DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

SALT FORK YOUNG MENS CHRISTIAN ASSOCIATION

002487081

(660) 886-3993

467 S ELLSWORTH AVE
MARSHALL
MO  65340-1916

SALT FORK YOUNG MENS CHRISTIAN ASSOCIATION

740 E. YERBY ST.
MARSHALL
MO  65340

BARCENAS, MYRA

armstrong@saltforkymca.org

Incorporated

SUSAN MARIE DOUGLAS

5 YEARS - 12 YEARS

60

SCHOOL AGE

 
Inspection Information

04/02/2018

2:30 PM

4:05 PM

ANNOUNCED

RENEWAL

2328359610


DocumentDocument-Date
STAFF SHEET 04/02/2018
EQUIPMENT LIST 04/02/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 7
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 11
StaffChildClass AgeNote
3 11 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
Violation
 Provider Comments
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 Reviews were missing/out of date for the following owner(s), board president or chairperson, center director or group day care home provider, person(s) employed or volunteer(s) counted in staff/child ratio: board president and all staff.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (3) states: After the child care provider applies for renewal of the license, the provider shall request the results of a criminal record review from the Missouri State Highway Patrol for the child care provider, the owner(s), board president or chairperson, the center director or group day care home provider, all persons employed by the child care provider, and all volunteers counted in staff/child ratios. 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

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, or center director or group day care home provider: board president and all staff.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (2) states: The facility owner(s), board president or chairperson, and the center director or group day care home provider shall be screened for child abuse/neglect prior to renewal of the license.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
The application for renewal of the facility's license was not completed correctly as evidence by board president signature.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (1) states: An application for license renewal shall be filed at least sixty (60) days prior to expiration of the license. In addition, the following information is required:
Correction Required
The facility shall submit an application as required for renewal.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
The facility did not meet requirements for music and rhythm activities. The facility needed an additional 16 items in this category.
Licensing Rule Reference
19 CSR 30-62.092 Furniture, Equipment and Materials (2) (B) 2. F. states: Music and rhythm activities;
Correction Required
The facility shall provide appropriate equipment for children as required.

Correction Verification
Submit Documentation

Compliance Date

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: the following people need 12 hours of training for 2017, Allison, Michelle, Stephanie. Katelynn needs 4 hours for 2017..
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 Stephanie.
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
Compliance
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Violation
 Provider Comments
Violation
Records were not available for inspection by the department upon request as evidenced by Monthly fire drills .
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (16) states: All records shall be available in the facility for inspection by the department upon request.
Correction Required
Records shall be available at the facility for inspection.

Correction Verification
Submit Documentation

Compliance Date

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