MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

Facility DVN
002613612

Phone
(417) 455-9999

Physical Address
1400 HALE MCGINTY DR
NEOSHO
MO 64850-7609

Owner
TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
4701 CHOUTEAU DR
NEOSHO
MO 64850-9123

Provider/Director
CANTWELL JR, JEFFERY RAY

E-mail Address
tinaferguson@crowder.edu

Incorporated
Incorporated

Child Care Specialist
PENNY KREITZER

Age Range
5 YEARS - 12 YEARS

Capacity
32

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
12/12/2018

Arrival Time
3:45 PM

Departure Time
4:09 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2346355040

Document	Document-Date
APPLICATION	08/19/2016
CERTIFICATE OF GOOD STANDING	08/19/2016
DIRECTOR'S QUALIFICATIONS	08/26/2016
EQUIPMENT LIST	08/26/2016
STAFF SHEET	08/24/2016

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 15

Staff	Child	Class Age	Note
2	15	SCHOOL AGE