DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA FOUR RIVERS BRANCH BEAUFORT ELEMENTARY

002369360

(314) 443-4357

3200 HWY 50
BEAUFORT
MO  63013

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

400 GRAND AVE
WASHINGTON
MO  63090-1204

SOUDERS, NANCY

melissa.mueller@gwrymca.org

Incorporated

LEATRICE L DIXON

5 YEARS - 12 YEARS

20

SCHOOL AGE

 
Inspection Information

12/01/2017

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2318962834


DocumentDocument-Date
CERTIFICATE OF INCORPORATION 08/20/2014
SAMPLE FORMS 08/19/2014
STAFF SHEET 08/19/2014
SAMPLE WEEKLY MENU 08/19/2014
POLICIES 08/19/2014
LOCAL FIRE DEPARTMENT NOTIFICATION 08/13/2014
JOB RESPONSIBILITIES 08/19/2014
DISCIPLINE POLICIES 08/19/2014
LINES OF ADMINISTRATIVE AUTHORITY 08/19/2014
CERTIFICATE OF GOOD STANDING 08/19/2014
ARTICLES OF INCORPORATION 08/19/2014
DAILY SCHEDULE 08/19/2014
CHILD CARE PRACTICES 08/19/2014
REGISTERING FICTITIOUS NAMES 08/06/2014
EQUIPMENT LIST 08/13/2014
APPLICATION 08/06/2014
DIRECTOR'S JOB RESPONSIBILITIES 10/27/2014
DIRECTOR'S QUALIFICATIONS 08/25/2015




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
Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
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: Nancy Souders (needs 12 clock hours 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
10/30/2017
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
12/1/2017
Violation
The provider did not meet requirements for requests/results of background reviews. Reviews were missing/out of date for the following owner(s), board president or chairperson, center director or group day care home provider, employees or volunteers counted in staff/child ration: Ryan Doepke.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (L) states: The child care provider shall request and have on file the results of a criminal record review from the Missouri State Highway Patrol as defined by 19 CSR 30-62.042 Initial Licensing Information and 19 CSR 30-62.052 License Renewal. The child care provider shall request a criminal record review within ten (10) days following a change of the facility owner(s), board president or chairperson, the center director or group day care home provider, employees of the provider, or volunteers counted in staff/child ratios. The department may request a criminal record review from the Missouri State Highway Patrol for any adult present in the facility when child care children are present. The criminal record reviews shall include records of criminal convictions, pending criminal charges, and suspended imposition of sentence during the term of probation. Requests for criminal record reviews shall be made on a form provided by the highway patrol.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
12/1/2017
Violation
The provider did not meet requirements for requests/results of background reviews. Reviews were missing/out of date for the following volunteers counted in staff/child ratio, caregivers or other personnel: Ryan Doepke.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (K) states: Volunteers counted in staff/child ratios, caregivers, and other personnel shall be screened for child abuse/neglect. The screening shall be requested by the provider within ten (10) days of any individual beginning employment or volunteering in the facility. Any investigated allegation of child abuse or neglect involving these persons in which the investigator finds reasonable cause to believe that the individual is the alleged perpetrator of child abuse or neglect shall be evaluated by the department. After review, the department may prohibit the person from being present in the facility during child care hours. A copy of the screening request and the response shall be filed in the employee's record.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
12/1/2017
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report 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
12/1/2017
Violation
Medical examination report was not on file for Ryan Doepke (worked 10.4.17 at the site/exact start date unknown) as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
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
12/1/2017
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
one 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
11/9/2017
Violation
two 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
11/8/2017
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance