DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-EMERSON BRANCH-PARKER ROAD ELEMENTARY

000171782

(314) 831-2647

2800 PARKER RD
FLORISSANT
MO  63033

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3390 PERSHALL RD
ST LOUIS
MO  63135-1407

SMITH, BRANITRIA

LAURIE.MCTEARNEN@GWRYMCA.ORG

Incorporated

SHALINDA WALLACE

5 YEARS - 13 YEARS

70

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

03/22/2017

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2300105203


DocumentDocument-Date
DIAGRAM/OUTDOOR 08/05/2016
DIAGRAM/INDOOR 08/05/2016
SAMPLE FORMS 07/31/2016
DIRECTOR'S QUALIFICATIONS 08/04/2016
SAMPLE WEEKLY MENU 07/29/2016
STAFF SHEET 07/29/2016
REGISTERING FICTITIOUS NAMES 07/06/2016
POLICIES 07/29/2016
LOCAL FIRE DEPARTMENT NOTIFICATION 07/29/2016
LINES OF ADMINISTRATIVE AUTHORITY 07/29/2016
JOB RESPONSIBILITIES 07/29/2016
EQUIPMENT LIST 07/29/2016
DISCIPLINE POLICIES 07/29/2016
DAILY SCHEDULE 07/29/2016
CHILD CARE PRACTICES 07/29/2016
APPLICATION 07/06/2016




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.
Attendance at Time of Inspection
Total Staff 3
Total Children 24
StaffChildClass AgeNote
3 24 SCHOOL AGE Ms. Amanda, Ms. Jessica, and Mr. Keith

 
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
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
2/7/2017
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
2/7/2017
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
2/7/2017
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
2/7/2017
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
2/7/2017
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
The director is not routinely on duty as required, as evidenced by she is not currently working due to personal reasons.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (2) (A) 2. states: Center directors and group day care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group day care home provider shall be on duty at least fifty percent (50%) of the operating hours.
Correction Required
The director/group day care home provider shall be routinely on duty as required.

Correction Verification
Submit Documentation

Compliance Date
12/1/2016
Violation
In the absence of the center director, there was no responsible individual designated to be in charge of the facility.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (2) (A) 4. states: In the absence of the center director or group day care home provider, another responsible individual shall be designated to be in charge of the facility.
Correction Required
A responsible individual shall be designated to be in charge of the facility when the director/group day care home provider is not present.

Correction Verification
Submit Documentation

Compliance Date
12/1/2016
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
A school-age child's health report was not on file at the time of enrollment as evidenced by the school age health forms were not signed by a parent.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (2) (D) states: The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child's health history, any current health problems, and any restrictions necessary for the child's care.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/7/2017
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
2/7/2017
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
2/7/2017
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 required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for five child(ren).
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
2/7/2017
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 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
2/7/2017
Violation
Three child(ren) records did not include employers' 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
2/7/2017
Violation
Seven 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
2/7/2017
Violation
Four child(ren) records did not include work telephone number 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
2/7/2017
Violation
One child(ren) records did not include telephone number of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
2/7/2017
Violation
Four 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
2/7/2017
Violation
Records were not available for inspection by the department upon request as evidenced by two children's enrollment forms were not available for inspection.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (16) states: All records shall be available in the facility for inspection by the department upon request.
Correction Required
Records shall be available at the facility for inspection.

Correction Verification
Submit Documentation

Compliance Date
2/7/2017
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance