DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA- EMERSON BRANCH- JAMESTOWN ELEMENTARY

001873398

(314) 953-4337

13750 OLD JAMESTOWN ROAD
ST LOUIS
MO  63033

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3390 PERSHALL RD
ST LOUIS
MO  63135

WILLIAMS, TIFFANY MICHELLE

mark.pacatte@gwrymca.org

Incorporated

DEBBIE ASHLOCK

5 YEARS - 13 YEARS

20

SCHOOL AGE

20 SCHOOL-AGE CHILDREN DURING THE SCHOOL YEAR; 20 SCHOOL-AGE CHILDREN DURING THE SUMMER
 
Inspection Information

12/06/2017

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2316138888


DocumentDocument-Date
DISCIPLINE POLICIES 03/26/2012
SAMPLE WEEKLY MENU 03/26/2012
LINES OF ADMINISTRATIVE AUTHORITY 03/26/2012
CHILD CARE PRACTICES 03/26/2012
ARTICLES OF INCORPORATION 03/26/2012
JOB RESPONSIBILITIES 03/26/2012
DAILY SCHEDULE 03/26/2012
POLICIES 03/26/2012
CERTIFICATE OF GOOD STANDING 09/08/2012
STAFF SHEET 10/14/2016
EQUIPMENT LIST 10/14/2016
APPLICATION 09/26/2016
DIRECTOR'S QUALIFICATIONS 12/23/2015




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.

 
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
11/14/2017
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
11/14/2017
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
11/14/2017
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
11/14/2017
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
The requirements for first aid and CPR training were not met as evidenced by at least one caregiver certified in first aid/CPR was not on site.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (O) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification and approved by the department. First aid/CPR training may count toward the annual clock hour training requirement.
Correction Required
Required certification in first aid/CPR shall be on file. At least one caregiver with the certification shall be on site as required.

Correction Verification
Submit Documentation

Compliance Date
11/14/2017
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Kimberlyn Miller's physical as evidenced by the medical examination was not signed by the required medical source.
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
11/14/2017
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
11/14/2017
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
11/14/2017
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
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