DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-MID COUNTY BRANCH-MARK TWAIN ELEMENTARY

001606828

(314) 962-0613

8636 LITZSINGER RD
ST LOUIS
MO  63144-2423

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

1900 URBAN DR
BRENTWOOD
MO  63144-1824

KOZAK, JONATHAN JOSEPH

Jacob.Nelson@gwrymca.org

Incorporated

ALYSSA MARIE RILEY

5 YEARS - 13 YEARS

48

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

04/19/2019

2:55 PM

4:22 PM

ANNOUNCED

RENEWAL

2355174881


DocumentDocument-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 04/03/2019
EQUIPMENT LIST 04/19/2019
STAFF SHEET 04/19/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 09/26/2018
JOB RESPONSIBILITIES 07/02/2001




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 3
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 28
StaffChildClass AgeNote
3 28 SCHOOL AGE 5 years-11 years with Mr. Jonathan Kozak, Ms. Connie James, and Ms. Charlene Pittman

 
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
Violation
 Provider Comments
Violation
The provider did not meet requirements for a criminal background check. Results were missing for: Constance James and Charlene Pittmann.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (4) states: Child care staff members shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
The provider did not meet requirements for a criminal background check. Results were missing for: Jonathan Kozak and Jacob Nelson.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (3) states: The facility owner(s), board president or chairperson, and the center director or group day care home provider, shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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
 Provider Comments
Violation
1 child(ren) records did not include telephone number 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

19 CSR 30-63.040 Background Screening Findings
Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance
RSMo 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules.
Compliance