DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-O'FALLON BRANCH-J. L. MUDD ELEMENTARY

000172414

(636) 293-6380

610 PRINCE RUPPERT DR
O FALLON
MO  63366-1802

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3451 PHEASANT MEADOW DR
O FALLON
MO  63368-7324

WOOD, HUNTER

KELLI.PHILLIPS@GWRYMCA.ORG

Incorporated

LAURA ROGERS

5 YEARS - 12 YEARS

48

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

05/22/2018

8:15 AM

8:51 AM

UNANNOUNCED

COMPLIANCE MONITORING

2331979495


DocumentDocument-Date
SAMPLE FORMS 05/15/1992
DIRECTOR'S QUALIFICATIONS 02/02/2011
CERTIFICATE OF GOOD STANDING 11/04/2014
ARTICLES OF INCORPORATION 11/04/2014
CERTIFICATE OF INCORPORATION 11/04/2014
REGISTERING FICTITIOUS NAMES 11/04/2014
CHILD CARE PRACTICES 11/17/2014
DAILY SCHEDULE 11/17/2014
DISCIPLINE POLICIES 11/17/2014
JOB RESPONSIBILITIES 11/17/2014
LINES OF ADMINISTRATIVE AUTHORITY 11/17/2014
DIRECTOR'S JOB RESPONSIBILITIES 11/17/2014
SAMPLE WEEKLY MENU 11/17/2014
POLICIES 11/17/2014
OWNER/PROVIDER REFERENCES 11/17/2014
LOCAL FIRE DEPARTMENT NOTIFICATION 11/17/2014
APPLICATION 10/31/2016
EQUIPMENT LIST 10/31/2016
STAFF SHEET 10/31/2016




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 4
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 44
StaffChildClass AgeNote
3 44 SCHOOL AGE Kelli Phillips, Kailey Barnes, and Belkis Palmero with 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
Violation
 Provider Comments
Violation
The center director was not responsible for the daily planning, monitoring and managing of the facilities program as evidence by the previous director, Hunter Wood, is no longer the director at the facility.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (2) (A) 1. states: The group day care home provider or the individual designated as the center director shall be responsible for planning, monitoring, and managing the facility's daily program.
Correction Required
Group Day Care Home provider or center director shall be responsible for the daily planning, monitoring and managing of the facilities daily operations.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not met as evidenced by there was no plan on file for a child with special needs.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.
Correction Required
An individualized plan from a professional source shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 1 immunization record(s) was/were not on file .
Licensing Rule Reference
19 CSR 30-62.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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 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