.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (3) (B) 2. states: Disaster drill procedures such as fire drill, tornado drill, carbon monoxide exposure, power failure, bomb threat, chemical spill, intruder training, and CPR or other medical procedures;
Correction Required
Facility must review emergency plan with staff as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility did not review with staff their duties and responsibilities in the event of an emergency.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (3) (B) 1. states: Staff duties and responsibilities in the event of an emergency;
Correction Required
Facility must review emergency plan with staff as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Requirements of facilities participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility's evacuation route diagram was not posted in each room.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (B) 2. states: A diagram of evacuation routes from the room;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility’s list of emergency numbers was not posted in each room.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Caregiver-child ratio requirements were not met as evidenced by seventeen children ages five to ten years of age were cared for by one caregiver(s).
Licensing Rule Reference
19 CSR 30-62.112 Staff/Child Ratios (1) (D) states: Ages Five (5) and Up. Groups composed solely of five (5)-year olds and older shall have no less than one (1) adult to every sixteen (16) children;
Correction Required
Correct caregiver-child ratios shall be maintained.

Correction Verification
Return Inspection

Compliance Date

19 CSR 30-62.122 Medical Examination Reports
Compliance
19 CSR 30-62.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not met as evidenced by there was no plan on file for a child with special needs.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.
Correction Required
An individualized plan from a professional source shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Two child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (F) states: Field trip and transportation authorization.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
One child(ren) records did not include date care begins and ends.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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