MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA-FOUR RIVERS BRANCH-MARTHASVILLE ELEMENTARY

Facility DVN
000978858

Phone
(636) 231-2650

Physical Address
800 E MAIN
MARTHASVILLE
MO 63357

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
400 GRAND AVE
WASHINGTON
MO 63090

Provider/Director
MUELLER, MELISSA

E-mail Address
melissa.mueller@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
JOY LYNN NICHOLS

Age Range
5 YEARS - 12 YEARS

Capacity
32

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
05/01/2018

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2330356485

Document	Document-Date
STAFF SHEET	10/04/2017
EQUIPMENT LIST	10/04/2017
APPLICATION	09/01/2017
CERTIFICATE OF GOOD STANDING	12/14/2015
JOB RESPONSIBILITIES	11/09/2015
LINES OF ADMINISTRATIVE AUTHORITY	12/14/2015
SAMPLE FORMS	11/09/2015
SAMPLE WEEKLY MENU	11/09/2015
DAILY SCHEDULE	11/09/2015
DIRECTOR'S QUALIFICATIONS	12/01/2015
POLICIES	12/01/2015
REGISTERING FICTITIOUS NAMES	12/14/2015
DISCIPLINE POLICIES	12/01/2015
ARTICLES OF INCORPORATION	12/01/2015
DIRECTOR'S JOB RESPONSIBILITIES	12/01/2015

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 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 Violation
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