MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
GRAND RIVER AREA FAMILY YMCA, INC.

Facility DVN
002547391

Phone
(660) 542-0011

Physical Address
207 E 9TH ST
CARROLLTON
MO 64633-2342

Owner
GRAND RIVER AREA FAMILY YMCA, INC.

Mailing Address
PO BOX 184
CARROLLTON
MO 64633-0184

Provider/Director
MCQUEEN, TERESA RENEE

E-mail Address
KLOCK@CARROLLCOUNTYAREAYMCA.ORG

Incorporated
Incorporated

Child Care Specialist
JILL EILEEN ZEIGENBEIN

Age Range
5 YEARS - 12 YEARS

Capacity
30

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
04/10/2018

Arrival Time
3:20 PM

Departure Time
3:56 PM

Notice
ANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2324933630

Document	Document-Date
EQUIPMENT LIST	02/13/2018
STAFF SHEET	02/13/2018
APPLICATION	01/24/2018
LOCAL FIRE DEPARTMENT NOTIFICATION	08/04/2016
DIRECTOR'S QUALIFICATIONS	09/09/2014
DIRECTOR'S JOB RESPONSIBILITIES	09/09/2014
DAILY SCHEDULE	09/15/2014
CHILD CARE PRACTICES	06/29/2015
DISCIPLINE POLICIES	06/29/2015
ARTICLES OF INCORPORATION	09/09/2015
SAMPLE WEEKLY MENU	08/04/2016
JOB RESPONSIBILITIES	09/09/2015
LINES OF ADMINISTRATIVE AUTHORITY	08/04/2016
POLICIES	06/29/2016

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 3

Total Children 21

Staff	Child	Class Age	Note
3	21	SCHOOL AGE


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 Compliance
19 CSR 30-62.112 Staff/Child Ratios Compliance
19 CSR 30-62.122 Medical Examination Reports Compliance
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 Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when. Compliance