MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
THE BOYS AND GIRLS CLUB OF POPLAR BLUFF

Facility DVN
002373515

Phone
(573) 776-1690

Physical Address
1200 CAMP RD
POPLAR BLUFF
MO 63901

Owner
THE BOYS & GIRLS CLUB OF POPLAR BLUFF

Mailing Address
PO BOX 55
POPLAR BLUFF
MO 63902-0055

Provider/Director
TIPTON, JEANNA DAWN

E-mail Address
lesley@bgcpb.org

Incorporated

Child Care Specialist
MELISSA JILL SMITH

Age Range
5 YEARS - 7 YEARS

Capacity
100

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
10/12/2017

Arrival Time
3:50 PM

Departure Time
5:26 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2315409663

Document	Document-Date
SAMPLE WEEKLY MENU	11/20/2015
APPLICATION	03/06/2017
DAILY SCHEDULE	12/04/2012
POLICIES	12/04/2012
LINES OF ADMINISTRATIVE AUTHORITY	12/04/2012
DIRECTOR'S JOB RESPONSIBILITIES	12/04/2012
JOB RESPONSIBILITIES	12/04/2012
CHILD CARE PRACTICES	12/04/2012
SAMPLE FORMS	12/04/2012
DIRECTOR'S QUALIFICATIONS	04/18/2013
EQUIPMENT LIST	03/06/2017
STAFF SHEET	03/06/2017
ARTICLES OF INCORPORATION	03/18/2015
CERTIFICATE OF INCORPORATION	03/18/2015
DISCIPLINE POLICIES	12/04/2012

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 8

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 5

Total Children 43

Staff	Child	Class Age	Note
2	10	SCHOOL AGE	Staff: Matt Smith and Mrs. Tipton
2	16	SCHOOL AGE	Staff: Elisha Stout and Jessica Billington Also present in this room, but not counting in staff/child ratio: Mrs. DeWitt (teacher at elementary school)
1	17	SCHOOL AGE	Staff: Skye Rush; also present, but not counting in staff/child ratio: Mrs. Hagar (school employee)