MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA SOUTH COUNTY BRANCH HAGEMANN ELEMENTARY

Facility DVN
000625863

Phone
(314) 467-5788

Physical Address
6401 HAGEMAN RD
ST LOUIS
MO 63128

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
12736 SOUTHFORK DR
ST LOUIS COUNTY
MO 63128

Provider/Director
DAVIS, JENNIFER

E-mail Address
jennifer.davis@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
AMBER JENNINGS

Age Range
5 YEARS - 12 YEARS

Capacity
40

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
08/21/2018

Arrival Time
3:20 PM

Departure Time
3:58 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2337897922

Document	Document-Date
DISASTER AND EMERGENCY PREPAREDNESS PLAN	02/15/2018
APPLICATION	01/08/2018
CERTIFICATE OF GOOD STANDING	01/25/2016
EQUIPMENT LIST	02/15/2018
STAFF SHEET	01/08/2018
POLICIES	09/02/1994
DIRECTOR'S QUALIFICATIONS	06/26/2012
DISCIPLINE POLICIES	09/02/1994
CHILD CARE PRACTICES	09/02/1994
REGISTERING FICTITIOUS NAMES	06/02/2012
DIRECTOR'S JOB RESPONSIBILITIES	09/02/1994
SAMPLE FORMS	09/02/1994
JOB RESPONSIBILITIES	09/02/1994
LLC ARTICLES OF ORGANIZATION	09/02/1994
SAMPLE WEEKLY MENU	09/02/1994
DAILY SCHEDULE	09/02/1994

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 3

Total Children 29

Staff	Child	Class Age	Note
3	29	SCHOOL AGE	Jackie (person in charge), Jasmine, and Susan present with 29 children ages 5-11 years old


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