DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

TWIN PIKE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION INC

002064359

(573) 324-9991

500 SCHOOL ST
FRANKFORD
MO  63441

TWIN PIKE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION INC

614 KELLY LN TWIN PIKE FAMILY YMCA
LOUISIANA
MO  63353

LARSON, MICHELLE

YMCALATCHKEY@SBCGLOBAL.NET

Incorporated

CHRISTINA BRUCE

5 YEARS - 12 YEARS

32

SCHOOL AGE

 
Inspection Information

03/13/2017

3:10 PM

4:01 PM

ANNOUNCED

RENEWAL

2301069860


DocumentDocument-Date
SAMPLE FORMS 09/05/2007
POLICIES 10/01/2007
LOCAL FIRE DEPARTMENT NOTIFICATION 09/05/2007
LINES OF ADMINISTRATIVE AUTHORITY 09/05/2007
JOB RESPONSIBILITIES 09/05/2007
SAMPLE WEEKLY MENU 09/05/2007
DISCIPLINE POLICIES 10/01/2007
DIRECTOR'S QUALIFICATIONS 12/03/2012
DIRECTOR'S JOB RESPONSIBILITIES 09/05/2007
DAILY SCHEDULE 09/05/2007
CHILD CARE PRACTICES 10/01/2007
CERTIFICATE OF GOOD STANDING 03/07/2013
CERTIFICATE OF INCORPORATION 09/05/2007
ARTICLES OF INCORPORATION 09/05/2007
APPLICATION 03/02/2015
EQUIPMENT LIST 03/24/2015
STAFF SHEET 03/24/2015




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 2
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 2
Total Children 12
StaffChildClass AgeNote
2 12 SCHOOL AGE Kathy and Cindy are the caregivers.

 
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 did not include a completed Risk Assessment for Tuberculosis form.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (B) states: Medical examination reports shall include a “Risk Assessment for Tuberculosis” form, included herein, completed and signed by a health care professional, as provided by the Missouri Department of Health and Senior Services (MDHSS). If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
TB reports shall be on file as required

Correction Verification
Submit Documentation

Compliance Date

Violation
Medical examination report was not on file for Chanae Bowman, Julie Colbert, Skyler Durham, Michelle Larson, and Kathryn Miller as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
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

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