MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

Facility DVN
002056573

Phone
(417) 451-8620

Physical Address
301 BIG SPRING DR
NEOSHO
MO 64850

Owner
TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
4701 CHOUTEAU AVE
NEOSHO
MO 64850-9123

Provider/Director
ENSLOW, COURTNEY RENEE

E-mail Address
tinaferguson@crowder.edu

Incorporated
Incorporated

Child Care Specialist
PENNY KREITZER

Age Range
5 YEARS - 12 YEARS

Capacity
20

Facility Type
SCHOOL AGE

Limitations
AFTER SCHOOL CARE ONLY

Inspection Information

Date
11/17/2017

Arrival Time
1:15 PM

Departure Time
1:38 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2318193132

Document	Document-Date
CERTIFICATE OF GOOD STANDING	04/10/2015
STAFF SHEET	04/18/2017
EQUIPMENT LIST	04/18/2017
APPLICATION	02/14/2017

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.

Attendance at Time of Inspection

Total Staff 2

Total Children 6

Staff	Child	Class Age	Note
2	6	SCHOOL AGE