MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

Back

Facility Information

Facility Name
YMCA-MID COUNTY BRANCH-MARK TWAIN ELEMENTARY

Facility DVN
001606828

Phone
(314) 962-0613

Physical Address
8636 LITZSINGER RD
ST LOUIS
MO 63144-2423

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
1900 URBAN DR
BRENTWOOD
MO 63144-1824

Provider/Director
KOZAK, JONATHAN JOSEPH

E-mail Address
brennan.hollingsworth@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
STEPHANIE SPAULDING

Age Range
5 YEARS - 13 YEARS

Capacity
35

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
05/17/2018

Arrival Time
3:03 PM

Departure Time
4:06 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2331785895

Document	Document-Date
SAMPLE WEEKLY MENU	08/28/2011
SAMPLE FORMS	08/28/2011
REGISTERING FICTITIOUS NAMES	06/02/2010
POLICIES	08/28/2011
LINES OF ADMINISTRATIVE AUTHORITY	08/28/2011
DISCIPLINE POLICIES	08/28/2011
DIRECTOR'S QUALIFICATIONS	02/25/2013
DIRECTOR'S JOB RESPONSIBILITIES	08/28/2011
DAILY SCHEDULE	08/28/2011
CHILD CARE PRACTICES	08/28/2011
CERTIFICATE OF INCORPORATION	08/28/2011
CERTIFICATE OF GOOD STANDING	03/09/2011
ARTICLES OF INCORPORATION	08/28/2011
APPLICATION	04/14/2015
EQUIPMENT LIST	04/14/2015
STAFF SHEET	04/14/2015

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.

Attendance at Time of Inspection

Total Staff 2

Total Children 20

Staff	Child	Class Age	Note
2	20	SCHOOL AGE	Mr. John and Ms. Ann were present with 20 children ages 5-13 years old in the cafeteria.


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