DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-ST. CHARLES BRANCH-COVERDELL ELEMENTARY

000319364

(636) 443-4526

2475 W RANDOLPH
ST CHARLES
MO  63301

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3900 SHADY SPRINGS LN
ST PETERS
MO  63376

MCTEARNEN, LAURIE

LAURIE.MCTEARNEN@GWRYMCA.ORG

Incorporated

REGINA WATKINS

5 YEARS - 12 YEARS

32

SCHOOL AGE

 
Inspection Information

09/18/2017

2:45 PM

3:56 PM

UNANNOUNCED

COMPLIANCE MONITORING

2314211186


DocumentDocument-Date
JOB RESPONSIBILITIES 09/13/1988
POLICIES 09/13/1988
LINES OF ADMINISTRATIVE AUTHORITY 09/13/1988
SAMPLE FORMS 05/15/1992
REGISTERING FICTITIOUS NAMES 11/01/2012
DISCIPLINE POLICIES 09/13/1988
CHILD CARE PRACTICES 09/13/1988
SAMPLE WEEKLY MENU 10/05/2016
EQUIPMENT LIST 10/05/2016
STAFF SHEET 10/05/2016
APPLICATION 09/15/2016
CERTIFICATE OF GOOD STANDING 10/17/2016
DIRECTOR'S QUALIFICATIONS 10/18/2016




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 6
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 18
StaffChildClass AgeNote
2 18 SCHOOL AGE Autumn R. and Emily O. was present with 18 school age children in care today.

 
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’s special instructions for infants and non-ambulatory children were not posted in each room.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (B) 3. states: Any special instructions for infants and non-ambulatory children;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility’s name and phone number of the building’s owner/manager was not posted in each room.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (2) (B) 1. D. states: When a facility occupies space it does not own, the name and telephone number of the owner of the building or the building manager;
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
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
1 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

Violation
1 child(ren) records did not include name 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

Violation
1 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

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