DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-FOUR RIVERS BRANCH-AUGUSTA ELEMENTARY

001481927

(636) 239-5704

5541 LOCUST ST
AUGUSTA
MO  63332

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

400 GRAND AVE
WASHINGTON
MO  63090-1204

MILLHEISER, MORGAN

dallas.pennock@gwrymca.org

Incorporated

DEBBIE ASHLOCK

5 YEARS - 12 YEARS

20

SCHOOL AGE

AFTER SCHOOL CARE ONLY
 
Inspection Information

10/25/2017

4:10 PM

5:04 PM

UNANNOUNCED

COMPLIANCE MONITORING

2316623074


DocumentDocument-Date
APPLICATION 07/09/2016
DIAGRAM/INDOOR 11/04/2015
DIAGRAM/OUTDOOR 11/04/2015
STAFF SHEET 07/06/2016
EQUIPMENT LIST 07/06/2016
ARTICLES OF INCORPORATION 07/09/2016
CERTIFICATE OF GOOD STANDING 07/09/2016
JOB RESPONSIBILITIES 07/06/2016
DIRECTOR'S QUALIFICATIONS 07/21/2016
DAILY SCHEDULE 07/06/2016
SAMPLE WEEKLY MENU 07/06/2016
POLICIES 07/06/2016
CHILD CARE PRACTICES 07/06/2016
DISCIPLINE POLICIES 07/06/2016
SAMPLE FORMS 07/06/2016
REGISTERING FICTITIOUS NAMES 08/01/2016
LINES OF ADMINISTRATIVE AUTHORITY 08/26/2016




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 8
StaffChildClass AgeNote
2 8 SCHOOL AGE with Morgan Millheiser, approved director and Patty Markee

 
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
Violation
 Provider Comments
Violation
The facility did not have a telephone in working order for incoming and outgoing calls as evidenced by the telephone was not working.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (A) 10. states: A telephone in working order shall be available for incoming and outgoing calls. If a telephone answering machine is used, it must be turned on so incoming messages can be heard and parents' calls can be returned promptly.
Correction Required
A working telephone and answering machine shall be used as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
The director is not routinely on duty as required, as evidenced by Morgan Millheiser only works 2 days a week (Monday and Wednesday) because of school and another job.
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

Violation
The requirements for documentation of 12 clock hours of annual training were not met as evidenced by there were no training documents on file. The staff listed need the following documentation: Morgan Millheiser did not have 12 clock hours on training certificates on file for 2016.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (A) states: The center director, group day care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each year of employment in training which is approved by the department in: health, safety, nutrition, guidance and discipline, appropriate activities and learning experiences for children, positive communication and interaction with parents, planning and setting up an appropriate environment for children, professional and administrative practices, or other child related areas.
Correction Required
Required training hours shall be documented for each employee.

Correction Verification
Submit Documentation

Compliance Date

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 for Morgan Milleiser needs a TB risk assessment form on file.
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

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
Violation
 Provider Comments
Violation
The provider did not supply and serve food according to the Meal and Snack Food Chart as evidenced by Afternoon snack was Sunflower butter on wheat bread and water. One more food group is required.
Licensing Rule Reference
19 CSR 30-62.202 Nutrition and Food Service (1) (A) states: The provider shall supply and serve nourishing food according to the Meal and Snack Food Chart provided in this rule.
Correction Required
Nourishing food shall be provided as required.

Correction Verification
Return Inspection

Compliance Date

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 address 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

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