DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

BOYS AND GIRLS CLUBS OF WEST CENTRAL MISSOURI

002164009

(660) 826-8331

401 W PETTIS ST
GREEN RIDGE
MO  65332-0070

BOYS' AND GIRLS' CLUBS OF WEST CENTRAL MISSOURI

3100 AARON AVE
SEDALIA
MO  65301-7907

WULF, ZACHARY WILLIAM

zwulf@bgckids.com

Incorporated

SUSAN MARIE DOUGLAS

5 YEARS - 16 YEARS

60

SCHOOL AGE

60 SCHOOL-AGE CHILDREN DURING THE SCHOOL YEAR
 
Inspection Information

10/01/2018

2:45 PM

3:34 PM

UNANNOUNCED

COMPLIANCE MONITORING

2340919842


DocumentDocument-Date
DIRECTOR'S QUALIFICATIONS 10/26/2015
LINES OF ADMINISTRATIVE AUTHORITY 05/19/2009
JOB RESPONSIBILITIES 05/19/2009
SAMPLE FORMS 05/19/2009
SAMPLE WEEKLY MENU 05/19/2009
CHILD CARE PRACTICES 05/19/2009
POLICIES 05/19/2009
DIAGRAM/OUTDOOR 05/19/2009
DIAGRAM/INDOOR 05/19/2009
ARTICLES OF INCORPORATION 05/19/2009
APPLICATION 04/02/2018
DIRECTOR'S JOB RESPONSIBILITIES 05/19/2009
DISCIPLINE POLICIES 05/19/2009
DAILY SCHEDULE 04/06/2018
STAFF SHEET 04/06/2018
EQUIPMENT LIST 04/06/2018
CERTIFICATE OF GOOD STANDING 04/25/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
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 4
Total Children 21
StaffChildClass AgeNote
4 21 SCHOOL AGE

 
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
Violation
 Provider Comments
Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Kasey, Asia and Jessica.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (B) states: Medical examination reports shall include a “Risk Assessment for Tuberculosis” form, included herein, completed and signed by a health care professional, as provided by the Missouri Department of Health and Senior Services (MDHSS). If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
TB reports shall be on file as required

Correction Verification
Submit Documentation

Compliance Date

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