DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-SOUTH COUNTY BRANCH-FORDER ELEMENTARY

000186310

(314) 467-5688

623 W RIPA AVE
ST LOUIS
MO  63125

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

12736 SOUTHFORK RD
ST LOUIS
MO  63128

WILLIAMS, DEBRA LYNN

LAURIE.MCTEARNEN@GWRYMCA.ORG

Incorporated

CHAZ CRABTREE

5 YEARS - 12 YEARS

40

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

05/10/2018

2:45 PM

4:21 PM

ANNOUNCED

RENEWAL

2331118513


DocumentDocument-Date
STAFF SHEET 04/04/2018
EQUIPMENT LIST 05/10/2018
APPLICATION 04/04/2018
SAMPLE WEEKLY MENU 09/04/1985
SAMPLE FORMS 09/04/1985
POLICIES 09/04/1985
LINES OF ADMINISTRATIVE AUTHORITY 09/04/1985
JOB RESPONSIBILITIES 09/04/1985
DISCIPLINE POLICIES 09/04/1985
DIRECTOR'S JOB RESPONSIBILITIES 09/04/1985
DAILY SCHEDULE 09/04/1985
CERTIFICATE OF INCORPORATION 02/25/1998
ARTICLES OF INCORPORATION 02/25/1998
CHILD CARE PRACTICES 09/04/1985
DIRECTOR'S QUALIFICATIONS 01/09/2007
CERTIFICATE OF GOOD STANDING 04/15/2014




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 3
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 14
StaffChildClass AgeNote
3 14 SCHOOL AGE Director Debra Mack (Williams), caregiver Laurie Bruna and caregiver Edina Matkovic were present with 14 school-age children.

 
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
Violation
 Provider Comments
Violation
1 child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
1 child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (F) states: Field trip and transportation authorization.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
1 child(ren) records did not include name of family physician or hospital.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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